The Transformation Issue | Idealog.co.nz
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feature
Robyn Whittaker, the clinical director
of innovation at the Institute for
Innovation and Improvement at
Waitemata District Health Board
and honorary Associate Professor
at the National Institute for Health
Innovation shares her stance on the
future of healthcare.
“The idea with moving in to a
more digital health system supported
by technologies like AI is that we
will be able to potentially collate far
greater information about individuals
that may be able to be used to help
support more personally tailored
health care.
This is not just the increased
electronic health information that
we are now starting to get with the
digitisation of our health system (for
example, Waitemata District Health
Board now has electronic prescribing
and administration of medicines, and
electronic collection of vital signs
and nursing observations) and new
data that we are only just beginning
to understand such as genomic data.
However, it is also a broad
range of other information that may
be collected via wearables (such
as wristbands and smartwatches),
environmental and other sensors (in
the home and in the community), and
also via the smartphone itself. There
is already a multitude of data that
can be collected during the routine
use of mobile phones that can
provide information on the person’s
movements, mood, stressors,
connections, conversations, activity
levels, location, and more.
The broader the information
on the individual, particularly those
with chronic conditions, the more
personalised and tailored health
care and wellbeing support that
could be provided.
However, there is still much work
to be done to develop such a system.
At this point, we don’t really know
how to collate all this information in
way that would make it truly usable
and useful, and at the same time
secure and accessible appropriately.
We don’t necessarily know what
to do with 24/7 data on parameters
that have previously only been
measured episodically. We may not
yet know how to take all that data
and turn it into information that can
easily be used and acted upon to help
individuals to live healthier lives.”“There is a lot of work in this space in New Zealand. Over the
next 20 years, you will see a secure platform emerge where
gradually our economy is digitising. We are getting better
at understanding controls around data, and when we start
talking about health, we always need to balance technology
with regulation, so there is a strong role for government in
setting down standards of how critical data is looked after.
Araci believes New Zealand sits in a strong position to
be leaders in the security of health data. Aotearoa already
ranks fourth in the world for quality of care, compared to
the US, which ranks 41st. Plus, New Zealand tends to score
highly in transparency and trustworthiness.
“Of all the countries in the world I would want our
health data to be stored, it would be New Zealand,” he says.
“Interestingly enough, I’ve had conversations with global
biotech companies who believe we could make more of
our story.”
Araci further alludes to ‘health equity’, ensuring that
different populations are being included in decisions about
what happens to their data, then given input about what is
appropriate for how far this data is used.
“New Zealand is doing some great stuff in this space,
like Genomics Aotearoa, who brings a Maori dimension and
perspective to the use of genetic sequencing and the use of
DNA information in New Zealand. We need to keep going
down the track to make sure there is informed consent and
trust about what is being used with our data.”Currently in the US, a research programme named All
of Us, which uses the health data and DNA of Americans
to build a precision medicine database for individualised
disease treatment and prevention and has come under
scrutiny for its plan to capture and use data from native
American tribes without properly consulting them.
Araci explains another racist example of data
manipulation: “America has quite a checkered history
of practicing genetic testing and genetic information on
indigenous people. For example, 20 years ago a researcher
approached a group of native Americans who said, ‘Could I
have a look at your genetic sequencing because there might
be a genetic trigger as to why you are more susceptible
to diabetes.’ Then, 10 years after the trial, they found out
that their data had been used for all sorts of other trials
of which they didn’t give their permission for, including
schizophrenia screening.”
Though these concerns persist, most in the industry are
hopeful these new technologies emerging will pave the way
to making personalised care more readily accessible to the
general public, rather than a privileged few.
Instead of living forever, perhaps it’s just a case of living
more healthily as the way people prevent, diagnose and cure
diseases is overhauled, with patient empowerment at the
forefront of this movement. ■Future thinking
We want to become globally
trusted traders of time: preserving
medical heritage with leading edge
technology advancements.ROBYN
WHITTAKER