The drivers for clinical change

7 June 2016

The facts

The NZ Budget Economic and Fiscal Update 2015 (BEFU) forecast that core Crown spending on health for 2015/16 will be $15.6 billion. Healthcare costs are unsustainable long term whilst research has estimated 30% of current spending may be wastage.

August, 2014 — “The U.S. spends more than $2.8 trillion on healthcare each year, and some estimate that 30% of that price tag may be waste.” Harvard, School of Population Health.

Margaret O'Kane, president of NCQA on unwarranted variation in medical practice, has stated;

"We're literally dying, waiting for the practice of medicine to catch up with medical knowledge," These deaths "should not be confused with those attributable to medical errors or lack of access to health care. This report shows that a thousand Americans die each week because the care they get is not consistent with the care that medical science tells us they should get."

The growing prevalence of both chronic diseases and aging populations is placing an increasingly heavy burden on the world’s health systems.

They now account for a significant component of the global healthcare spend and this amount is likely to increase in coming years.

Furthermore, in almost every country, the proportion of people aged 60 or older is growing far faster than any other age group, a result of both longer life expectancy and declining fertility rates.

Progress to address the problems

Over the last decade numerous clinical pathway programs or portfolios have been implemented in both primary and secondary care environments in an attempt to address these issues.

These typically have been portfolios of pathways clinically developed covering a large range of clinical pathways. They are disease specific and are modified with local input to fit each market in which they are implemented.

The intention of making these pathways available has been to provide a `best-practice’ approach to treating conditions/illnesses, and to reduce the wide variation of care typical in most markets.

These localised pathways have been presented through an easily accessed website and presented to clinicians in both primary and secondary care. 

There are a number of these portfolios available for a region to purchase and localise.

The challenge is that on their own, these static published clinical pathways have not led to significant improvements in the areas of:

  • Reduced variation of care
  • Quality of life and
  • Reduced pressure on healthcare budgets.

A gap exists

We believe there is a gap between the current development and publication of clinical pathways, the way that these pathways are used by primary, secondary and allied healthcare providers and realising the potential benefits.

The Nexxt solution takes a fresh innovative, clinically led approach to solving these problems. 

Written by Eric van der Sluis, Pathway Navigator Ltd.