Health Informatics
for chronic complex
conditions
Left: Emily with husband Ivor and children Aterea and Tanira, marking the much
celebrated Thanksgiving Day in America with a family photo.
Above: Capturing the moment – the family exploring its neighbourhood for the year;
Coolidge Corner, Boston.
Below: The 2018 Harkness fellows gathered in front of the White House, Washington D.C.
In August 2017, Dr Emily Gill, GP at both Te
Whānau-ā-Apanui Community Health Centre
in Te Kaha and Whakatōhea Health Centre in
Ōpōtiki, her husband Ivor Jones and two pre-
schoolers Aterea and Tanira packed up and
headed on a year-long adventure to America.
The family was bound for Boston as Emily had been awarded
the prestigious Harkness Fellowship in Health Care Policy and
Practice by the Commonwealth Fund. She’s now back home in
Ōpōtiki and Checkup spoke to her about the experience.
Where were you based, and what was the
focus of your research?
I was based at the Brigham and Women's Hospital in Boston, a
major teaching hospital of Harvard Medical School. My research
centred around the use of digital technology to facilitate better
care co-ordination for people with complex health needs. People
who have multiple health conditions such as diabetes, COPD,
heart disease plus social needs have a huge care provider team to
co-ordinate that care around them. A lot of information needs to be
exchanged between the providers in a timely way.
Why did you choose this topic?
Being a rural based GP on the remote East Coast, I have patients
with complex needs and I have spent a lot of time with paper
based or manual processing of their health information. I know
technology does exist that would improve this.
What were the challenges you faced
balancing your research with family life?
The challenge was to fit everything in and make the most of our
year in the States as a family. Although I lived in Santa Cruz,
California until I left school, it was a totally new experience for my
family. I think I had FOMO (fear of missing out) so tried to squeeze
in as much in as possible. We travelled to New York, Washington
DC, California, Vancouver and the U.K. The logistics with two pre-
schoolers is no mean feat!
the quality of care for patients living in rural areas, without the
caseload of clinical practice.
What was the highlight from a family
perspective?
The new adventures we’ll treasure. Seeing my children play in the
snow, watching Ivor shovelling snow in Boston, truly a world away
from Ōpōtiki.
What are the findings from your research?
I think here in New Zealand we have the perception that
everything is better and more tech savy in America. But my
research found that, that’s not the case. They face the same
health challenges coordinating care for people with complex needs
as we do, but the American environment is a lot more complex
with more information to process. Patients with complex needs
have multiple providers and their information is often spread
between several electronic health records and it is difficult for this
electronic information to be exchanged Despite computers being
used so much, there are piles of faxes still being sent, and people
playing phone-tag as providers try to ensure they have the correct
information to help patients make good decisions about their
complex medical care.
How do these findings relate to or are being
applied to your job / and or health in the
New Zealand context?
What was the highlight from a work
perspective? I think the challenge is to develop a system where health data is
in one health repository and from there developing apps designed
for the individual (clinicians, health administrators, patients etc) to
access the right piece of information they need at the right time.
It may sound simplistic, but the highlight for me was having that
time to focus entirely on health systems and technology to improve I’m also very interested in the Midland Clinical Portal under
development. I think primary care has a role to play.
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