HCHs — a key plank in the SDHB’s primary and community strategy — are modernised general practices, which will see greater use of technology by patients to access information, and more integration of health services at GP clinics.
"It will take the emphasis off the consultation between the doctor and the patient and make it more of a team-based approach, and give us a lot more flexibility in how we work with patients on their own healthcare," Dr Susie Lawless of Roslyn’s Amity Healthcare — one of the new HCHs — said.
Joining Amity in the HCH vanguard are Gore Health Centre, Gore Medical Centre and Queenstown Medical Centre.
Another 12 practices across Otago and Southland will follow in the next year and it is expected most, if not all, practices will eventually follow.
"We need to learn how healthcare homes, healthcare hubs and local hospitals all work together," SDHB primary and community medical director Hywel Lloyd said.
Health Care Homes received $12,500 for start-up costs and could apply for up to $17,500 for other start-up costs. It received $8 per enrolled patient per annum for three years, with an extra $8 per patient a year after reaching agreed targets.
The SDHB and primary health organisation WellSouth received more applications than expected from would-be HCHs.
"We evaluated applications and took the top four from that first tranche," Dr Lloyd said.
"We were hugely encouraged by the response we had to this proposal, and I think we’ve got a really broad coverage as well, across the region."
Dr Lawless said becoming an HCH meant Amity needed more nurses, and was also considering employing a healthcare assistant.
"We want to get people working to the top of their scope as much as possible," Dr Lawless said.
"GPs will do what only GPs can do, nurses will do what only nurses can do, and not other kind of work that occupies time ... vaccine ordering, checking expiry dates, at the moment that is done by nurses, and it is a waste of their valuable clinical time."
A key aspect of HCHs was more use of technology by patients. About 55% of Amity patients already did, she said.
"Some of our more elderly patients have absolutely embraced it — the techno grannies out there are fantastic.
"There are lots of elderly people out there who are very high users of the internet and they have enthusiastically embraced the opportunity to email us, to request stuff online, to look at their results and to keep track of their health.
"The younger patients are so used to operating online, that to operate online for their healthcare is just second nature."
Queenstown Medical Centre’s Richard Macharg said becoming an HCH would bring greater efficiency.
"Given the isolated nature of the Wakatipu, it is essential that maximum effort is put into providing the best possible care, as close to home as possible for our enrolled patients," he said.
"The nature of the healthcare home as the base for all services to run and be co-ordinated from is one that QMC has operated under since its inception and with which we are very comfortable."
Gore Health Centre business manager Rhonda Reid said increasing pressure from an ageing and more complex patient base encouraged the practice to become an HCH.
"With limited time, we need to ensure that all our patients needs are being met, which means changing our current model," she said.
"This will allow us to triage our patients so they receive the most appropriate level of care while closely monitoring our more complex patients.
"We want to utilise the technology available so that our patients can book appointments and review results online along will offering video consultations in the future."
Health Care Homes
Now
Amity Health Centre (Dunedin); Gore Health Centre; Gore Medical Centre; Queenstown Medical Centre.
Later this year
Meridian Medical Centre, Mataora and Broadway Medical Centre (Dunedin); Waihopai Health Services (Invercargill); Junction Health (Cromwell); Wanaka Medical Centre, Aspiring Medical Centre (Wanaka).
Mid-2019
Mornington Health Centre (Dunedin); Alexandra Medical Centre practices (the current Centennial, Cornerstone, and Central Medical practices); North End Health Centre and Junction Doctors (Oamaru); Clutha Health First (Balclutha); Invercargill Medical Centre.
