Denis Tebutt is an adviser to the National E-Health Transition Authority (NEHTA). Denis has spent the last 40 years in high technology businesses with over 30 in the growing information technology sector working across the globe in manufacturing, finance and for the past 10 years in healthcare.
He is a dynamic leader with strong strategic and business development skills founded on a deep understanding of the technology and its role in supporting the development of a more agile and innovative business model for the industries that he has served. The challenge faced by the healthcare sector brings together the experiences and lessons of earlier industries.
During the past year he has been the advisor to the National Electronic Health Transition Authority on its engagements with industry to effect collaboration, change and adoption of a new infrastructure and to move the interoperability of the continuum of care into a new domain.
We interviewed Denis to learn about the latest news from NEHTA which he will discuss at CeBIT’s eHealth Conference.
He started by telling us how the IT Industry can transform Australian healthcare because “this industry just keeps getting more exciting and interesting”.
Denis explained the story of where he had worked in the past because he said it went to the core of why he is working with NEHTA to form relationships and collaborate with the many stakeholders that are involved in the delivery of healthcare in Australia.
“Engineering is my first love and in my 20’s I had a great opportunity to work for Ford in the powertrain division, building the best mass produced engines in the world for cars, boats and heavy vehicles.”
“That’s where the IT bug caught me as it was an industry just starting to impact manufacturing. I wanted to know more so I joined a subsidiary of BP who were the world leaders in linear programming and quickly developed a commercial business providing high performance computing services to other industries.”
“It was another 10 years before I got back involved with the automotive world and by then the impact of Demming was being seen from Japan on the integrated methods of western production systems.”
“Just-in-Time manufacturing caused the disaggregation of the industry and a recognition that to compete in this new world you needed to form strong collaborative relationships with designers and suppliers, this followed the recognition that although the manufacturers were fully integrated, their core competence was in fact the process of bringing everything together to create the best quality of vehicle not actually designing and building every part itself.”
10 years ago Denis had the opportunity to take a rest from hectic international travelling as an executive and focus on the Australia and NZ market. The business he joined then is a leader in core technology and a recognised contributor to the many developments worldwide in the healthcare sector.
In Australia we invest in healthcare IT approximately 1.8% of operating expenses, which is half of the worldwide average of 3.6%.
The challenge Denis sees is not simply to spend more but to spend more wisely and that requires the collaboration of all parties and in particular a new way of engaging for the IT sector.
He went on to paint the big picture of Australia’s healthcare system:
“In Australia we spend over $100 billion a year on our health system and it is growing at a steady rate because it is the one industry that has constant growth in customers”.
“Why you might ask, because we provide quality healthcare and are doing a very good job of providing longer lifetimes for those with chronic conditions. Basically we are becoming very good and successful at keeping people alive. So we have an aging population that may have more than one chronic condition, conditions that would have resulted in them dying from their condition 50 years ago”.
“There are many reasons why this is happening and results from a combination of health practitioners developing their skill set, working and collaborating with suppliers of medical instruments and drugs to eliminate or control certain conditions.”
“Demand on the investment dollar in health is therefore very high and growing every day.”
“Today people can take medication for conditions that were resulting in death 40 years ago. Back then transplanting organs was still an experimental activity undertaken by leaders like Dr. Christian Barnard in the UK who was a pioneer in the field of heart transplants. Today there are very few organs that have not been transplanted and the learnings about the management of the body in this regard has exploded.”
“During the past year I heard that there were something like 80 heart transplants done in NSW, more than 70 still living which is a huge change in my lifetime. People are now transplanting faces, hands and much more. These great leaps forward only work because everyone collaborates including the patient. Behind the scenes IT does play a role in such programs, but there is much more we believe we can achieve.”
“Today the health sector is entering a new challenge and that is how to share the information among medical practitioners using the technologies developed and matured in other industries. Challenges remain and they are of a complexity experienced elsewhere in terminology and interoperability but on a scale much greater that all of the other industries put together. Ironically, unlike the other industries that had to disaggregate, healthcare just needs to be joined up, a challenge you would have thought to be tailormade for IT.”
“There are lots of opportunities for Australian IT industry to provide services to the health sector to help it improve service delivery. This would significantly increase the value of the IT industry in health and make it more competitive on a worldwide scale.”
“If as technologists we think we can have as little as a 5% impact on the operating budget of our client then we’re making a 5 billion difference to the 100 billion spend. I don’t think it’s unreasonable to say we can achieve that and motivate the IT industry by saying ‘wouldn’t it be a reasonable proposition to keep 20cents in every $1 that you can prove to be released for investment elsewhere in the system?’ Because if that is the case then you could be looking at a $1BN IT market!”.
“This next decade is when we will truly re-engineer healthcare processes, many of this will be driven by the consumer and the impact of mobile technology on every aspect of the system. This demands that the core clinical systems and the capturing of this data is efficient, clinically accurate and appropriately available to whoever needs it when, where and whenever it is required.”
“That is a massive infrastructure build and more importantly a transformation of the way we work and rely upon colleagues in the process of delivering care. Although we do not think of the healthcare industry being close to an industry driven by revenue opportunities, it does have a transactional nature that prevents some from seeing the opportunities for collaboration because the benefactor of the service delivered is not always the person who pays to provide the data”.
“Its crazy that sitting here I can book an airline ticket, hotel room, restaurant and a car but not make an appointment with my GP. My hairdresser sends me an sms and my dentist sends me an email as a reminder along with electronic birthday cards but my GP doesn’t enquire if I have taken my prescribed medication”.
“As consumers we have choices and we exercise those based upon the quality of service we receive. Of course geography and availability are core ingredients of supply and demand, so the behaviour in the cities is very different to rural areas but what happens when IT communications provides another conduit and facilitates choice?”
“We’re just seeing the advent now of one vendor in the GP desktop software marketplace announcing SMS functionality and such a small element as this will make a positive impact on managing the patient quees as well as service levels and the productivity of the surgery. Its just one element but a foundation one that we are now all used to utilising and comfortable with receiving such messages.”