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Dr Lance O'Sullivan Q&A

06 Sep 2018

Dr Lance O'Sullivan

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Q&A with Dr Lance O'Sullivan

1. Hi Lance, what can you tell us about the projects you are working on at the moment?

There are a couple of really exciting areas in health I’m working on. Number one is Digital Health with iMoko which we have been developing over the last 5 years. We’ve recently brought the operations of the business to Auckland from Kaitaia to look at achieving the scale in this service that we hope to see - in it being the national digital health programme for children across New Zealand, accessing healthcare in seconds and minutes rather than hours and days and weeks in some cases. So that’s exciting, using exciting technologies like the Cloud, applications, mobile devices and in time using smarter technologies like blockchain, artificial intelligence, Internet of Things - a very exciting space for us to be in at the moment.

The second thing I’m working on which we announced this week is a large genetics project that’s going to be based in Kaitaia, a five year programme being funded by the Health Research Council as a part of a collaborative project including the Maurice Wilkins Centre out of Auckland University and Ngati Porou Hauora. Our role in that is to conduct some community based research around genetics, looking at the genetic variance that can predispose people to disease and excitingly for me, the idea of using genetics to allow us to develop precision medical regimes for people using medications - pharmacogenetics – a really exciting area to enable us to create and deliver the smartest possible health system.

2. You recently talked about the current state of the New Zealand health system. What made you speak out?

I guess after a number of years in the health system and working inside it and realising that it has absolute huge potential but that it underdelivers and underachieves so often because we are wedded to very historical and inefficient models of care that are very clinical centric, hospital facility or clinical facility based care and we have an opportunity with some of the new models of care. Certainly if based more around genetics and technologies, that could allow us to develop our system that is far more efficient, costs less, can deliver more care to more people across New Zealand at less cost and of a far higher quality and in a more convenient way.

3. What do you see as the biggest challenge facing the public health system today in New Zealand?

One of the biggest challenges is we are shackled to this idea that most of the system is OK, we just need to tinker around the edges to change it, and it’s completely wrong. The system is not OK. Actually it needs a considerable overhaul. We need to start from scratch almost. Now that’s a very challenging and in fact impossible thought for some people and that’s another challenge for me – unfortunately we have a large part of our workforce that don’t have an appetite for change and they don’t have an appetite for the significant change and some would say the structural change that needs to occur to enable us to truly realise the benefits of the new models of care on the horizon on which New Zealand could actually lead development.

4. And what key changes do you feel are needed to provide a better public health system for New Zealanders?

We need to develop a health system that actually finds out what our patients, our users of the health system want, and figure out how in this day and age and in the next 10 years how we can develop that and be future proofed. If you asked people they may say they want care that is fast, that is convenient, that is high quality and doesn’t cost us a lot as individuals or as a country because at the end of the day all of the taxpayers are paying for this hugely inefficient health system

5. How did you come to be involved with the partnership between nib and Ngāti Whātua Ōrākei, and what are your thoughts on the partnership?

I’m excited about this – this has happened through my relationship with nib who were looking for someone or some organisation who had experience working with Maori populations. It was a natural fit in some ways because we are working with nib who, in my opinion, is one of the thought leaders in the area of how private health insurance and a wellness and prevention strategy serve their members, but also contribute to a more sustainable public health system. It’s a very exciting relationship and I’m excited about the opportunities we’ve been afforded and given around the use of digital models of care. It’s an exciting opportunity for iwi and Maori in New Zealand to look at what’s happening with the Ngāti Whātua Ōrākei and nib relationship and see whether this would be something that would be fit for purpose for them as well. This is a huge opportunity for iwi in a post-settlement environment to look at where they can invest back in their people. For a long time there’s been a sense that health and education is not their core business but their core business is a healthy and prosperous membership and iwi need to look at where they can supplement services to their people that government can’t reach.

6. What can you tell us about your iMoko platform?

iMoko is a platform that wants to democratise health care for children in New Zealand. We want to put health care within arms reach of every child in New Zealand, at their fingertips, for every parent or every child in New Zealand. We’ve been delivering this service for the last five years. Its focus has been delivering health services to children in schools and early childhood centres around New Zealand. We service almost 10,000 children across New Zealand from Kaitaia to Bluff and we will be looking at wanting to see this programme reach every child from 0 – 17 across New Zealand which is 1.7 million children. At the moment the focus is on a number of common health problems that children experience such as, skin problems, infections, untreated and unmanaged eczema and other types of skin problems, dental problems, head lice and sore throats. We’re looking at wanting to refine and offer this as a service of excellence to expand those offerings. In some situations where children used to get access to care through a GP that might take them hours and days and sometimes days and weeks, these children are getting access to care in seconds and in minutes, or minutes and hours. This is incredible and I’m very proud of this and it’s a demonstration of where a transformational model of care can highlight the opportunities the wider public health system has.

7. Why is private health insurance so important for families in NZ?

Private health insurance gives individuals, families and populations and communities the opportunity to supplement what is available through the public health system but is not always quick and convenient. You can see this with Ngāti Whātua Ōrākei. On one hand we hope that would happen with some of the changes with the health system in New Zealand with some of the new technologies and new models of care I’m talking about. It’s also an opportunity for us to take responsibility for some of the things that may not fall within the normal responsibility of government. I say that with a little bit of reservation in the sense that we know that in New Zealand patients don’t pay for all of their care – they do have to pay for some of their care – but there’s an opportunity here where people could recognise that having health insurance for themselves and their family could give them ready access to treatment and care that may not be available currently in the public health system, but also contribute to that idea of having a sustainable health system. I am very excited about this and hope that the value of these partnerships like Ngāti Whātua Ōrākei and nib reflect the possibilities and the promise for the health of New Zealanders.

Important things to know

Information correct as at September 2018