Why don’t Auckland Hospitals Work Smarter Instead of Harder


A friend of mine was prepped for 2 days with nil by mouth a month or 2 ago for urgent cancer surgery. The first day she got bumped and the 2nd day was the start of a radiographers strike. Last night she was prepped for an 8 hour operation and got bumped due to a critical case that suddenly appeared. We thought she was criticial, but obviously that’s not for us to judge.

I’ve asked the question before “Is hospital the best place to be when you are sick?” and pretty  much decided unless it was a private hospital, possibly not. But of course most of us don’t have any choice especially as we get older.

It is nice to see that some things are improving. For example Auckland Health Board has decided to send some patients to private clinics for radiation treatment to reduce waiting times.

I had blogged previously about waiting times at North Shore Hospital based on experiences waiting with family members in A & E and subsequently in corridors in some cases for days, without being assigned to wards. Each time we were told that it was an exceptional case and we were just unlucky. A registrar was sick and therefore his team couldn’t operate was a common excuse. Think about it, an entire team doesn’t operate because one person doesn’t turn up? Maybe they were stretching the truth, being they are short staffed and can’t afford another registrar, and they didn’t turn up because they didn’t exist.

According to the reports, North Shore Hospital is improving and it is now only the 3rd worst in New Zealand. North Shore Hospital supports North Shore and Waitakere with an excess of 400,000 population and rapidly growing. Of course things will change with the new Super City, but the problems won’t go away.

As you can see in previous blogs I’ve written such as ‘76 Deaths, Surgical Mistakes in New Zealand Hospitals‘ I have been pushing for more specialized technology to streamline processes for many years. The technology has been around for a long time, yet we still seem to rely heavily on paper. Tablet and handheld computing has been around for a long time. Most of us use WiFi in the home, in cafe’s, at the airport and understand the power of dealing with information once, accurately and allowing instant access to anyone who needs it in a timely fashion. That’s how we live.

I now see bar codes on patient wrist bands, but I don’t see them being read by a handheld computer to check for allergies, conditions etc at the bedside. This technology could have saved many NZ lives at a tiny fraction of the cost of their lost lives, productivity etc.

When I started promoting this technology, it was with Pocket PC, Palm and Symbol technologies (handheld computers, 3D Bar Code Readers, Portable Printers, Digital Cameras which were being used in many US and European hospitals and that was 20 years ago!

Today there is superior technology such as the Panasonic Mobile Clinical Assistant CF-H1 which runs on Windows 7. The video is pretty corny but it really does illustrate how efficient it is to use mobile technology. Of course this technology has a rugged drop spec, is chemical resistant, lasts 6 hours on a standard battery.

This technology means everyone is in sync and has access to critical data on demand. Paper gets misplaced in hospitals. I had one visit with a daughter that was delayed by 90 minutes simply because someone had misplaced her file. Data can be shared with specialists and medical staff in and out of hospital, including images such as scans, x-rays, photos, test results, charts and graphs. Allergies and condition interactions can be monitored to minimise risk of causing new problems, doses can be confirmed, approvals provided remotely. Pretty much the whole world’s medical knowledge is available online today.

Today’s world should be about harnessing technology to work smarter rather than harder. I suspect the focus is on cost of the technology because our hospitals are run by administrators tasked with saving money. Of course they are largely man aged by politicians. If health is a major election platform every election, why is it that the performance is still so poor?

Next time you are in hospital, have a look at how they use or don’t use technology. Think about how you operate in your business. Think about what’s at stake and ask them why they do things the way they do.

We have national elections next year. They will be talking about improving the health system. Will they be talking about improving the ICT structure and putting information in the hands of the clinicians? Or will they be talking about saving money, improving the monitoring of staff performance and measuring waiting times in A&E?

We have an ageing population and growing population. They are going to need more services and we could increase our throughput, reduce patient risk, significantly improve outcomes by harnessing technology, working smarter rather than harder, expecting great results from staff working double shifts several times a week.

Is that a Blackberry in your pocket or?


I’ve spent the last 3 days at the GeoCart’2008 Conference. It was an academic conference with speakers and attendees from all over the world. The content was excellent and I found it fascinating to see not only the results of academic research in the modern world of geography, location based technology research and web mapping, but also some of the great products that have and are being developed. But this is not what today’s blog is about. Perhaps more on the conference in the next few days.

I was an exhibitor at the conference and during the quiet times, was checking my phone for messages and emails as the Internet services at the venue at Auckland Univesity were shocking. I was in a building next door to the Auckland university IT Campus and the best local internet I could get was 128kbps. This morning I was listening to a podcast while I was in the shower about Internet services in Mali and how their pipe was only 2Gbps. Being landlocked they have to rely on other countries for access to the submarine cable. They would be horrified at the speed I got in Auckland, but I digress.

A number of people asked if my phone was a Blackberry and how did I like it. My answer was, yes, indeed it is a Blackberry, as issued by my company. Do I like it? I intensely dislike it. I’m a power user of mobile internet, after all I wrote the book, Unleashing the Roadwarrior and I taught companies how to improve efficiency in the field using mobile and wireless devices. Unfortunately I no longer walk the talk.

You see, to me mobile and wireless computing is about efficiency and touching things as few times as necessary. I’ve come from the world of touch screens and along with the book, published texts including Mastering your Palm and Mastering your Pocket PC.

For people who only use the phone ‘killer apps’ of voice and text, the Blackberry is a wonderful device. It has a qwerty keyboard so if you don’t use txt abbreviations, you can type your messages without having to remember the buttons and as a phone, it is perfectly adequate. If you are a Baby Boomer, the ability to do these things as well as read, send and receive email is wonderful. Attachments are another story, but you can send and receive email and you can do it securely through your MS Exchange Server which makes the IT Department happy. It does also synch wirelessly with Exchange for my contacts and calendar, but that’s pretty much where the fun and utility ends for me.

Here’s what I did with my Blackberry over 3 days at the conference. I sent and received a couple of urgent emails. I sent and received a couple of Twitter messages (which all but exhausted the ability of the browser.

Here’s what I could have done if I still had a Windows Mobile or Palm device. Actually I do still own old models, but they are old and I don’t really want to carry multiple devices anymore, although I could possibly consider a new Windows Mobile, Palm or iPhone, given the right opportunity, especially since there is now an iPhone Reader:)

I could have made lots of notes using handwriting recognition on the touch screen. I can write Graffiti or block characters without having to look at the device, so that I can concentrate on the speaker. These would have been written straight into MS Word, so that I would have them available for other purposes, such as copying and pasting into my blog. Instead I used scraps of paper, one of which I have already misplaced.

I could have taken photos of exhibits, slides and delegates for future use and reference.

I could have beamed my digital business card to others who used similar devices.

I could have shown off some of our mapping technology on the IE browser, even richer if the phone also had GPS, which my Blackberry doesn’t. (Mine is probably 2 years old) Relevant given that I work for a mapping company, specialising in web mapping API’s, routing, tracking and car navigation.

I could have quickly referenced web sites discussed during the papers and bookmarked them on the spot for future reference and integration with my favourites on the desktop.

I could have drawn mind-maps to enhance my note taking.

I could have read one of my eBooks, after setting up and while waiting for the delegates to arrive in the morning, or checked the daily paper.

I could have made audible notes and embedded them into an email, or even recorded segments of a presentation.

I could go on, but if you want to know all the other things I could have done, read my eBook, which you can purchase at ReadingIt.

It’s about efficiency, about touching things once but having access to them in lots of ways. It’s about being able to combine real time research with the discussion on the browser. You see, we can think and take in a lot more in the time that a presenter speaks, and in terms of our points of reference. It’s about then being able to access any of those pieces of information, communicate them and collaborate with other people.

Instead I have a few pieces of paper that I hope I won’t lose.

I guess this is about the dichotomy I live and work in. On the one side there is an infrastructure designed to keep data secure and cater to the lowest common denominator, for the most of whom, without training and motivation, even a Blackberry is overkill. On the other side, a busy person who wants to make the most of the information, people and media available at any given point in time. To leverage it.

The conference providers gave the delegates a CD with copies of all of the presentations, which was great. But it is pretty analogue and although I am very interested, I will probably never get around to looking at it. I will hopefully get to some of my notes, along with notes from other events that I havebeen to recently, scribbles on pieces of paper or the backs of business cards.

Then of course there are podcasts. I am big on maximising my time and whenever I am in the car, walking, exercising or doing chores, I am connected to my iPod.

So, yes it is a Blackberry in my pocket. Would I recommend it to anyone? No. Not unless all you want is a phone that does exchange / text email really well. That’s all it was designed for. I want more! I’m a busy person who wants to multitask. I want a touch screen, preferably multipoint. I want efficiency.