Media Release

Monday 14 June 2004

Health Innovation Award Winners Announced

Auckland District Health Board and community healthcare provider ProCare's streamlined treatment plan for stomach problems has scooped the Supreme Award in the New Zealand Health Innovation Awards.

The improved treatment procedure for dyspepsia and heartburn has already reduced waiting lists at Auckland DHB and is producing savings of $1.5 million a year.

Auckland DHB and ProCare also won the Organisation Award at tonight’s presentation at Te Papa in Wellington.

The improvements were made following an examination of the treatment given by 158 central Auckland general practitioners. It found a quarter of GP referrals were unnecessary and just as many patients were going without treatment when they needed it.

New Zealand’s premier health and rehabilitation awards were introduced last year to promote and encourage health innovation and the sharing of innovative products, services and processes that can benefit more New Zealanders.

The awards were initiated jointly by the Ministry of Health and ACC. Telecom New Zealand has recently stepped on-board as the awards’ major sponsor.

The Ministry of Health's Deputy-Director General of Clinical Services, Dr Colin Feek, said the awards were a wonderful way of celebrating the creativity and innovation shown in our health system.

“I congratulate all tonight's finalists for their willingness to share their good ideas so they can benefit many more New Zealanders."

ACC's General Manager of Healthwise, Dr David Rankin, said cost savings resulting from innovation in the health sector would enable more people to get the treatment they needed more quickly.

"In the case of Auckland DHB's partnership with ProCare, we've seen this more than amply demonstrated, with people getting better and more timely treatment, and $1.5 million in savings to boot."

Selected from 126 initial entries, the winners are health providers and practitioners from around New Zealand, representing main centres and smaller towns.

The winner of each category (individual, group and organisation) received a certificate and cash prize of $8000. The Supreme Award winner received $15,000 and a Popular Choice award of $5000 was also presented.

The 25 finalists at tonight’s ceremony presented their ideas through multimedia seminars and trade fair style displays during the day at Te Papa.

A team of evaluators and panel of judges, independent from the Ministry of Health and ACC, assessed the applications and made site visits to scrutinise entries.


The award winners are:

Supreme Award:
Auckland District Health Board and ProCare - Improved primary health care management of dyspepsia.


Individual Award:
Winner: Electrodiagnostic Unit, led by Dr Rudy Hidajat, the Ophthalmology Department, Canterbury District Health Board - Hue colour vision test.
*The judges made special note of this entry, the use of a barcode scanner in a colour vision test at Christchurch hospital that has cut the time it takes to produce reports from an hour to four minutes. The team that developed the test was led by Rudy Hidajat who was assisted with the innovation by his 16-year-old son Ray, a mathematics prodigy who passed his first university paper Comp 101 with an A+ at the age of 11. Ray hopes to complete his Bachelor of Commerce and Management Degree in October.

Highly Commended: Gore Health - Community wellness and education programme.


Group Award:
Winner: Cytogenetics Lab LabPlus - Therapy for advanced breast cancer.

Highly Commended: Elizabeth Brookbanks and Avril Lee - Care of patients on anticoagulant drugs.
The judges noted that this is a key innovation for the health sector and fits well with the national drive for the safe use of medicines.


Organisation Award:
Winner: Auckland District Health Board and ProCare - Improved primary health care management of dyspepsia.

Highly Commended: Hutt Valley District Health Board – Nurse-led respiratory clinics.


Popular Choice Award:
Kura Whanau GP Clinic, Wairarapa

ENDS

For further information contact:

Trish Green,
Communications adviser,
Health Innovation Awards
ph: 021 687 201 or 04 4753 702.

More details about the awards and finalists are also available on the Health Innovation Awards website: www.healthinnovationawards.co.nz


Profiles for the main award winners

Electrodiagnostic Unit, Canterbury District Health Board - Hue colour vision test

Doctors and nurses from Christchurch Hospital's ophthalmology team have slashed the time it takes to complete the Farnsworth-Munsell 100-hue colour vision test.
The test is useful for diagnosing early stages of acquired colour vision defects in the optic nerve, diabetic retinopathy and glaucoma.

It requires the patient to arrange 85 coloured caps so that their hue changes progressively through the colours of the spectrum. Once the patient has finished, the operator had to turn the caps over, record the numbers on their reverse side and then manually calculate an error score for each individual cap. These individual errors are then plotted on a polar graph.

This process was very labour intensive in an area where staff time was at a premium.

The solution was ingeniously simple – replace the numbers on the caps with bar code so the order of the caps could then be recorded with a hand-held bar code scanner. A computer then calculates the error score of each cap and plots it so an ophthalmologist can interpret it.

The system has been in routine use in eye clinics at Christchurch Hospital for more than a year and has eliminated arithmetic errors as well as saving time.

It produces two reports, one for each eye, in four minutes, compared with 60 minutes required by the conventional manual reporting system.


Gore Health - Community Wellness and Education Programme

The shift from service-based to population-based funding under the Primary Health Care Strategy was the spur to Gore Health's Community Wellness and Education Programme.

Centred at Gore Hospital, the programme began in September 2003 with seminars and wellness clinics covering all facets of a healthy lifestyle for old and young, male and female, based on 13 areas identified by the Primary Health Care Strategy as having potential for substantial improvement.

The community immediately embraced the programme and was soon offering suggestions for more topics.

The first wellness clinic was a pharmaceutical brown bag check in which people brought along their drugs and supplements for review by local pharmacists.

This was a great success. In one case, a woman’s bag full of drugs was found to include three primary and very expensive medications – two to start kidney function and one to stop it. After a $50 blood test, one medication was retracted with a better result for the patient and a saving of $200 a month.

The original concept was developed by Ralph La Salle, who secured funding and support from a wide range of agencies.


FISH testing to detect candidates for herceptin therapy among patients with metastatic breast cancer

Cytogenetics laboratory, LabPlus, Auckland Hospital, has developed a test that identifies advanced breast cancer patients likely to respond to treatment by the drug Herceptin.

Herceptin targets cells with too much HER2, a breast tissue protein that becomes abnormally increased in around 20 percent of breast cancers. Herceptin is relatively expensive, and LabPlus’s new test helps to identify breast cancer patients who are most likely to respond to its use.

The amount of HER2 is typically determined by a technique known as ‘protein staining’ and results are scored as 0, 1+, 2+ or 3+, where 0 and 1+ are normal amounts of protein, 3+ is increased amount of HER2 and 2+ is an equivocal result. Studies have indicated that a subset of the 2+ cases has an increased amount of HER2, and that can only be determined by analysis of the HER2 gene.

LabPlus’s new test uses a fluorescently-labelled probe to detect increased copies of the HER2 gene (HER2 FISH). The probe is applied to paraffin embedded tissue sections that have been evaluated by a histopathologist to identify the area of tumour cells.

The cytogenetics laboratory tested over 200 advanced breast cancer cases that have a 2+ HER2 protein staining pattern. Around one third of these cases have an increased HER2 gene copy number according to the FISH test. These are the cases most likely to benefit from the use of Herceptin.

LabPlus’s cytogenetics laboratory’s breakthrough in applying FISH probes to paraffin embedded tissue material (PET FISH) is an important resource for other labs in New Zealand and Australia trying to develop tests using this technique.


Warfarin – Paint a Better Picture

After recognising shortcomings in the monitoring of patients taking the anti-coagulant drug warfarin at North Shore Hospital, pharmacy manager, Marilyn Crawley, brought in two pharmacists to audit the hospital’s charting, monitoring and discharge processes in this area.

Over three months, Avril Lee, the Waitemata District Health Board’s hospital/community integration pharmacist, and Elizabeth Brookbanks, clinical pharmacist responsible for drug use and evaluation, studied warfarin therapy for inpatients.

They also assessed the quality of the hospital’s discharge processes by following some patients through their discharge, subsequent care and warfarin use after they had left hospital.

They then developed an alternative plan outlining improvements to the initiation and prescribing and discharge procedures of warfarin patients for the hospital. These improvements included a special section for warfarin initiation on a patient’s electronic discharge summary, and an improvement in the information given to GPs about how to care for the patients after they leave hospital.

They also helped to write protocols for GPs and to run training sessions for GPs, practice nurses and pharmacists in the community to help ensure that all patients discharged from the hospital received the best possible care.

Partly as a result of the success this initiative, the Waitemata District Health Board now has plans for an anticoagulation clinic and to employ a nurse dedicated to this area.


(No) scope for improvement: avoiding unnecessary gastroscopy through improved Primary Care Management of dyspepsia

Auckland District Health Board in a project with ProCare has trimmed waiting times for dyspepsia treatment and saved $1.5 million a year to boot.

Examination of the treatment given by 158 central Auckland GPs to patients aged 18-45 who complained of dyspepsia or heartburn, found a quarter of GP referrals for gastroscopy were unnecessary, and just as many went without gastroscopy when they should have been referred.

Evaluation was extensive, and included 1490 clinical scenarios, 232 referrals to gastroenterology OPD and six months’ laboratory and pharmaceutical data.

Having confirmed extremely inappropriate referral rates, a remedial training campaign was instigated that aimed to ensure as many dyspeptic sufferers as possible were treated in primary care with non-invasive, affordable, and cost effective measures.

This included testing for and treating helicobacter pylori infection, thereby reducing the number of avoidable gastroscopies. Training was also given in high-risk patient identification.

The project also includes an advertising campaign for patients to attend their GPs for correct management of dyspepsia, a common problem that patients often do not raise with their GP.

As a result of the project, gastroscopy referrals are down 10 percent in the target GPs, resulting in fewer barium meals and reduced waiting times.

Resources previously used for gastroscopy in the secondary sector are now diverted to colonoscopy, reducing the waiting time in this area as well.

The $70,000 project has produced an annual saving of $1.5 million for the Auckland District Health Board, and savings of more than $100,000 are estimated for even the smallest district health board covering a population of 40,000.


Nurse-led Respiratory Clinics at Hutt Hospital

Hutt Hospital’s Respiratory Services had a backlog in respiratory referrals of up to two years, no respiratory physician and was in desperate need of a solution. Thanks to a restructure and patient pre-assessment by a specialist nurse that enables efficient use of limited doctor-led clinics, they now have no waiting list and provide a greatly improved service.

Before 2000, Hutt Hospital had a physician-led respiratory service, providing four clinics a week. Its one- to two-year waiting list consisted predominantly of Chronic Obstructive Airways Disease (COPD) patients awaiting assessment. Many of these patients could not afford to travel to Wellington Hospital. After the resignation of the respiratory physician, a suitable replacement could not be found.

An initial pilot was developed and launched by general physician Iwona Stolarek in which a respiratory project nurse pre-assessed and reviewed wait-listed patients.

Dr Stolarek supervised and reviewed all assessments and results, provided medical advice to GPs on their patients and ran two formal medical clinics a week for respiratory patients. Gradually the waiting list decreased and GPs began to refer more and more patients.

Three years on, there are three part-time nurses providing assessment and education clinics in hospital wards, outpatient clinics and patients’ homes.

The assessment clinics provide immediate access to diagnostic tools such as blood tests, chest X-rays and scans, allowing for quicker diagnosis and more timely management.


ENDS

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Listen to the award announcements and speeches from the 2004 Health Innovation Awards.

Windows Media Player is required to listen to the audio. The player is avaliable free from Microsoft.

Introduction	Low or High bandwith (dialup or broadband))
Peter Biggs	Low or High
Awards Part. 1	Low or High
Awards Part. 2	Low or High