First published 11 April 2007

In February New Zealand Doctor asked GPs for their views on hospital information website Healthpoint. This issue website reviewer Jon Wilcox tell us what he thinks.

Website : www.healthpoint.co.nz

OUT OF FIVE STARS

High quality content ***
Up to date ***
Good presentation  *****
Level of unfettered access ****
Useful patient information ***
Interactive CME **

Advertising itself as "New Zealand's foremost medical referral portal", Healthpoint has been going for a couple of years and, as with a number of modern "entrepreneurial" websites, has been a little slow to get established.
When we looked at it 18 months ago for a site review, I was disappointed with the serious sparseness of content for a supposedly national website.
The company Healthpoint started in 2004 and presumably had its site up and running soon after that - focused largely on getting hospital-based information out into the public arena and also to their main clients and users, the GPs and their primary care teams.

It started with Counties Manukau - which I might add has made excellent use of the site with a broad and comprehensive range of referral information and guidelines for all of its wide range of services. The utilisation of CMDHB has not, it seems, rubbed off on any of the other Auckland regional DHBs even after two years and such a hiatus of institutional disinterest is not an especially healthy sign for a "healthy" website.

Conceptually the site looks good - it is fast and it works well. It is powered by somebody or something called Supermodel (possibly Rachel Hunter's new and recently announced "business venture"?).

Not practical
It is a resource for both patients and medical professionals and there are separate log-ins allowing filtered access to different components. It was probably on the basis of these features that Healthpoint won the 2005 "Excellence in the Use of IT" award from ComputerWorld, but from the point of view of practical usefulness at a national level it should have flunked badly - and, given the ensuing two years, nothing much has changed.

On the North Shore we apparently do have a hospital with an emergency care centre, but little else. That is with the quite notable exception of John Cullen's orthopaedic service - which happily has a presence which is comprehensive, informative and educational. It probably duplicates information on referral processes from other sites such as the DHB's own site but the latter has not at any stage ever been promoted to primary care. At least Healthpoint sends us out a pamphlet and does the odd bit of advertising.

So, in summary, it seems Healthpoint has had a fairly hard selling job to DHBs all around the country with the clear exception of Counties Manukau. Knowing the DHBs' cynicism, naivety and overt lack of appreciation of community and primary healthcare sector "outside of the hospital towers", perhaps a hard sale was to be expected.
After all, if I was running a hospital which was inefficiently structured, somewhat dysfunctional and purportedly "bulging at the seams" (with apologies to some of the better run hospitals and DHBs around New Zealand), why would I want to advertise for more work?

Lack of clarity
From the point of view of describing the hospital services, there is also a blatant lack of clarity of what is a tertiary or regional service and what is a secondary service. For example, listed under services available in the North Shore/Waitakere/Rodney area might be Electrophysiology/EMG services. We are not advised whether referrals can properly be made by GPs. This is the sort of information we need.
It all goes to show running this kind of venture properly is not that simple - it needs a lot of work on a regular basis.
The worst possible advertising is out-of-date content and there are some hints of this also at Healthpoint - even if some of these are via independent links to support services not under the immediate control of Healthpoint.
The other requirement, in my view, for these pages is a "last updated" notification. It is one of the best ways to give good advertising for a website..
Healthpoint also includes private sector information. And, as with the hospitals, this is also seriously deficient. Only subscribing specialists are listed. If there is one lesson which should have been learned by e-entrepreneurs in the medical field over the years is you must include non-subscribers in your database albeit with the minimum information. To exclude them in my opinion is tantamount to business suicide.
So, on the North Shore we have a remarkable lack of any specialist services in the private sector whatsoever - the odd cosmetic and plastic surgeon, and not much else really.

Good points
One of the good things about the site is its comprehensive listing of New Zealand support groups with a large number of specific website links.
But Healthpoint surely must have some potential. It claims to have 7500 CMDHB pages viewed per month by 75 per cent of the GPs in the area registered with them, and the Auckland DHB appears to have been committing itself towards comprehensive participation over the last six months also.
So, presumably Healthpoint will not be too short of funding just yet - but it surely has a lot of work to do with the private sector.
Finally, it is an important part of a business guiding principle to not advertise a bad or deficient service. It is far better to allow it to evolve. According to Healthpoint their site:
"…provides information for patients, referring doctors and caregivers which clarifies for patients what to expect prior, during and following an appointment with both private and public specialist medical services. Specialists have secure access to edit information, meaning patients will have relevant and service-specific information. For New Zealanders this means there will be greater transparency in the health system and it offers increased comfort and trust in New Zealand health services."
The "greater transparency" appears to be less than visible.