The Accident Compensation Corporation (ACC) is New Zealand’s national health insurance scheme. Through processing over $5 billion in claims every year, ACC supports every New Zealand resident and visitor recover from injuries suffered from an accident. 

Improving access to care is a core focus of ACC and MRI scans are a vital tool to assess patient injuries. Unfortunately, due to a lack of trained personnel and a complex referral process, significant delays were delaying treatment. Working with Eightwire, ACC undertook an improvement programme to reduce delays by allowing GPs to route patient data straight to the radiology service. This removed several steps in the referral process and drastically reduced wait times. Through Eightwire’s automation, wait times were reduced by nearly 50% and saved millions of dollars and hours of waiting time for patients has been saved.

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Delays in assessing MRI scans can extend timelines for care

MRI scans are a core diagnostic tool for health professionals to assess the condition of patients, and to decide on any treatment, surgery and/or rehabilitation.

Average wait times from GP consultation to the MRI appointment are 30 days due to staffing shortages and a complex referral process that relies GPs to refer to a surgeon that then refers to the MRI and then assesses the scan. 

These delays lead to two major costs: first, ACC effectively pays for this ‘wait time’ from a financial perspective. Second, for the patient,  waiting times can delay further steps such as clinical advice and rehabilitation. With ACC bearing a significant share of the overall funding cost these costs will drive up healthcare costs across the sector. 

ACC needs timely and meaningful reporting of critical data relating to health care and a clearer picture of the various medical costs involved from the providers, the recommended treatment pathways, and ultimately the rehabilitation outcomes.

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The GPMRI Programme: data sharing to improve care

The GPMRI plan introduced a model of care where GPs can refer patients directly to MRI providers (hospitals or other specialist radiology providers) for scans relating to specific patient requirements. Using technology provided by Eightwire, ACC can extract the necessary referral data set from the participating Primary Health Organisations (PHOs) and route it to the imagery centre. 

Eightwire’s data sharing network is used to link up the systems within ACC, the PHOs and the radiology providers. When a patient needs an MRI, Eightwire is used to manage the contracts and analytics between the numerous organisations to streamline the service delivery.  

In addition to data flows, GPs were trained in assessing MRI scans to remove a bottleneck that relied on surgeons to assess MRI scans. 

Finally, accessing the data quickly and easily using the Eightwire secure data exchange service has helped ACC build a complete reporting and analysis model. This additional information and insight can be used to assess where efficiencies can be considered and enforced.

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The benefits to ACC

The first two years of operation of the GPMRI model has brought multiple benefits:

Patient wait time was reduced by nearly 50% from 30 days to 16. This has led to major cost savings to ACC and improved care outcomes for patients. This speeds up the patient's journey from injury to recovery and allows them to return to their lives as before. 

Treatment cost per claim and other performance data is managed more proactively and in a targeted way. This is partly due to greater transparency: cost information at the individual health professional level is now accessible. ACC’s entire contract management function improves through improved access to this data.

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