We can perform brain surgery, but healthcare is still drowning in paperwork

Modern medicine is extraordinary. We perform complex brain surgery using sophisticated imaging and surgical navigation. We diagnose disease through increasingly precise tests and develop treatments that would have been unimaginable a generation ago. Significant scientific and clinical advances of the past few decades have revolutionised  what healthcare can achieve…but look at the administrative experience of healthcare and you could be forgiven for thinking very little has changed!

A GP can have access to extraordinary medical knowledge but still spend valuable consultation time gathering information a patient could have provided beforehand. A nurse can deliver highly specialised care and then spend considerable time documenting what happened, preparing follow-up information and coordinating the next steps manually with a patient. Patients are often expected to remember everything discussed during a short appointment, keep track of pieces of paper, follow a plan at home that can be challenging, and find their own way back into the system when something changes.

Even our supposedly 'modern' patient portals frequently operate like digital filing cabinets. They display appointments, test results, prescriptions or documents, but offer little meaningful two-way support. When a patient needs something, the process can still involve manually generated secure messages, another notification in an already crowded inbox and another administrative task for someone in the practice. Frustratingly, we've digitised parts of the transaction without fundamentally changing the way care is delivered.

Today, a new generation of AI-native healthcare technology could help change that... 

The Groov Health Platform  is now being introduced into New Zealand primary healthcare with two large Primary Health Organisations, working alongside Health Coaches, Health Improvement Practitioners and other clinical professionals. The platform  helps clinicians save time at each appointment by collecting patient information upfront and reduces their post visit work by automating patient action plans agreed during the visit. Patients are empowered to manage their health between appointments, maintain their health goals and access practical support around the clock. It also allows healthcare teams to proactively reconnect with patients who may otherwise remain disengaged from care on an automated basis. The technology is already being deployed with two major New Zealand primary health organisations and will be deployed in clinics with GPs, Nurses and Pharmacists later this month.

One New Zealand healthcare organisation preparing to introduce Groov's Health Platform across its doctors, nurses and pharmacists, estimates that the technology could free up an additional five minutes in every 15-minute consultation by collecting relevant patient information beforehand and reducing the administrative work surrounding each appointment. That's potentially a third of the consultation available for more meaningful clinical interaction. 

Now imagine if every healthcare professional involved in a patient's care could see the same up-to-date health plan, understand what had been agreed, track progress, understand patient concerns, and identify when additional support was needed. Instead of patients having to repeat their story, remember instructions or navigate disconnected services, the system itself could help maintain continuity across providers and support patients between appointments. 

That is a very different proposition from simply putting another form or dashboard online and I find that contrast increasingly difficult to accept, particularly when New Zealand is confronting a healthcare workforce challenge that cannot be resolved simply by recruiting more people.

Exploring the invisible workload holding primary care together

Much of the work required to provide good healthcare happens outside a consultation itself. Reviewing patient histories, gathering information, recording outcomes, preparing care plans, following up patients with chronic conditions, checking whether advice has been understood and identifying people who have stopped engaging with care are all essential activities. This is also difficult to deliver consistently when clinicians have limited time and patients need support at different points in their lives.

Take someone managing diabetes or any of a number of chronic diseases and mental issues. Their health is influenced by decisions made every day: what they eat, whether they're physically active, how they manage medication and what happens when they're uncertain about their symptoms or their care plan. A consultation might last 15 minutes but the clinical responsibility for managing the condition is held by the clinician and continues through every hour until the next appointment.

A more traditional operating model concentrates much of our clinical capacity into appointments and administrative follow-up. We then rely heavily on patients to manage the period between those encounters, often with limited practical support. If they struggle, the health system may not know until they return to the clinic, their condition deteriorates or they need more intensive care.

This is an infrastructure problem that asks highly trained people to compensate for gaps in the system through more manual work, more administration and extraordinary personal effort. At some point, adding more effort becomes a poor substitute for changing the model.

A portal is not the same thing as care

Healthcare has invested significantly in digital systems and many have delivered genuine improvements. Electronic records, online bookings and secure communications all serve important purposes but we should be clear about what they do and what they don't do. A portal that allows a patient to view information is useful. It is not necessarily a system that helps them understand that information, take appropriate action, remain engaged or communicate something important to their care team. Similarly, sending a secure message is not the same thing as knowing whether a patient understood the advice, encountered a problem or followed through. We should be moving beyond systems that simply store and transmit information towards infrastructure that actively supports the delivery of care.

Extending the reach of the workforce we already have

At Groov, we're exploring this model with primary healthcare organisations in New Zealand. Our first implementation with Tāmaki Health has produced strong early findings. Among a targeted group of patients with poorly controlled diabetes who had not been attending care, technology-supported outreach resulted in seven times as many enrolments as a previous comparable human-only approach. The implementation also generated 200 additional patient touchpoints between appointments without additional workforce time, alongside an 11% increase in patient-reported health outcome collection.

These are early operational measures, not proof that we have reduced hospital admissions or delivered long-term cost savings but they provide useful evidence that a different model of patient engagement can work in routine primary care.

The economics of healthcare need a different conversation

We need more GPs, nurses and other healthcare professionals. That isn't in dispute but recruiting and training them takes time and additional workforce capacity becomes less valuable than it could be if we continue to surround highly skilled people with inefficient processes. The productivity and clinician wellbeing opportunity is to change what happens before and after those appointments, prevent avoidable administrative work and improve patients' ability to manage their health between visits. 

Technology should make healthcare feel more human

There is a reasonable concern that introducing more technology into healthcare could create a colder, more impersonal experience. I think that risk is real when technology is introduced primarily to reduce contact or move patients through transactions faster but this isn't the only possible outcome. 

If a GP spends less time collecting routine information, they can spend more time discussing what matters to the patient. If nurses have better visibility of people struggling between appointments, they can focus their attention more effectively. If a patient has somewhere to turn when they're uncertain about their care plan, they don't have to wait until the next consultation to take a useful step.

The opportunity is to remove unnecessary work from the people delivering it, while giving patients more meaningful support. New Zealand has an opportunity to help establish what this model looks like in practice. We're already seeing interest from international healthcare organisations in how we're applying technology within existing primary-care pathways, rather than treating digital health as a parallel service. We've made extraordinary progress in what medicine can do. It's time the everyday experience of delivering and receiving care caught up.