Adding value to healthcare

Freemans Bay Care Plus recipient Ray O'Loughlin steps out. Picture / Paul Estcourt

Ray O'Loughlin used to be a fitness fanatic until the day he had a mini-stroke exercising in his home gym.

"It gave me such a damn scare, I gave up all gym work," says the Freemans Bay man, who is a former Army physical training instructor.

"I used it as an excuse and I went so lazy."

Since that stroke the 72-year-old has had a second hip replacement, developed diabetes and had a major operation for an aneurism.

Despite the chronic illness he suffers, Mr O'Loughlin is motivated to exercise again after joining the Care Plus programme run out of the Freemans Bay Medical Centre, one of Auckland's ProCare practices.

The Ministry of Health-funded programme is designed to help Primary Health Organisations manage their high-needs patients better.

A critical part of the programme is a "Wellness Plan" that contains information about the patient, such as medical condition, medication and health goals. Patients make regular visits to their GP or practice nurse for check-ups and to monitor progress towards their goals.

For Mr O'Loughlin, who used to play a variety of sports from rugby to squash, one of his main goals is to lose weight. He wants to get down from 105kg to 90kg.
"That was my best fighting weight," the former boxer said.

He also aims to get out of the house more and go for regular walks.

"I became locked into the house and I could hardly get out of bed.

"For over 10 years I did nothing much ... this gives me the motivation to get out and do something."

Mr O'Loughlin visits his practice nurse about once a month to talk through his wellness plan, be weighed and have his blood pressure checked.

Nurse Karyn Seagar said the aim was to improve Mr O'Loughlin's health to the point where he was fit and healthy and able to contribute to the community.

"The introduction of the Care Plus programme means that people like Ray, who are likely to have poor health outcomes in the foreseeable future, and who may require high-cost health services or significant care, can benefit from early intervention to prevent illness or improve their health status."

ProCare, a group of Auckland general practices, has 15,000 people enrolled in its Care Plus programme.

Chairman Tom Marshall was encouraged by the programme's uptake and said it was in line with the health system's shift in focus from illness and disease to health promotion, sickness prevention and wellness.

Hands-on health

* Care Plus is a Ministry of Health initiative aimed at people who visit their GP or nurse regularly because of a chronic illness such as diabetes or heart disease. It aims to help them better manage their health.

* It started in July last year and is run through practices that are part of a Primary Health Organisation.

* Over time Care Plus will replace the High-Use Health Card.

* About 21,500 people are enrolled in the programme nationally.

* An independent evaluation of Care Plus is expected to start next month.