These days it's all about doing things online, rather than fronting up to speak to a living person or handing in our carefully completed form across the counter.
The internet has changed our lives in so many ways that you can think all the change that will happen already has. Yet the internet is still influencing how institutions like schools, universities, hospitals, businesses, councils and government departments operate.
A feature of online technology is that it sets up a push-and-pull between centralisation and decentralisation.
On the one hand, online technology allows us to do our shopping and form-filling anywhere. Communication from any organisation, be it a school or business, can reach us wherever we are. This is the decentralising effect.
Yet the internet also encourages centralisation, often driven by cost-saving, but also because decision-making and power operate efficiently from a centre.
And so we get the closure of the WDC's Hikurangi service centre and an imposing building in the centre of Whangārei that speaks volumes about a centralised authority.
I don't lament the absence of a service centre in Hikurangi, which I only used a handful of times. I understand that the centralisation of services and staff makes sense, especially when most of us have access to a computer or phone.
These processes are happening in the private sector for similar reasons. Think of the closure of banks and even the removal of cash machines in towns and suburbs because it will save the banks money if everyone does their banking online.
Understandably this can make people grumpy if they were used to the old ways.
You can carry out your banking anywhere, but you can't turn up at a bank or expect an ATM machine to be everywhere. Welcome to the new world.
It's that new world we'll have to get used to in the health sector too.
The Public Health Authority being established by the Government will endeavour to make the best use of online technology.
The old District Health Board structure didn't encourage the effective use of centralised online communication and co-ordination. There wasn't even a national patient database.
The co-ordination of the health response to Covid has shown the effectiveness of centralised decision-making and online communication that reaches out to all of us via our phones and computers.
To consolidate this direction, the recent Budget announced $600 million of spending on new data and digital health projects.
Many of us will already have experience using online tools like Manage My Health, which allows us to book appointments, get test results and arrange prescriptions without leaving home.
The Public Health Authority will look to consolidate innovations in digital health already occurring, but not yet in a nationally effective way.
The new era of healthcare will marry the centralisation of decision-making with increased online and phone communication with patients from Bluff to Awanui.
I'm not suggesting that we'll no longer be seeing doctors in person or visiting hospitals. Obviously, this remains at the heart of patient-centred healthcare, but there will be more online facilitated diagnoses and patient self-management. This isn't necessarily a bad thing.
Innovative online services that reach remote communities, backed up with mobile clinics, have the potential to increase access to healthcare rather than decrease it.
There's room for getting this wrong. Care will need to be taken, with lots of patient and health professional feedback, but change is happening now and will continue.
I do hope, however, that there are no plans to build a big new building in Wellington for the Public Health Authority. With remote working, Zoom calls and the like, there's no need for a building that speaks of its centralising power.
If the people in charge can just get on with developing the appropriate digital infrastructure to make our health system work better, that would be nice.
