Political tremors hit the health IT world

Pretty much every Kiwi and many Australians – and the odd dual citizen, like me and my cuzzy bro Barnaby – were pretty much transfixed to the telly on Thursday as we awaited Winston Peters' announcement about who he'd back to occupy the top floors of the Beehive, and didn't Winston just love the limelight.

Considering how long he'd taken to deliberate and then to deliver the verdict, his choice of Labour became increasingly likely, so NZ now has a young, attractive leader to rival the Trudeaus and Macrons of this world. It will be a couple of days yet before we know who will take over the health portfolio but most people's money would be on Labour nabbing the ministry, health policy being one of its traditional strengths.

The new health minister is likely to be David Clark, who also happens to be a Presbyterian minister. An affable Dunedinite, he will fill the shoes of the equally affable Jonathan Coleman, and is likely to concentrate initially on mental health as well as trying to find some money to quiet the fractious DHBs. What the new government will do with eHealth is a big unknown, although you wouldn't imagine they'd do much tinkering in the short term.

In the longer term, what to do with one of the big pillars of Digital Health 2020, formerly known as the National Health IT Plan, will be of intense interest. The National government sent the proposal for a national electronic health record back to the Ministry in July asking for more data on costs and benefits, and it was expected that the proposal would be resubmitted to Cabinet in December. Whether that goes ahead or not now will be a matter of debate at the Health Informatics New Zealand (HINZ) conference in Rotorua, starting on November 1.

Whether or not NZ actually needs a national EHR at all should also be a matter for debate, considering the DHBs and primary health organisations (PHOs) seem to be getting on with it themselves already, albeit in an ad hoc way. Pulse+IT has given plenty of coverage to the HealthOne-Health Connect South system, which now provides an EHR for the whole population of the South Island, but we also had a nice chat this week to Royal New Zealand College of General Practitioners medical director Richard Medlicott about the lower North Island's version.

Dr Medlicott has a deep background in health informatics as well as being a practising GP, and he told us all about the use of patient portals, Health Care Homes and a shared care record in the greater Wellington area. There, hospital clinicians can see a list of diagnoses, medications, allergies, alerts and immunisations just by pressing a button, and soon enough GPs will press a button in their PMS to see hospital information too.

The lower North Island is using easily available off the shelf technology to achieve this in the ManageMyHealth platform, and Dr Medlicott couldn't resist having a bit of a dig at the South Island system as it doesn't yet allow patients to see their record, whereas the Shared Care Record system can.

He also couldn't resist having a dig at the gobsmacking amount that Australia has spent on our national health record, especially considering that he reckons the spend for the whole of New Zealand on shared care records would not top $10 million, let alone $1.5 to $2 billion.

Another person who had a dig at the Australian health record – or more correctly, who took a great big shovel to it – was Grahame Grieve, father of the FHIR standard and all-around good guy. We've formally interviewed Grahame a few times over the years now and he has always been a diplomat and very measured in his words. He was nothing less than diplomatic when we spoke to him on Wednesday, but he certainly didn't hold back in his blog on Tuesday , where he laid out what he saw as the fundamental flaw in the My Health Record – its basic architecture – and how he thinks it can be fixed.

We suggest you read the blog in full and our story as well, which turned out to be by far our most popular for the week. As such, we thought we'd poll both our Australian and New Zealand readers on this general question: are national electronic health records going to be of any long-term use?

To vote on this question, sign up for our weekend edition or leave a comment below.

Our poll last week asked: Do you think blockchain technology in healthcare is all hype? This split our readers down the middle: 51 per cent said hype, 49 per cent said nope.

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