Health IT Board working on next five-year plan for NZ
New Zealand's National Health IT Board (NHITB) is developing a national health IT plan for the next five years, with a draft due to be released in March 2015.
NHITB director Graeme Osborne told the Health Informatics New Zealand (HiNZ) conference in Auckland last week that he hoped the plan would be finalised and in place by June 2015.
The NHITB released its first national health IT plan in 2010 as part of the government's vision to provide all New Zealanders with electronic access to their core health information.
The plan involves a large program of work covering electronic medication management, national clinical solutions, regional information platforms and community-based integrated care initiatives.
The plan was updated last year, and a new plan for the next five years is now being developed to continue some of the existing foundational projects and begin to increase the focus on how to enable new and improved models of care, Mr Osborne said.
These include the use of telehealth, patient portals and care pathways as part of the move towards personalised care.
“Take two apps and call me in the morning is going to be the new prescription,” he said. “Medicine will be scientifically designed for me as an individual. How can I manage that? What about adherence? What about cost?
“The IT Board is thinking about how we can create an environment for a greater level of personalisation and ownership by the consumer.”
Mr Osborne provided an update on two major projects that are due to be rolled out nationwide: hospital ePrescribing and the National Child Health Information Program (NCHIP).
Hospital ePrescribing will go live in Canterbury District Health Board (DHB) hospitals from next year, the fourth DHB to roll out a standardised system.
Mr Osborne highlighted the logical and iterative way that these difficult health IT initiatives had been rolled out, pointing to an increased professionalism in health IT and health informatics in NZ.
“We had clinicians that were leading the project [in Canterbury] and they had been to Southland, which was the previous implementation, and they had learned how it worked,” Mr Osborne said.
“And they brought all these skills back to Canterbury to roll them out. We had clinicians in the room who took time out of their day to come and talk to us about how they found it and how good it was and how they were surprised it worked the first time.
“That’s professionalism: learning from the past, replacing and reusing the services and systems and tools and key things and processes and making sure we do a great execution job.”
Similarly, NCHIP began in the Thames region in Waikato and is now being implemented by the Midland Health Network.
NCHIP consists of a telephone-based child health coordination service located in Hamilton along with an information platform from Orion Health and BPAC. Every child aged from birth to six years will be enrolled in the program, which will provide a shared view of the child's health milestones, including immunisations, well child checks, hearing and vision checks, and B4school checks.
Doctors will be able to log on to the system through their patient management software or a password-protected website. The plan is to roll it out nationwide once it has been established in the pilot region.
Mr Osborne said it was essential that these national systems were economically sustainable. “We need to see hard dollars,” he said. “We need to be able to measure the effectiveness and we need to be able to get some returns on investment.”
Underpinning this focus on sustainability are some of the recent developments in the national infrastructure program, including the move to put all services and systems used by the 20 DHBs into two data centres.
“What a smart idea,” he said. “It’s cost effective, it reduces future costs because we know we’re going to increase the amount of CPU and data that we’re going to need, and it’s a smart financial decision.”
Another example is the national maternity system that has gone live in Palmerston North, with a view that the 20 separate maternity systems currently operational in New Zealand will be consolidated into one platform.
“It’s also working in South Canterbury, is soon to come to Auckland and Counties, and over the next two years the national maternity system will be turned on for all 60,000 children that have been born,” he said. “And it has a neonatal system so if they do require neonatal services, it’s the same system, same processes. Exciting, sustainable, cost effective.
“NCHIP is the next stage. How do we measure all the milestones from zero to six and ultimately zero to 17?”
While the plan to have patient portals available to every New Zealander by the end of the year is not doable, progress is being made. The government has provided $3 million for the roll-out, most of which is being directed to the PHOs with some set aside for marketing.
Mr Osborne said rolling out patient portals was challenging, so the NHITB had decided that rather than standardise the portals themselves and all of the data, certain essential elements would be standardised, particularly medications and problem lists.
“Everything to do with [medications] we’re actually pitching to go to unification straight away,” he said. “Getting the medication right is more critical than anything else we do.”
Mr Osborne acknowledged that getting it right was difficult, and that it required the engagement of clinicians, funders, business managers and consumers.
“Our goal is to get something that we all agree on,” he said. “It’s high quality and good healthcare outcomes.”
Posted in New Zealand eHealth