Data & Digital Futures: MoH View

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Picture: Ministry of Health deputy director-general of data & digital Shayne Hunter

In a new quarterly column from the Ministry of Health’s Data and Digital team, deputy director-general data and digital Shayne Hunter reflects on progress made in his first six months in the role.

Time sure does fly. It has been six months since I started in the role of deputy director-general data and digital at the Ministry of Health. There is certainly much to do, but progress is being made.

The Health and Disability Review interim report was recently released. It provides a comprehensive view of the current state of the health system, developed from significant engagement with the sector and wider public. The report identifies reform themes and directions, but notes significantly more discussion and evaluation is needed before recommendations will be made.

I was pleased with the strong emphasis on the need to invest around data and digital, in particular the key message that the implementation of data standards, data stewardship, identity management and interoperability must be accelerated. Further, it supports for some of the work we are progressing already, for example, the national Health Information Platform (nHIP).

nHIP rebranding

Development of a detailed business case for nHIP is underway following Cabinet approval to proceed . This is a really positive step in creating a digital health landscape for the future that will support the health and disability system to better meet the needs of New Zealanders.

We’re intending to rebrand the nHIP title, as it currently constrains people’s thinking to just a technical platform, when in fact it’s much more, encompassing specific national services, as well as standards, architecture, interoperability, commercial, investment and innovation frameworks as well as security, privacy and trust. It’s also an ecosystem play – there are many parties to a connected digital health environment.

A key current priority for the Ministry is around a digital health identity for the health workforce and consumers. This is a critical foundation we need to get on and deliver in conjunction with other central agencies. If we can crack this, it opens enormous opportunities for patient and system benefit.

Health Data Strategy by next year

Data is another area of focus. We will work collaboratively with the health and disability sector and other government agencies to produce a Health Data Strategy, which I would like to be published around March/April next year.

The strategy will cover what information we’re currently capturing and tackle questions around whether the system is making the best use of it, as well as standards and the role the Ministry best plays in the future.

Using modern platforms and approaches we could significantly rationalise the multiple systems and platforms that currently provide data services across the Ministry and the sector. We shouldn't be duplicating or storing data where we don't have to, which means, for example, we might architect registers (particularly the less functional ones) in a different way so we only get data when it's required.

We can do a lot more with data and analytics, in particular in the areas of service improvement, population health, equity, and proactive and preventive services.

Data governance improvements

Improving data governance in the sector is part of the security, privacy, trust framework. The issues here centre around who has access to the data, who uses it and in ensuring patient privacy.

We’re also establishing a Māori data governance advisory group, which will link to other agencies to ensure we’re aligned. The group will advise on how to better reflect Māori in data and how to govern data in a way Māori are comfortable with.

We recently published a set of minimum requirements for digital data and technology services that health organisations and the vendors are expected to meet.

We will flesh these out over time to provide greater specificity where required including identifying conformance versus compliance is required. For example, data standards will be compliance focused and security will be more around conformance and what we want to achieve as an outcome, rather than defining the how.

In saying that, security is an ongoing challenge and we may become more prescriptive in parts of the sector. We have to stay ahead of those trying to compromise our systems or access our data and, ultimately, patient trust.

Investment approach

We’re looking at investment generally, answering questions of sector alignment around our investments and whether we’re getting best value for our spend. Central government agencies want to understand our long-term investment strategy to get an overview and look for opportunities to get smarter in how we invest and how to leverage investments in other parts of the sector and other agencies.

Work needs to be done on some of our national platforms such as the screening, clinical registers and reporting, and we are looking at all areas to determine where we need to prioritise investment over the coming years to ensure not only that the systems are secure and reliable, but are continuing to meet the needs of the Ministry and the broader sector.

I believe we need to shift away from the investment model that funds large capital projects which partially deliver what is needed, with further iterations or improvements not eventuating because of competing funding priorities.

We should move towards a more modern delivery model that allows for continuous delivery and innovation. The nHIP business case will propose a model of funding digital ways of work, including iterative delivery, aligning investment to value delivery.

We also need to address funding for digital and data across the system. The Ministry is in the process of creating a Digital Investment Board to give advice on where we need to invest and, in some cases, help us build a case for change and investment. Members will represent the broader stakeholder group.

Overall, I can’t think of a more exciting time in the digital health space. I feel very positive about the future.

Shayne Hunter is the deputy director-general data and digital at the Ministry of Health. He will be giving the keynote address at HiNZ Conference 2019.  Read more about Digital Health Week NZ 2019.

If you want to contact eHealthNews.nz regarding this View, please email the editor Rebecca McBeth .

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