New Zealand in top-five globally for health data interoperability

NEWS - eHealthNews.nz editor Rebecca McBeth 

New Zealand is ranked in the top-five countries for healthcare interoperability in a new global report, ahead of Australia, the United Kingdom and Singapore.

Experts say it is welcome to see New Zealand recognised globally as a leader in this space, but are concerned about the impact of recent data and digital budget and staff cuts on the country’s ability to maintain momentum.

The international research, released by research firm Black Book, ranks the digital interoperability performance of 18 high-income countries and found that New Zealand achieved a national interoperability rate of 90.3%, placing it fifth behind Estonia, Finland, Denmark and Sweden.

It says New Zealand, Sweden and Singapore have, “achieved high interoperability through national strategies that prioritise data standards, patient-centred platforms, and public-private collaboration. 

“New Zealand's Health Information Standards Organisation (HISO) and Singapore's national electronic health record system were specifically highlighted in surveys for their responsiveness and efficiency in clinical workflows,” the research says.

It cites the delivery of Hira tranche one as a major milestone in New Zealand’s interoperability journey, however Hira has since been paused due to a funding cut.

Health New Zealand | Te Whatu Ora former director strategy and investment Darren Douglass wrote to the Minister of Health in May 2024 about the impact of pausing or shutting down Hira services.

The letter says, “the immediate operational impacts will be reduced access for consumers and clinicians to summary health data, continued lack of data standards adoption and systems interoperability”.

Heath Tolley, group manager integration, data and digital, says that Health NZ has made significant strides over the past few years in enhancing its digital and data services, particularly in regards to interoperability. 

“We have worked collaboratively with the wider health sector on the adoption of national standards through HISO, and we are proud of the progress made through programs like Hira and the NZCDI (core data for interoperability), as well as our primary care initiatives such as GP2GP and, more recently, the Shared Digital Health Record, (SDHR)” he says.

Tolley says there is still work to do, recognising that Hira has been paused, but says the delivery of Tranche One established critical technology foundations such as the; Digital Service Hub; New Zealand Terminology Service; and National Events Management Service.

Tolley says the SDHR builds on the work of Hira and delivery continues on other services such as Immunisation API to support vaccine information and a Cervical Screening API to give primary care access to patients' screening histories.

“We believe that these initiatives will continue to drive positive outcomes for New Zealand's healthcare system, ensuring that we maintain our high standards and continue to innovate in the face of challenges.”

Scott Arrol, chief executive of Health Informatics New Zealand (HiNZ) says it is great to see New Zealand performing well globally on interoperability and shows the benefits of the widespread adoption of both international and local standards, such as the National Health Index (NHI).

However, he cautioned against complacency, noting the potential impact of recent budget and staffing cuts in New Zealand’s data and digital sector.

“It is encouraging to see that we are ahead of the curve, but without sustained investment and focus, there is a real risk we will fall behind. We need to keep our foot on the pedal to stay competitive,” he says.

The Black Book report says that the success of countries like New Zealand, “is powered in part by interoperability-focused technology vendors delivering the infrastructure for real-time, standardised health data exchange”.

It mentions InterSystems and Orion Health as being active in New Zealand and supporting the rollout of enterprise-level platforms that enable the integration of patient data across hospitals, clinics, pharmacies, and labs.

Niru Rajakumar, chief executive of McCrae Tech Hospitals, which was divested from Orion Health in a recent buyout of the company, says maintaining a global edge requires ongoing commitment, warning that “good is not good enough anymore”. 

“Striving for world-class interoperability is how we move from potential to performance and ultimately deliver a more connected, equitable, and person-centred health system,” he says

Peter Jordan, HL7 New Zealand secretary, says the top-five ranking surprised him a little and while New Zealand has a lot of technical interoperability, the country still has a way to go. 

“We have always had a big advantage in the key building blocks – notably the NHI and Health Provider Index (HPI) – plus the endorsement of international standards, notably FHIR and SNOMED CT, by HISO,” he tells eHealthNews. 

While New Zealand has also built a “fair amount” of key, modern infrastructure using these standards and APIs, “there is little doubt that the reduction in resources allocated to digital health has slowed progress over the past year,” says Jordan.

The Black Book rankings are based on data collected between 2020 and 2025 from over two million healthcare professionals and stakeholders about how effectively their national health systems enabled the secure and standardised sharing of patient data across healthcare settings. 

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