Eight PHOs to jointly procure AI-enabled health platform

NEWS - eHealthNews.nz editor Rebecca McBeth

Eight Primary Health Organisations (PHOs) from across the country have launched a joint procurement process to identify a shared, AI-capable technology platform for primary health operations. 

WellSouth Primary Health Network, Tū Ora Compass Health, THINK Hauora, Health Hawke's Bay, ProCare Health Ltd, Pinnacle Midlands Health Network, RAPHS Primary Health Support, and Nelson Bays Primary Health together support the delivery of primary healthcare to communities from Northland to Southland.

The procurement covers four interconnected functional domains that the organisations say form the operational backbone of PHO activity: claims and payments, provider portal, case management, and referrals.

Damon Campbell, chief operating officer at WellSouth Primary Health Network, says the PHOs face similar challenges and there is a lot of opportunity to do things more efficiently and effectively. The collaborative approach provides the scale to make it attractive to a range of industry partners.

"We are not procuring a single tool to fix a single problem, we are looking for a platform that can transform how eight PHOs operate across four critical domains, with AI and automation at the centre of that transformation."

Artificial intelligence features as a central theme across all four domains and the PHOs say that the procurement focuses on workforce support rather than replacement. 

Matthew Lord, chief information officer at Tū Ora Compass Health, says their teams spend enormous amounts of time on administrative processes that technology should be handling.

"This procurement is about reclaiming that capacity, not by reducing our workforce, but by giving them better tools so they can focus on the work that actually makes a difference to people's health,” he says.

The claims and payments domain involves end-to-end management of health service claims, payment processing, reconciliation, and financial reporting. 

The provider portal covers the interface through which contracted general practices and allied health providers interact with PHO systems, including enrolment, service reporting, document submission, and communication. 

Case management involves tracking and coordination of health improvement programmes, care plans, and complex patient journeys across primary and community settings and the PHOs are interested in AI-assisted prioritisation, intelligent workflow support, and automation of routine documentation.

The referrals domain covers management of referral pathways between primary, community, and secondary services, including initiating, tracking, and closing referrals, with automation and integration with national systems as central requirements.

Janice McDougall, general manager – strategy and enablement at THINK Hauora, says any platform must support culturally responsive ways of working and enable the PHOs to see and respond to inequity in their data.

"We were clear from the outset that Te Tiriti o Waitangi principles are not an afterthought, they are a requirement, and the collective approach gives us the weight to make that expectation stick,” she says.

Garry Johnston, general manager digital and innovation at Pinnacle Midlands Health Network, says he is excited to understand how the market may be able to better support delivering at scale, whilst allowing for the unique and diverse needs of the PHO’s communities to be met.

The eight PHOs collectively cover a substantial portion of the New Zealand population and operate across urban, provincial, and rural settings. Each organisation administers primary health funding, supports general practice teams, and delivers health improvement and equity programmes within its region.

Peter Goodwin, strategic projects team lead at Rotorua Area Primary Health Services, says that for a smaller PHOs like his, the ability to participate in a procurement of this scale is a genuine opportunity. 

"We carry the same operational complexity as the larger organisations, but with a smaller team to manage it,” he says.

Campbell says that while each of the PHOs involved are at different stages, having a collective mindset is the best approach to the AI and automation space. 

"The fact that eight organisations have chosen to do this together, rather than separately, is itself a statement about where primary health is heading," he says.

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