Implementation of data and digital services must be accelerated, report says

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eHealthNews.nz editor Rebecca McBeth

Implementation of data standards, data stewardship, identity management and interoperability must be accelerated in the health sector, the interim report from the Health and Disability System Review Panel says.

The report, released on 3 September, highlights problems and necessary improvements in the area of data and digital as one of 12 key messages, saying, “some current ways of working in New Zealand inhibit the full potential of technology across the health and disability system”.

While health systems worldwide are assessing their readiness for a digital future, “New Zealand is lagging behind other countries with limited interoperability of systems and a lack of national data standards,” it says.

“Investment in information technologies has been low, and core foundation work will be required before the health and disability system can generate the potential gains from operating a more digitally enabled system.”

A theme raised in almost every discussion in phase one of the engagement of the review panel was the role of data in the health system.

“Access to much improved, up-to-date, reliable data is fundamental in a system that aims to deliver more equitable outcomes, improved health and wellbeing, and a better consumer journey through the system,” the report says.

However, much of the data the system generates is treated as a by-product of clinical processes and is not used to its full potential.

“Real-time access to standardised datasets that can be linked virtually will give clinicians access to more complete patient information more quickly from any location, enabling them to, for example, work more efficiently and effectively, track and monitor performance, plan the future workforce more robustly, and build evidence of what works,” it says.

In order to take advantage of the opportunities this wealth of data brings, issues of digital literacy, data stewardship, cybersecurity and ethical frameworks need to be addressed.

The health workforce of the future will require digital skills and people will need enhanced digital literacy at all levels in organisations.

“The health and disability workforce of the future will need to work in new ways and use new digital technologies and better data. The system will need to develop new ways to train, retrain, develop, and support the health and disability workforce,” says the report.

It also details significant issues with interoperability between the myriad IT systems in use in New Zealand’s health sector and a fragmented vendor landscape.

To address the lack of integration and interoperability, the Ministry has proposed a national health information platform (nHIP) that will create a virtual electronic health record.

The report endorses this proposal, saying nHIP would provide a powerful platform for data integration and systems interoperability across the sector.

The opposite approach, of forcing a transition to a monolithic system, would involve large-scale change and “experience has shown that, for a variety of reasons, health, and the public sector in general, does not do large-scale IT projects well,” it says.

“However, large integration platforms can add complexity of their own, so, while they may provide massive benefit in the short to medium term, experience shows they can become bottlenecks and barriers to future change.

“There is no question that the sector needs nHIP now, but it will not be sufficient on its own.”

Clinical Informatics Leadership Network advisory panel member Rebecca George says the group is pleased to see data and digital featured strongly in the interim report.

“We endorse the need for robust governance, effective analytics and the recognition that a workforce with capability to lead, manage and develop this is required,” she says.

“CILN welcomes the opportunity to work alongside the Data and Digital team at the MOH to provide clinical informatics leadership; as we seek to ultimately support our patients, the public and their family, whanau and carers in their health journeys.”

Panel chair Health Simpson says the review is still very much a work in progress.

“We have identified the likely reform themes and directions but significantly more discussion and evaluation is needed before we will be in a position to bring our thinking to recommendation stage,” she says.

Recommendations will be made in the panel’s final report, due by 30 March 2020.

If you would like to provide feedback on this news story please contact the editor Rebecca McBeth .

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