SDHR - first contract awarded + GP leader calls for wider consultation

NEWS - eHealthNews.nz editor Rebecca McBeth 

Middleware New Zealand has been awarded the contract to deliver the technology integration components of the Shared Digital Health Record.

The project has a budget of $4 million through to the expected go-live of a Minimum Viable Product at the end of June 2025, but some primary care leaders have raised concern about the lack of engagement with GPs and patients as the system nears implementation.

Darren Douglass, acting chief information and technology officer says Middleware will provide Fast Healthcare Interoperability Resources (FHIR) expertise, architecture, development, testing and project management capability.

“We are working with other sector and industry organisations who will contribute to and integrate with the Shared Digital Health Record and there will be further procurements in the future to support it, subject to future funding,” he says.

A presentation on the SDHR at an HL7 symposium on March 18, said the programme will be providing a “crucial piece of technology” to enable healthcare providers to access and later update health data across care settings, all within the applications they already use.

“Instead of building a new interface, the SDHR will deliver data into existing proven products,” it says.

This means that healthcare providers can continue to use the systems they already have access to, such as well-established shared record systems HealthOne in the South Island and TestSafe in the Northern region.

The focus initially is on creating a new repository for primary care data including conditions and allergies. This would be combined with existing national data services such as the National Health Index (NHI) and Medicines Data Repository.

Early users will be unplanned care providers – after-hours and urgent care, telehealth and emergency departments, the presentation says.

Clinical director at ProCare PHO Allan Moffitt strongly supports the concept of a SDHR, but is concerned about limited engagement about the new shared record with GPs and patients.

“I do not have any problem with the content. We know that it is being set up in a way that would give people the right to opt off, and if anybody has marked a condition or comment as confidential, then that would not come through into the system,” he explains. 

“But it has taken a long time to start consulting with the public in a broader sense.”

He says GPs also remain uncertain about how data will be transferred into the new national repository and which interfaces clinicians will use to access it. 

“The more there is a vacuum of information, the more people make up their own paranoia about it and that is not very helpful,” he says. 

Both individual patients and entire practices will be able to opt out of sharing their information with the national SDHR, which one practice has already vowed to do.

However, Moffitt believes it is not fair for a practice to be able to make that decision for all of their patients. 

“The law actually enables sharing for direct clinical care: in fact, it requires it,” he says.

But he stressed the need for robust access controls and auditing, and more clarity and communication from Health NZ to ensure people know what is happening to patient data.

A GPNZ spokesperson says the organisation “continues to work closely with Te Whatu Ora on the SDHR programme, emphasising the need for sector engagement and communication”.

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