Dear Minister,
Our response is confined to Appendix three of the report,
specifically the sections relating to improving the use of
information technology within the sector. We fully agree with the
findings of section three of the report and assure Government of
our full support in putting these recommendations into place.
We believe the following findings to be of particular
significance:
That the sector is currently inundated with too much information
and too many IT projects. That we are currently missing a national
IT architecture that clearly shows how a distributed
patient-centred electronic health information system works for
consumers and providers.
That it is important that we clarify who has a national
strategic leadership role for national health IT strategy and
planning and confirm the preferred approach for establishing an
architecture for a safe, shared and transferable patient electronic
health record for the New Zealand health sector.
We fully support the report's recommendation of an interoperable
and connected distributed approach as the preferred path. In
addition, we ask government to enact the following
strategies:
To help the sector to address problems which are holding back
interoperability To make proactive efforts to establish trusting
business relationships with private sector health IT service
providers
To reduce the extent to which healthcare providers are able to
cross subsidise information technology and service development in
competition with the private sector.
To critically assess the 'Connected Health' component of The
National Systems Development Plan
We have expanded on our suggestions in the paper attached.
Thank-you for the opportunity to provide input.
Yours sincerely HealthLink Limited
Tom Bowden Chief Executive
HealthLink Limited
HealthLink Ltd is a New Zealand-based company founded in 1993 under
an agreement with the New Zealand Government.
Realising that development of complex electronic communications
technology required specialist expertise, the Government sought out
companies with whom it could form partnerships.
Over the following 15 years HealthLink developed an array of
electronic communications systems and services to increase the flow
of clinical information across a health sector that had undergone
extensive restructuring.
Today HealthLink provides electronic communications and data
security services to more than 9,000 individual healthcare
organisations across New Zealand, Australia and the Pacific. With
more than 70 staff, the organisation provides commercial health
information exchange (HIE) services enabling the delivery of more
than 50 million items of clinical information annually.
HealthLink also provides technical support for a wide range of
New Zealand government owned and operated data facilities and
health management programmes.
In nearby Australia, HealthLink has HIE contracts with six state
and territory governments.
HealthLink is currently leading an Australasian-wide initiative
to implement electronic referrals between primary care providers
and hospitals.
HealthLink's Response
HealthLink's response is confined to Appendix three of the
report, specifically the sections relating to improving the use of
information technology within the sector.
We fully agree with the findings of the report and assure
Government of our full support in putting these recommendations
into place. In particular we agree with the finding that the sector
is currently inundated with too much information and too many IT
projects and that we are currently missing a national IT
architecture that clearly shows how a distributed patient-centred
electronic health information system works for consumers and
providers.
We agree with the MRG Report that the first and most essential
steps are:
Establishing clarity on who has a national strategic leadership
role for national health IT strategy and planning.
And confirming the preferred approach for establishing an
architecture for a safe, shared and transferable patient electronic
health record for the New Zealand health sector
We concur with the report's recommendation (f): That the
interoperable and connected distributed approach rather than the
single sector-wide enterprise system be confirmed as the preferred
approach for the development of a safe sharing and transfer of
patient electronic health information for the New Zealand health
sector.
We agree with the CRG's recommendation against proceeding with
the current HMSC proposal and its suggestion that HMSC be refocused
on replacing end-of-life hospital PASs with systems that meet HISO
standards and allow easy sharing of electronic information with
other providers.
We agree that with the MRG report's finding that it is essential
that the next generation of high-performing GP Practice Management
Systems has timely access to comprehensive information about
patients and their families, decision support tools for individuals
and population groups, and better interfaces with other primary
providers such as pharmacy information systems.
Additional Recommendations
HealthLink makes the following recommendations
1. Please help the sector to address problems that are
holding back interoperability
We recommend that as a matter of urgency Government moves
to encourage and support industry self-regulation, particularly in
respect of settling upon economic models to support interchange of
patient data in a manner that will minimise the burden of cost upon
the health sector but still recompense the healthcare IT industry
in a fair, equitable and transparent manner.
We note that The Health IT Cluster, backed by the Ministry of
Health is moving to address this and we strongly support their
efforts to do this.
2. Please make proactive efforts to establish trusting
business relationships with the private sector
We recommend that the proposed National Health IT Board
proactively studies the opportunities for developing public private
partnerships and other arrangements to maximize the involvement of
private sector IT companies.
We wish to draw government's attention to the report's statement
that "Not so long ago New Zealand's primary care provider's
(general practice, laboratory, and pharmacies) information systems
led the world" (in section 3.4). And to remind the government that
this was to a very large extent due to the efforts of private
sector health IT companies, working in collaboration with an
encouraging government that this was achieved.
We believe that returning to an era of effective and innovative
public-private partnership will achieve a better and more
cost-effective result than will continuation of the current
approach or a rearrangement of the current approach under a new
structure
3. Please reduce the extent to which healthcare
providers are able to cross subsidise information technology and
service development in competition with the private
sector
We would encourage government to look carefully at the industry
structure in order to create a marketplace attractive to industry
participation and investment. It is unlikely that this will be
possible unless government discourages government agencies from
competing with private sector organisations because of the market
distortions that this creates.
It is difficult to attract and retain private sector investment in
healthcare IT if private sector companies are competing against
government agencies which are effectively subsidized from within
their tax-payer funded healthcare delivery budgets. To create a
robust and sustainable private sector, this form of activity needs
to be actively curtailed.
4. Please re-evaluate the 'Connected Health' Component
of The National Systems Development Plan
We are very dubious about the underpinning assumptions supporting
the 'Connected Health' Strategy. We believe that the concept of
putting all healthcare providers into a 'Gated Community' to
provide added security is likely to create an insecure
environment.
We also note that a considerable amount of time and effort has been
invested in this project with no tangible outcomes achieved. We
believe the resources being expended in this area should be
channelled elsewhere.