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Electronic health records 'back on' thanks to $400m of Budget funding
Tom Pullar-Strecker05:00, Jun 03 2021


SIMON O'CONNOR/STUFF
A comprehensive system of electronic health records was once due to be in place by 2014 and has now been reborn, in a different form.
Hopes are rising that the health service may be on the verge of a big step forward in its use of information technology after the Government allocated $400 million in the Budget to making improvements.

But Ernie Newman, former chief executive of the Technology Users Association, said a deep cultural shift would be needed to knock the sector into shape.

Most of the $400m will be spent on a new health information platform known as Hira that revives an ‘on-again, off-again’ effort to create a set of integrated electronic health records for the population.

The Health Ministry indicated a business case for Hira was still under development and had not yet been approved.


The Government has yet to release the Cabinet paper approving the Budget funding.


But the Health Ministry appears in no doubt Hira will proceed, saying it will “transform” the way people interact with health services.

“Hira will enable access to a virtual electronic health record as needed by drawing together a person’s latest health data from trusted sources,” it says.

Consumers would be able to access and control their health information through “their choice of website or application using a digital device such as a smartphone, tablet or computer”, it also says.


The investment is being advanced as Waikato DHB continues to struggle to restore its computer systems following a devastating ransomware attack.



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Efforts to create a single of set health records that would allow clinicians to access all relevant information about a patient have long history, with discussions dating back to at least 2004.

A project to achieve that was originally due to be completed in 2014.

Although earlier initiatives fizzled out, patient portals developed by the private sector and offered by GP surgeries have provided a significant part of the originally-intended solution.

Health Ministry spokesman Blair Cunningham said Hira was not designed to create “a closed, all-in-one, centralised technology solution”, as had once been an option for electronic health records.

They would not replace GP patient portals that are already in use, for example.

Instead, Hira would comprise “multiple solutions using multiple technologies in a connected ecosystem” that integrated with existing patient management systems and online portals, he said.

Cunningham said the business case for the “first tranche” of Hira was under development and could be released once it was approved by ministers.

Consideration would be given to reducing the risk Hira could become a target for ransomware, he said.

“Hira will have measures in place to ensure data and digital services are secure, including robust security certification, testing and ongoing monitoring.”


The Health Ministry says it will consider ransomware risks when designing Hira.
Trent Lash, chief executive of New Zealand Health IT, an industry body mainly representing technology vendors, said Hira would be critical to the Government’s wider reforms of the health sector.

Those reforms will centralise the functions currently performed by the country’s 20 district health boards.

Lash said Hira had two key elements; a set of standards to deliver interoperability “with a strong overlay to ensure the privacy and security of data”, and a set of distributed databases of patient information.

It would call up information about patients from a variety of different systems, as and when it was needed, he said.

Lash said overseas experience had shown that the alternative of creating a centralised system of electronic health records was “hugely expensive, difficult to set up and has greater cyber-security risks”.

“I see this as a move towards mitigating risk and creating a more secure platform and framework,” he said.


ROSS GIBLIN/STUFF
Technology consultant and former Tuanz boss Ernie Newman says “culture and structure” not right.
The Health Ministry’s ability to deliver on large technology projects has previously been called into question.

Newman blasted the culture and structure of health IT in 2017, saying it needed “re-engineering from the top down” and describing the Ministry of Health as “dysfunctional”.

“The prize for the most conspicuous incompetence in the public sector must go uncontested to the Ministry of Health,” he said then.

Newman said on Wednesday that “nothing had changed”.

Director-general of health Ashley Bloomfield had done a good job as “a front person for the sector”, he said.

“But at the end of the day, his day job is to get his sector sorted out and his ministry running efficiently and there is no sign he has done anything to improve their performance.”

Successive ministers had “a tremendous amount to answer for,” Newman said.

“We need a minister who has got the fortitude to almost rebuild the sector from scratch – that is what it comes down to,” he said.