Health New Zealand Te Whatu Ora plans to simplify its clinical application landscape and migrate local ICT systems to accredited cloud providers as immediate priorities this year.
The plans were revealed in Health NZ’s briefing to incoming Health Minister Shane Reti and released publicly earlier this month.
Health NZ outlined what it called a fragmented data and digital environment with over 4000 clinical and business system applications, many of which have reached or are beyond end of life with high technical debt.
However, it says the centralised of IT functions nationally as part of the Te Whatu Ora reorganisation had enabled it to better respond to risks such as regional and local projects that were affecting clinical delivery, such as the problematic implementation of radiology information systems in the Central region.
“As a national organisation, we are now positioned to understand the total state of our health infrastructure,” the document says. “We inherited a physical and digital infrastructure portfolio with significant historic under-investment, variable quality across the country, and many assets at or close to end-of-life – and we are still uncovering new issues.
“Our digital portfolio is complex, comprising the data and digital environments of 28 entities, with varying degrees of maturity and quality, and significant technical debt.”
It said capability and investment varied across the country, with a “patchwork of about 4000 systems that are not integrated and are often out of date with no effective back-up”.
Significant resources are required to maintain legacy systems, it says. The plan is to simplify the clinical application landscape by limiting the proliferation of ICT systems and moving to fewer, more robust platforms, it says.
This mirrors plans revealed in a speech last year by Te Whatu Ora’s director of strategy and investment for data and digital, Darren Douglass, in which he outlined a strategy that would see the numerous cloud platforms consolidated and the IT environment simplified.
It will do this by migrating local ICT systems to accredited cloud providers to increase service resilience and availability in a more cost-effective and secure way, it said.
It will also accelerate new ICT capabilities for new models of care and broaden “investment beyond the traditional focus on hospital care to focus on shifting care closer to home”.
National data collection will be standardised and automated to mitigate the risk of privacy breaches and improve reporting and innovation.
Digital health agency
The Digital Health Association (DHA) has also released its briefing to the incoming minister, calling for the establishment of a new digital health agency.
DHA CEO chief executive Ryl Jensen said an independent and standalone Digital Health Agency would drive the uptake of health technologies and significantly reduce sector-wide costs, as well as help address workforce issues.
“New Zealand faces major challenges to the sustainability of our health services and the equity of their delivery,” Ms Jensen said in a statement late last year. “Prioritising digital health technologies will be a game changer.”
However, she said a separate digital health agency was needed as digital health was currently treated as ‘a vertical’ within the health sector structure, whereas it is ‘a horizontal’ that touches every corner of the health system.
“Due to its complex and technical nature, digital health requires experts to govern and lead it,” she said.
“Without this type of governance for digital health, the criticality of it can be underestimated.”
A standalone agency would provide expert digital health governance and help build an environment for digital health to thrive, she said.
The agency would also be responsible for establishing a national digital health innovation network, creating a digital health academy for the health workforce, and creating a digital mental health hub to ease workforce pressures and service mental health needs.
“Properly funded and implemented, a government digital health agency would deliver real value to every part of the health system,” she said.
Ryl doesn’t explain the benefits to health service delivery people and health service consumers of her proposal. Health IT does enable health services widely. Yet decisions about those services rest with Te Whatu Ora and government – for the very reason that IT is an enabler not the main purpose of Te Whatu Ora.
What would the purpose of a single agency be? Monitoring like Infracom? Maybe that could be useful. Procurement? Wouldn’t a single agency increase the separation from users who need IT to enable their work – similar to MoH pre-reforms?
Be good to hear the value proposition?
There does not seem to be any transparency on how IT decisions are made. For solutions outside of the EMR and hospital admin systems, there are no public calls for EIO as a result solutions are implemented that are not fit for purpose nor cloud based as they have expressed in the article.
Perhaps an improved and more transparent procurement process is what is needed.