The digital health sector in Aotearoa New Zealand is at an inflection point.

The data breaches and system outages that have marked the start of 2026 have rightly prompted public concern. But if we focus only on what went wrong, we miss the more important question: what does this moment make possible?

I believe it makes a great deal possible – if we are willing to move from reflection to action.

The foundation already exists

One thing worth stating clearly: New Zealand is not starting from zero. Health New Zealand has published a robust Health Information Security Framework – HISO 10029 – covering hospitals, community providers, and suppliers. The framework sets out clear security obligations across the sector. The standards exist. What has been missing is consistent, verifiable adherence to them.

This is not a criticism. Building and publishing a framework of this kind is genuinely hard work, and it reflects serious intent. But the gap between a standard on a page and a standard embedded in practice is where patient risk lives. Closing that gap – through assurance, enforcement, and support for those who need it – is the work ahead.

What Australia is telling us

Earlier this year, the Australian Medical Association released research that put the interoperability challenge in stark terms. Its conclusion: without enforcement, having systems that talk to each other will remain a pipe dream.

Australia’s challenges mirror ours – isolated databases, incompatible systems, fragmented accountability. But Australia is also showing what coordinated action looks like. The Australian Digital Health Agency’s Sparked AU FHIR Accelerator brings together government, vendors, and providers to implement interoperability standards at pace and at scale. It is a model built on shared purpose rather than voluntary good intentions – and it is working.

New Zealand’s Centre for Digital Modernisation has the opportunity to draw on exactly this kind of approach. The architecture doesn’t need to be imported wholesale; the principle does.

The Digital Investment Plan is our moment

New Zealand’s Digital Investment Plan represents a genuine, once-in-a-generation opportunity to build the foundations the system actually needs. But its success will depend on the choices made now, before the proverbial concrete is poured.

That means prioritising interoperability and governance alongside speed. It means resisting the temptation to bolt new tools onto old foundations. It also means fixing a procurement system that too often works against the innovation it is trying to unlock. Local vendors with proven solutions have consistently struggled to access large-scale opportunities. An agile, tiered approach to procurement – one that creates genuine pathways for New Zealand capability to contribute – would accelerate delivery and reduce risk. And, finally, it means treating security not as a compliance exercise but as a design principle – built in from the start, not patched on afterwards.

Done well, modern, connected, standards-based platforms are measurably safer than the patchwork of legacy systems they replace. The evidence from comparable health systems is clear on this. The case for investment is not just about ambition – it’s about patient safety.

Three investments that will define success

The path forward requires investment in three things simultaneously – technology, people and trust.

Interoperability and cybersecurity are not products you procure once. They are capabilities you operate every day. The workforce who design, integrate, secure and run our health systems needs sustained, deliberate investment. Without it, even the best architecture will underperform.

And public trust. Trust is not rebuilt through statements. It returns when people can understand what happens with their information, who is accountable when things go wrong, and what concretely changes as a result. That requires plain communication, genuine transparency, and a long-term commitment to digital literacy across communities – not just within the sector.

Industry is ready

The digital health industry in New Zealand is not waiting to be told what to do. Across the sector, vendors, providers, and implementers are already working on interoperability, already meeting security frameworks, and already looking to Australia and beyond to understand what good implementation looks like at scale. Many DHA members operate across both countries and bring direct experience of what coordinated, standards-led delivery requires in practice. 

Industry is not the only part of the sector that is ready. Clinicians – the people who actually use these systems to deliver care – have been saying for years that digital tools need to work with them, not around them. Genuine clinician engagement is not a nice-to-have at the end of an implementation. It is a prerequisite for any of this to stick.

What industry needs – and what the sector as a whole needs – is a clear, consistent signal from government about what will be required, and when. Mandates are not a threat to industry. They are a level playing field. They remove the commercial incentive to stay siloed. And they make it possible to build shared infrastructure rather than duplicating effort across hundreds of disconnected systems.

Setting clear, enforceable standards is not a radical proposition. It is just common sense – and other countries are doing it precisely because voluntary approaches have not delivered at the pace patients deserve.

The answer is already taking shape

There is genuine momentum here. Reviews are underway. Investment is committed. The standards framework exists. The sector is engaged and, frankly, energised by this moment in a way I haven’t seen in some time.

But momentum must reach beyond the hospital. Primary care, community services, and rural providers cannot be an afterthought in the Digital Investment Plan. Equity in digital health means ensuring that the foundations being built now are foundations that serve everyone – not just those already well-connected to the system.

The question is not whether New Zealand can build a safer, more connected digital health system. It is whether we will use this moment to make the decisions that actually get us there.

The answer to poor digital health is better digital health – built on clear standards, real accountability, and the kind of genuine partnership between government and industry that turns frameworks into reality.

That is what the sector is ready to deliver.

Poll question: Do you believe government mandates accelerate safer, more connected digital health?