Draft delivers five-year plan for health IT

Once a leader, New Zealand has faltered in deploying health IT, report says

The Health IT Board has released its draft plan for the use of IT in the New Zealand public health sector — and there's a whiff of the now defunct Health Management System Collaborative (HMSC) about it in its focus on clinical leadership.

Referring to the failure of IT to deliver on promises of person-centric health, the director of the board, Graeme Osborne, says the draft "recognises the critical role clinicians play in leading the development of integrated clinical pathways to improve the design and operation of health IT solutions".

As expected, a shared services approach for support systems features prominently, as does a consolidation of health IT into regional rather than local deployments.

New Zealand does not have the luxury of continuing with an organisation centric, fragmented approach to health IT investment, the draft plan says. While New Zealand was the envy of the world in adopting IT into the health system, investment in next generation systems has "reached a plateau" and the way forward is unclear.

"Early adoption and successful use of early generations of health information solutions may mean that it has taken longer for the sector to recognise the lackorf recent progress," Osborne writes.

The plan, which paints a picture of complexity, duplication and a lack of integration in the current health system, was developed after a Ministerial Review Group appointed by health minister Tony Ryall found last July that the sector could do better. It outlines a two phased approach to deliver a core set of health information to patients by 2014, a goal set by that review.

The deployment of new health IT systems is seen as a way of creating more sustainable health services as the cost of care increases. Health solutions are both a barrier and an enabler, says the report, and more time has to be taken to design, make explicit and implement better models of care.

Too many projects are underway without any reference to the overall system into account, it says, and there is need for a stronger sense of direction as resource scarcities emerge.

Phase 1, through to December 2011, is to consolidate, cooperate and "foundation" to provide systems to capture, transfer and provide access to patient information. Phase 2 will deliver shared care capabilities featuring a clinical data repository feeding historical patient information and delivering decision support.

A "stretch goal" of phase 1 is to ensure each region has a foundation set of systems and platforms.

The plan aims to draw together the "diverse strands" of health IT into a coherent programme of work for the next five years. This will involve engaging clinicians and health workers, open engagement with health IT vendors and the certification of health systems to ensure information can be shared securely, the draft says.

Such systems need to support the long-term planning framework for health service design. Investment will be focused on a "small number of key projects" across DHBs, primary care and the Ministry of Health.

The plan favours an incremental approach, saying this can lead to transformational change. Investments that support the delivery of national services will receive priority. Consolidation to fewer system "instances", or installations, into regional platforms is also a feature.

The plan is due to be complete by 30 June.