Nelson Marlborough District Health Board CEO John Peters says a collaboration between up to 10 DHBs to procure new, shared electronic health management systems is a natural extension of other forms of health collaboration.
Peters says DHBs already collaborate in many areas, with examples such as professional employment contracts now being standardised across the sector and the buying of drugs through Pharmac. He says Nelson Marlborough is also addressing other types of software in a similar way, cooperating with other DHBs to replace its financial management information system.
"It's not seen as out of the ordinary in terms of the things we do," he says.
Peters concedes such an approach impacts on some of the providers who currently provide patient management systems to individual DHBs. However, he adds it also offers them a "wonderful opportunity" to build on what they have already done.
Peters, who used to be managing director of IT providers ICL and Fujitsu, says a recent request for information (RFI) for the shared platform, issued by seven DHBs and called the Health Management System Collaborative (HMSC), was purely to look at the options in the market.
Up to three additional DHBs may join the effort at a later date, Peters says, meaning nearly half of the 21 DHBs could be on the same software platform.
The idea that this would lead to the development of a monolithic system rather than a best-of-breed approach is a misconception. He says there will be a range of responses from monolithic to best-of-breed and there is no preconception among the DHBs about what will suit their purposes.
"What we are looking for is functionality, not the shape of the solution."
DHB executives have been studying overseas examples in places like Denmark, the UK and the US.
He says the fact that the Ministry of Health is currently reviewing this country's health IT strategy is complementary to the HMSC's efforts.
Peters says the New Zealand health system architecture has been partially addressed by 12 Action Zones developed by HISAC, the Health Information Strategy Advisory Committee, a few years ago. However, this addresses the infrastructure layer and less work has been done at the application layer.
His comments come in response to an exchange of letters between the HMC and a group representing Health IT vendors, The Health IT Cluster. In mid-February, the cluster expressed concerns about the HMSC's plans, warning against a "monolithic" approach.
On March 5, the HMSC responded, asking for its views to be transmitted to the same audience that received the cluster's letter.
The letter, written by Simpl consultant Joanne Wakelin and copied to HMSC member and the Ministry of Health, says individual tender efforts undertaken by the DHBs had failed to elicit the kinds of "innovative and collaborative responses" received from local vendors through the current RFI process.
The letter states RFI is an "essential information and learning phase" ahead of a formal tender. It says the ministry feels the HMSC's vision is appropriate and the fact the RFI is in the market while the ministry is updating New Zealand's health IT strategy, one of the issues raised in the cluster's letter, is "complementary rather than contradictory".
The letter then warned that vendors wishing to participate must do so through the RFI process and the HMSC will not engage with them, or the cluster, regarding the RFI outside of that process.
The letter concludes by saying the HMSC effort is a potential "tipping point", which could result in dramatic improvements in health care delivery and outcomes.
The health boards involved in the HMSC are Canterbury, Nelson Marlborough, South Canterbury, MidCentral, Wairarapa, Whanganui and Northland.