Forum: Opportunities go begging as DHBs reinvent the wheel

What, if anything, will the budget deliver for health sector transformation?

Health Minister David Cunliffe has hinted at major changes in the way ICT delivers to the health sector.

In an address to a health leadership forum on May 1, he said it was time to change the way the Ministry of Health operated within the broader sector, that it should move to a stronger role of central leadership and, rather than being primarily the minister’s advisor, it should be the government’s leading agent of change within the system.

The speech was long on rhetoric and short on specifics but of particular note was Cunliffe’s reference to ICT. To quote:

“Long-term productivity and quality gains depend crucially on improved flows of clinical operational information between providers. Relevant clinical information should follow the patient wherever possible to facilitate seamless interaction along the patient care journey.

“DHBs must be networked with high-speed connectivity and interoperability to enable the sharing of data and the benefits of telemedicine. Achieving these gains will require a long-term and centrally coordinated approached to investment in information and communications systems.”

Computerworld approached the minister’s office for clarification, but this was not available due to a certain event at the end of the month: the Budget.

The logical next step would be to bring either the Government Shared Network or the Advanced Network {KAREN} into play. But, last year, the ministry bemused the industry by entering into discussions for the provision of a health shared network. A sector-only network was wanted, largely because of health privacy issues.

Why, the industry thought, the need for a third network when either GSN or KAREN could do the job?

GSN links government agencies with high-speed internet and telecommunications services. KAREN does similar thing but for the research and education sectors. There is high-level security fabric over the network, at least with GSN, provided in consultation with GCSB. That would seem to address those privacy issues.

It’s widely accepted that IT infrastructure at some DHBs is desperately in need of a refresh. Couple that with the fact that sharing applications and information between DHBs makes sense.

Why, for example, does New Zealand need individual patient management systems for each of its 21 DHBs?

Coming back to Cunliffe’s statement that DHBs must be networked with high-speed connectivity, the answer seems obvious.

Late last year, HealthLink chief executive Tom Bowden was scathing of the ministry’s approach to delivery and called for public-private partnerships to increase efficiencies.

He talked of a system in which wheels are being reinvented on a daily basis, and suggested that it would be good to see some of the best DHB systems scaled up and used nationally.

A study commissioned last year by the Australian National e-Health Transition Authority estimated that Australia could save around A$2 billion annually though automating its healthcare information. Bowden estimates savings of $350-400 million annually in New Zealand by taking a similar approach.

Cunliffe, as joint ICT and Health minister, is in a unique position to understand the opportunities and pitfalls. We await the Budget with interest.

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