Digital’s time to shine in NZ health reforms
The massive health reforms that will see the establishment of two new national organisations—Health NZ and the Māori Health Authority—is a fantastic opportunity for digital. That’s according to the man leading the charge, Ministry of Health deputy director-general for data and digital Shayne Hunter.
“It’s our time,” Hunter announced at a recent HiNZ Networking Event, run by Health Informatics New Zealand. “I don’t think we’ve had a such a major policy announcement in New Zealand where digital has featured,” he says.
The health reforms are due to kick off in July 2022, with the Transition Unit currently charged with getting all the digital (among other) ducks in a row. Hunter says data will be key, even more so than applications. “We have not got time to worry about getting onto a common payroll system, a common finance system, a common HR system, or a whole bunch of common platforms—we’ve got to focus on data. Focus on it from a performance oversight of the system point of view, but from a clinical point of view as well.”
He also noted that resilient technology platforms and dealing with legacy debt will be possible by “accelerating the move to the cloud”. And, as if all that weren’t enough to be getting on with, there is also “lifting our game on cybersecurity.” The latter is of particular concern given the recent cyberattacks suffered by the Waikato District Health Board, where Hunter noted that systems in the cloud came through relatively unscathed, and it has been the on-premises systems that suffered worst from the attacks.
Part of the focus on data will be working through issues around Māori Data Sovereignty, which Hunter says isn’t necessarily about resistance to moving to the public cloud but about ensuring the conversation takes place with Māori on what occurs with their data, and why.
Prevention and early diagnosis aided by digital approach
Emily Mailes, director of digital health at EY and lead policy advisor for the Transition Unit, also spoke at the HiNZ event, where she provided an insight into what a digital-first health approach can enable. “We’re inspired by the kinds of experiences that we think are going to happen sooner than we’ve expected before,” she told the audience.
She described the example of a young person with chronic illness who can avoid life-threatening episodes because they get notifications about pollution or other risk factors. Another example: The kaupapa Māori services that can provide targeted, preventative support to whanau because there is visibility of risk factors, including broader determinants of health. Likewise, an example for women, wherever they live in Aotearoa New Zealand: getting breast cancer diagnosis years earlier because their providers have access to the latest preventative diagnostic tools.
It sounds good—if they can get everyone working in the ‘ecosystem’, adhering to standards that are strong and aid interoperability. There is a lot riding on these reforms, and the Labour government will be looking for some quick wins ahead of the next general election in 2023. Hunter pointed out they will want to see those wins before 2022 is out. “They [politicians] will come in and they will put the pressure on, and fair enough. So, we’ve got to start now,” he says.
Hunter’s team has got a taste of tech reform at pace having led the government’s digital response to the COVID-19. Obviously this is ongoing, but during the most intense periods of last year’s lockdowns he noted the acceleration of digital services; for example, prior to COVID-19, e-prescriptions were at 32%, and now they’re at 90%.
Health informatics rebranded
Digital health sure is the sector to be in, and Hunter expressed the desire to hold onto the talent already working in both the public and private sectors, as well as recruiting in a few more with digital and data skills into the fold. Rebranding the sector might help drive up the numbers, and maybe that’s why the field previously known as ‘health informatics’ in New Zealand has been rebranded to ‘digital health’. The former moniker was apparently not “user-friendly” (although maybe don’t tell the folks at HiNZ!).
Chris Paton, who is course director for Otago University’s new online digital health postgraduate programmes, explains, “Over the last five years, everyone’s started to call it ‘digital health’ because it’s an easier way of talking about it. Most people understand what you mean when you say ‘digital health’.”
Just to be really clear, digital health encompasses both the administrative (electronic health records) and the innovative (artificial intelligence), Paton says.