Plan for doctors to share medical records

The privacy commissioner is backing a $38 million plan in which patient information would be shared between every clinician in the lower North Island, but says patients should have the right to opt out.

Health boards say the shared system will give clinicians quicker information and reduce the risk of medication or treatment errors and will do away with "disparate, fragmented and in some cases obsolescent" information systems.

Under the plan, every clinician in the central region will gain access to medical information on every patient in the Capital & Coast, Hutt Valley, MidCentral, Hawke's Bay, Whanganui and Wairarapa district health boards by 2015.

The plan will cost $32.2 million in capital costs, plus a further $6m in internal DHB staff costs, and $16.5m in operating costs over the next five years.

It will be implemented by Technical Advisory Services, which is owned by the DHBs and governed by the boards' chief executive officers. The cost is split among the boards, with Capital & Coast paying the most, at $7.085m. Wairarapa DHB pays the least, at $3.9m.

A heads of agreement, due to be signed this month, will continue indefinitely unless any DHB decides to pull out after a review of the plan early next year.

Hawke's Bay DHB chief executive Kevin Snee said the plan put in place a system that many patients already thought existed.

People assumed clinicians everywhere could access their information, such as allergies and medical history.

"People may be surprised to know how limited the information [available to other boards] actually is."

Future plans would look at sharing information throughout all health boards and between primary and secondary health sectors, he said.

Privacy Commissioner Marie Shroff said "joined-up electronic health records are the way of the future", but added that, for an e-health system to work, patients and the health practitioners would need to know their privacy was assured.

"This includes building in proper privacy safeguards like making sure that only the appropriate people can access the information and that patients are fully informed about what's happening.

"In New Zealand we have very high levels of trust in our health professionals and everyone is working hard to keep it that way.

"But we can't afford to get it wrong – if people think the new IT system undermines their privacy and they refuse to engage with it, all the money that's been spent is down the drain."

Ideally, patients should have direct control over how their information was managed, for example by being able to opt out of systems, Ms Shroff said.

"We would expect patients to have that ability with the central region system. There's a lot of detail that still has to be worked out, though, before any system goes live, so we'll be keeping a close watch on how it goes."


The Central Region Information Systems Plan

Allows clinicians throughout the lower North Island to access a patient's care record.

This includes laboratory results and radiology reports.

Clinicians can be alerted to a patient's ongoing care and treatment regardless of where they are in the region.

A "problem list'' will list a patient's health problems such as medical, nursing and mental health diagnoses and allergies.

A "medication history form'' will show the medicines a patient has used.

A single shared radiology system will consolidate the six DHBs and avoid the need for an upgrade at Whanganui DHB and would support regionalisation of after-hours on call support.

The Dominion Post