Health data access delayed

The health service may not achieve the Government's goal of letting everyone access their health information online by the end of next year, experts say.

The objective was the cornerstone of a national health information technology plan agreed by the Government in 2010.

By the end of next year all New Zealanders should have been able to access a summarised history of their GP visits, specialist and hospital treatment, test results and prescriptions online.

National Health IT Board chairman Murray Milner said most of the "building blocks" had been put in place. These included a revamped basic database containing people's National Health Index (NHI) numbers, their demographic details and details of any allergies or "alerts" that were held at a national level.

But Milner said "getting universal adoption across the health system" of electronic health records was "going to be a challenge over the next 12 months, there is no question about that".

Ian McCrae, the chief executive of New Zealand's largest software exporter, Orion Health, said that in order to complete the job next year, DHBs would probably need to be starting the roll-out now.

The theory behind establishing a system of electronic health records was that by giving people access to their health information, they would become more engaged in "self-care" and could become more confident that different parts of the health system were looking at the same information about them, Milner said.

"Put sunshine on that information and all of a sudden the quality of that information lifts."

National Health IT Board director Graeme Osborne said the use of health information was improving. Progress included a new system which went live on July 1 that ensured that when people changed their address everyone in the health sector was alerted. That had had the spin-off of helping lift immunisation rates, he said.

The primary care records of 20,000 people each month were being transferred electronically when they changed GPs making it more likely that people would have "comprehensive primary care information right through their lifetimes".

GPs in 16 district health board zones were using electronic systems to book their patients appointments with hospital specialists, up from just one a few years ago, he said.

Milner said the new NHI database, which was built by IBM and went live in August, had greatly reduced but not eliminated the problem that some people had duplicated records, with versions that might not be complete.

In general, when it came to the use of IT in the health system, there were countries that were doing things better than New Zealand, and "lots of countries that are doing worse than us", he said.

McCrae said New Zealand "absolutely led the world in 2000" but was "perhaps not keeping up" because of large investments that were being made overseas.

Other countries would ultimately emerge with very sophisticated health information systems and electronic health records that could be accessed from mobiles and integrated with genomic information, he said.

Healthcare was on the cusp of an information revolution, driven by "big data" that would see all patients receive customised treatment plans suggested by computer software and which were based on their demographics, health history and genetics, he believed.

But that would require the sector collected better information on the outcome of treatments, he said. "If you want to mathematically optimise the system, you have got to know what the treatments were and what the outcome was."

Influential Harvard University academic Michael Porter has estimated such an approach could generate efficiencies of 30 to 35 per cent in healthcare spending, for example by cutting unwarranted tests. "In the New Zealand context you are talking about a $5 billion wastage," McCrae said.

Fairfax Media