Online health records available in 2014

Kiwis will be able to access an online record of their health by 2014 under a new national health information technology plan.

The electronic health records will contain a summarised history of a person's GP visits, specialist and hospital treatment, test results and prescriptions. The records will be shared among health professionals in an effort to improve the quality and continuity of healthcare.

The national IT plan has been drafted by the national health IT board, which earlier this year canned a project led by seven district health boards to buy a shared records system in favour of a national approach.

The board, comprised of clinicians, as well as technology experts, is charged with planning and funding national health IT services, after a ministerial report found services were fragmented and duplicated.

Board chairman Graeme Osborne says it is likely shared records will be rolled out for certain parts of the population first to test and prove the concept.

"It could be those people who have chronic illnesses who require multiple doctors ... or for the early years of someone's life, through pregnancy, birth, early childhood and adolescence."

District health boards will have two years to implement electronic referrals and discharges and set up four regional repositories into which patient data can be fed, in preparation for the launch of shared records.

GPs and primary health providers in the Hutt Valley and Northland already send electronic patient referrals to hospitals and Auckland GPs are about to start.

Hospitals have been sending electronic patient discharge summaries for about 10 years, but this is fragmented and the board is working with a group of clinicians to identify a national standard for these.

The regional repositories will be similar to Auckland's Testsafe system which holds laboratory results for the region's patients.

Clinical buy-in is essential if shared records are to succeed, so the board has opted to build on systems, such as e-referrals and Testsafe, that clinicians are already using, Mr Osborne says.

"If you don't build off what people are actually doing, you don't get good data. With a shared care record, you want to go and visit your GP, give them your national health index number and have them pull up a record that has your history, and they can trust the fact that they're looking at something of value."

The board is working alongside a shared services establishment board, which will set up an agency to provide back-office services and IT systems for New Zealand's 21 district health boards.

The agency's services and structure is yet to be decided, but it will likely consolidate the health boards' human resources and payroll systems, Mr Osborne says.

Ian McCrae, chief executive of Auckland firm Orion Health, a large health software supplier, says it is an "absurd waste to have 20 different payroll systems" and it makes sense to consolidate back-office systems.

The national health IT board needs to streamline drawn-out procurement processes and ensure Kiwi firms get a look-in when health boards go shopping for systems and technology to encourage innovation in New Zealand's health IT market, Mr McCrae says.

"New Zealand used to lead the world [in health IT], but unfortunately we've stopped and had a cup of tea for the past 10 years.

"The New Zealand health system is about the size of one hospital group in America but we have 20 different IT operations all struggling to get funding and with no money and no capacity to innovate."

Mr Osborne responds the board is talking to health vendors about the new model for health IT and will seek to improve procurement processes. Health boards may need to look overseas for software in the move to shared records, but "we do recognise we have very good solutions here in New Zealand".

The seven health boards launched the electronic health records project after a key vendor of patient and clinical systems said it would stop supporting them this year, but support has been extended until 2014.

The board is working with the health boards to identify suitable system replacements, Mr Osborne says. It will consult with the health sector and the public on the draft plan before finalising it in June.

- © Fairfax NZ News