THE ‘MEANINGFUL USE’
OF INFORMATION TECHNOLOGY IN HEALTHCARE
S
IN NEW ZEALAND
Thomas Bowden
CEO, HealthLink Ltd
The views expressed in this paper do not
necessarily reflect the official position of the
New Zealand government. Government officials
have been consulted extensively during the
preparation of this paper. The presenter is not an
official spokesperson.
IF New Zealand was a US state…
24
25
26
27
28
South Carolina
Louisiana
Kentucky
New Zealand
Oregon
Oklahoma
4,479,800
4,410,796
4,269,245
4,173,460
3,790,060
3,642,361
An environment that works
collaboratively...
 Many IT vendors
 Three Health-system Integrators
 A strong industry association
 Government leadership/sponsorship
 Vigorous experimentation and debate
= a Learning Environment
Key Aims
 Support efficient primary care
 Automate routine processes
 Building on existing functionality
 Good working relationships
..... We have a clear health reform strategy
Development ofMultiple
New specialised
Zealand’s
chronic care services
Electronic Health Records System
1993-2012
Hospitals
Online Referrals
Referrals
A
Status
L
Reports
L
On-Line
1100 General Practices
H Discharge Queries
O Summaries-Hospital
S
Practice Support Systems
-Specialist
P
I
-Pharmacy
T
A
ORDER ENTRY
L
D
-Pharmacy
EMR Access
O
-Laboratory
C
Electronic
Messaging Services (50
U million messages
Patient Connection to GP
-Radiology
M
4.5 million patients
Any authorized provider E
may send a structured N
T
online query to any
S
EMR system
NB: This is still a work in progress…
Specialists
Ancillary
Professionals
Pharmacies
per annum)
Radiology
Services
Laboratory
Services
4000000
3500000
3000000
2500000
2000000
1500000
1000000
-500000
199909
199912
200003
200006
200009
200012
200103
200106
200109
200112
200203
200206
200209
200212
200303
200306
200309
200312
200403
200406
200409
200412
200503
200506
200509
200512
200603
200606
200609
200612
200703
200706
200709
200712
200803
200806
200809
200812
200903
200906
200909
Electronic Clinical Transactions
(Per Month)
5000000
4500000
1
0
0
%
E
M
R
U
p
t
a
k
e
National Child
Immunisation
Register
Total Messages
500000
0
Number of electronic partners
(monthly average per general practice)
60
1
0
0
%
E
M
R
U
P
T
A
K
E
50
40
30
20
10
0
Aug-99
Aug-00
Aug-01
Aug-02
Aug-03
Aug-04
Aug-05
Aug-06
Aug-07
Aug-08
Aug-09
Aug-10
Number of electronic partners
(monthly average per general practice)
60
1
0
0
%
E
M
R
U
P
T
A
K
E
50
40
30
20
10
0
Aug-99
Aug-00
Aug-01
Aug-02
Aug-03
Aug-04
Aug-05
Aug-06
Aug-07
Aug-08
Aug-09
Aug-10
Building clinical messaging applications
E
A
S
E
V
A
L
U
E
Our Views on...
.
Incentives and regulatory requirements to promote
implementation?
Incentives? As long as they are aligned with the overall drivers,
Regulatory requirements? Clear cut but light handed.
·
Vender certification and technical assistance?
Light handed certification and encouraging development of a
market for technical assistance.
·
Strategies for national standards and interoperability?
Clear easy to implement standards, gradually lifting the bar,
An environment that makes interoperability desirable.
.
The role of a national health integrator?
Why not open it up to anyone that can chin the bar?
·
Privacy and confidentiality safeguards?
It is absolutely critical to have a strong underpinning
understanding of privacy and the fundamental importance of
privacy to the human condition.
·
Use of public/private partnerships to support innovation?
PPPs are a low-risk way of enabling specialised/core bits of
infrastructure to be delivered efficiently and in a disciplined,
well controlled manner.
Ideally innovation is encouraged not contracted for
CURRENT FOCUS
 Electronic Referrals – online submission of
very detailed information directly into a
hospital’s electronic medical record system
 Emergency room access to GPs’ EMRs
– immediate, complete and up-to-date
information
 Gradually pushing the agenda forward
THANK-YOU
tom.bowden@healthlink.net