Interesting article about the NZ health system, potentially may help ALC if they are one of the cloud/platform providers utilised...
https://www.pulseit.news/new-zealand-digital-health/fewer-better-platforms-and-national-scale-at-the-heart-of-nzs-data-and-digital-plans/?utm_source=Pulse%2BIT+-+eNewsletters&utm_campaign=4029a82790-PulseIT_eNews_23_08_2023&utm_medium=email&utm_term=0_-4029a82790-%5BLIST_EMAIL_ID%5D&goal=0_b39f06f53f-4029a82790-413265617&mc_cid=4029a82790&mc_eid=eeee4aadd4
Fewer, better platforms and national scale at the heart of NZ’s data and digital plans
23 August 2023
By Kate McDonald
Te Whatu Ora's director of strategy and investment for data and digital, Darren Douglass.
Te Whatu Ora – Health New Zealand plans to consolidate its health technology assets on fewer, better cloud-delivered platforms, look to scale existing technologies on a national rather than district level and even slow down or cease planned procurements as part of its data and digital strategy in the coming years.
A refresh to the national interoperability roadmap is also underway as part of Te Whatu Ora’s data and digital thinking in response to the Pae Ora (Healthy Futures) Bill that came into force last year.
The legislation saw the district health boards replaced with Health NZ and the establishment of Te Aka Whai Ora (Māori Health Authority) and a new public health agency, but it also set a vision for the New Zealand health system that achieves Pae Ora Healthy Futures for all New Zealanders.
This includes five system shifts, including reinforcing Treaty of Waitangi principles and obligations; ensuring that people have access to a comprehensive range of support in their local communities, which has led to the establishment of localities; equitable access to high quality emergency and specialist care; and empowering the workforce.
It also emphasised the need for digital services to be at the core of achieving system reform. According to Te Whatu Ora’s director of strategy and investment for data and digital, that has provided the organisation with the ability to set policy, to commission digital services and to contract commercially at scale in ways that couldn't be done under the devolved structure.
“Our strategy … is very much intending to use those levers,” Mr Douglass told the MedInfo conference in Sydney last month. “We haven't published a digital strategy yet, but we're pretty well advanced in our thinking of what the key components of a digital strategy are.
“New Zealanders I think are really good at innovating but we are pretty rubbish at scaling that innovation. So how do we make sure that we enable innovation, we ensure that innovation is aligned to our mission and the priorities we have? I talked about levers. We have commissioning, commercial and funding levers that we can and will use to ensure conformance to standards and minimum data and digital requirements. And that will accelerate the delivery of safe and effective services.
“And where we need to will apply policy and regulatory levers as well. As we start our journey, we will simply be using commissioning, funding and other incentives, but in time, if we need to move to a regulatory environment, then we were prepared to do that.”
DIGITAL AND DATA PILLARS
New Zealand published a national interoperability framework led by chief standards adviser Alastair Kenworthy and the Health Information Standards Organisation (HISO), in September 2020, which is now being refreshed.
Mr Douglass said the roadmap was built on the principle that we should not unreasonably block or hinder access to data. “Rght now in New Zealand, within our sector organisations and within our industry, we have lots of example of blocking and hindering access to data. New Zealanders need to have access to their own data. That's the journey we're on and we're improving.
“The idea that interoperability is a feature that we might choose to add needs to go away. It needs to be at the core of everything we do. We've been moving down this track and have delivered some some really useful capability in terms of FHIR infrastructure, in terms of terminology, services, in terms of driving standards adoption, but we will we will be accelerating this.”
Te Whatu Ora has also recently announced that Accenture will build the National Data Platform (NDP) to unify information previously held by numerous organisations such as district health boards.
Te Whatu Ora has also recently announced that Accenture will build the National Data Platform (NDP) to unify information previously held by numerous organisations such as district health boards. This platform is targeted at data for planning, insights and analytics rather than data for direct patient care but is one of the data and digital team’s big priorities for the next 12 to 18 months.
Mr Douglass said the platform would make data more accessible within Te Whatu Ora and out to the wider sector. “It also mitigates a lot of our technology debt, because today, a lot of our data is locked up in pretty ageing technology that you can't get access to,” he said. “This is a major modernisation drive as well.”
NZ also has a data and information strategy for health, developed by the manager for data governance Simon Ross.
“The data and information strategy for health really strongly focuses on effective data governance, focuses on Maori data sovereignty. It is about that security, privacy, trust, social licence aspect of information. Technology is great in that we can make information and data accessible and usable in ways that five years ago we couldn't, but our governance and our maturity are really lagging behind the technology. And that's a risk.”
AGILE PLATFORMS
Te Whatu Ora is also developing a strategy around platform and agile, targeting the numerous cloud platforms that are in use but which Mr Douglass said are not used consistently.
“Our strategy is to consolidate to fewer, better cloud delivered platforms that enable reuse and innovation in scaling, alongside continuing to invest in our cybersecurity capability and maturity,” he said.
“We will be making choices and decisions around the platforms we leverage and use and then driving those out. That allows us to pool our investment, enable collaboration, and also to start small and then innovate on top of that platform capability.
“That will also simplify the environment that we have. We're going to reduce complexity and standardise our systems and processes. We’ll leverage what we've got and will accelerate delivery of these digital services nationwide. That reduces cost of risk and accelerates release of value.
“Our discussions currently are that we are going to look to restrict technologies to no more than two technical solutions in any one domain in the short term, and in the longer term, we would be looking to move to nationwide strategic platforms where feasible.”
Mr Douglass said the digital and data team met weekly with chief data officer Leigh Donoghue to look at investment proposals. A number of plans that were proposing to go to market to look for solutions that already exist in other parts of the system have been put aside.
“We've stopped activity in order to focus on how do we scale up and leverage the tools that are there,” he said “Or if we go to market, how do we go to market at national scale, not a district or even regional scale.”
Corporate systems are also being looked at as part of the organisational change that has come with Pae Ora. Bringing 29 different organisations into one means it needs corporate systems and capabilities to support the change.
“Today we have 20 payroll systems. If you were to ask anyone how many people Te Whatu Ora employs, I can almost guarantee that we wouldn't know the answer to that, because that data is spread across multiple systems. There's a balance, we can consolidate our corporate systems and deliver absolutely nothing to get us closer to Pae Ora, but if we don't address that, then you have an organisation that just finds it really difficult to do the basics.”
KEY INITIATIVES
Driving conformance to a minimum set of data and digital requirements and standards is a key initiative, which will be supported by a move towards certification of applications and solutions, Mr Douglass said.
That means a balance between setting standards but also looking at the cost of complying. “We can't fund it all from the centre, but nor can we simply set the standard and expect the sector to get there without assistance.”
Other key initiatives are the national data platform and consolidating the fewer, better platforms. “We're looking at platform capability that can be leveraged by our organisations now into the sector. We are reducing complexity and variation and we're already stopping procurements.
“We're already looking at reuse of what we've got, and scaling it up. A good example is our national maternity platform and the roll-out that's been optional for district health boards. It's no longer optional.
“We will be strongly pushing the roll-out of that national maternity platform. One of the things that gives us as a national maternity spine, so a maternity record that will be accessible everywhere in the country.”
The Hira program to provide summary record data to consumers and their whanau and available to their care team is also a key initiative, as is the technology to support population health screening programs.
“Our national immunisation register is currently being deployed and there's a lot to build on from the COVID technology platforms around population health. So bowel screening, cervical, breast screening, a lot of investment going into those areas. And then there's about 300 other things that aren't on that list.”
