eHealth New Zealand: 2022 Year in Review

Ryl Jensen, chief executive of the Digital Health Association (DHA), said the Future Health Index (FHI) report highlighted that “Covid-19 gave us a different worldview and changed the playing field for digital health”.

“The report highlights what is top of mind for health leaders across Australia and I would argue those same things are top of mind for our health leaders here too,” she said.

Jensen said digital health solutions can help achieve more equitable health outcomes, provide greater continuity of care, better patient experiences and efficiencies for the health workforce.

“This will be through scaling and adapting Covid-19 developed solutions, improving interoperability through programs like Hira, and improving digital access in rural and primary care settings,” said Jensen.

Key barriers, also highlighted in the report, include workforce shortages in the digital health sector, and operational data silos that hinder the ability to share and use data.

“Innovation and partnerships across the health sector are really important to enable the use of data to unleash the power of predictive analytics and provide better patient experiences, improving population health and reducing the cost of care,” she told the webinar attendees.

Alastair Kenworthy, chief standards advisor, data and digital at Te Whatu Ora, and chair of the Health Information Standards Organisation (HISO), said the report highlighted the rate of investment globally in artificial intelligence, and in the quality of digital health records.

“If we have high quality digital health records then it is possible to use this data to do things like; calculate a person's personal health risk score, choose the best pathway for them, drive clinical workflows, and fuel predictive analytics, which is a big theme of the report,” he said.

Kenworthy said the health system is held back by a lack of standardised data and interoperability and these areas need focus going forward.

“Standards and interoperability can contribute to a simpler, more unified and fairer health system,” he said.

“But diversity and innovation are also important to us, so we need to use standards with a light touch and seek just enough uniformity to achieve those goals.”

HL7 FHIR for APIs and SNOMED CT for clinical terminology, are New Zealand’s principal standards for interoperability around personal health information and the standards team in Te Whatu Ora works in partnership with government agencies across the world.

“Industry here doesn't want to be developing products which only conform to local or proprietary standards, so our first choice for New Zealand is to pick standards that make sense internationally,” he said.

Becky George, clinical director, data and digital - Hira, Te Whatu Ora, picked up on three themes from the report; equity of access, digital enablement and workforce needs.

George spoke about the need for informed consumers and health practitioners to work in partnership.

“We're offering a service, but we can't offer an effective service to a passive recipient. We need to have a much more active and dynamic relationship, and it improves the outcomes for consumers when that happens,” she said.

“We can't perpetuate and increase inequities by wanting to go forward and race ahead with technology development. We have to balance that with digital enablement in order to level the playing field, because otherwise we're just going to create and perpetuate that divide.”

Erin Currie, country manager, Philips, said the pandemic exposed challenges associated with the accessibility, availability, and adequacy of care, especially for underserved populations such as Māori and Pacifika communities, aged care, people with disabilities and mental health challenges.

“Patients in underserved communities may struggle to get the most out of digital health technology due to issues with poor internet access or lower digital literacy,” she said.

“To prevent a growing digital divide, we believe digital transformation should take an inclusive approach that promotes access to care for all – no matter where patients live.”

George said health professionals need access to the right information in the right place at the right time, and reiterated that data standards are key as they enable the exchange of health information.

However, the digital capability of the health workforce is similar to that of consumers and both groups need to be upskilled in this key area.

“We need to enable and empower our workforce: it is crucial that we start looking at tools and research to underpin how we meet the needs of our workforce in order to improve their confidence and their competence,” she said.

Jensen agreed that lack of digital literacy amongst staff can be a major barrier to technology adoption in health.

She added that the DHA produced a report in 2021 that recommended the creation of a Digital Health Academy to enable online learning in digital tools and technologies.

George also said there is an increasing emphasis on clinical value and the contribution of clinical informatics at a more national level, as well as partnerships with industry.

“Our contribution adds value, and we can support our industry partners in developing fantastic products and fantastic solutions, because this is about mutual benefit and advantage,” she said.

Digital uplift is a key priority in New Zealand’s interim Health Plan – Te Pae Tata which highlights the need to develop greater use of digital services to provide more care in people’s homes and communities.

Currie said the restructuring of the health sector is a positive step towards a more seamless and integrated health system in New Zealand.

“There is a unique opportunity to embed the digital, data-driven practices we’ve gained throughout the Covid-19 crisis into everyday healthcare operations, and to rethink how and where care is delivered,” she said.

Currie added that despite the rapid rise of virtual care and increased data sharing in the wake of Covid-19, digital transformation of healthcare across the globe has been piecemeal so far.

“Healthcare systems need to overcome several barriers to move from pockets of digital innovation to a sustained and integrated approach to digital transformation,” she said.

Jensen agreed that New Zealand’s interim health plan and health system reforms provide a huge opportunity to reset the current landscape.

“We have the chance to provide a more streamlined and efficient way of working in a far better more continuous patient experience,” she told webinar attendees.

“I would really like to see innovation in the digital health space championed here in New Zealand. We have a lot of really amazing products and I would like to see how we build out ecosystems and enable them to move forward.”

Kenworthy said New Zealand has some world-leading innovation, and the country has all the conditions to rapidly scale nationally.

“The opportunities here are as big as anywhere else in the world, so to any New Zealand health provider, or industry partners who are only thinking about serving the local market, I say embrace the standards and go for it,” he said.

At the conclusion of the webinar, each panelist was asked to briefly describe what they see as the key achievement in digital health in New Zealand in 2022.

Kenworthy said it was the launch of the New Zealand Health Terminology Service.

“Please register with us as a user, as it will provide access to all our standard terminologies and code sets. We have also stood up a New Zealand FHIR registry, so be a user of that too,” he told attendees.

George said the Te Whatu Ora Hira clinical team has created a draft Digital Clinical Governance Framework, and that is “really going to enable and empower our workforce to step into the space of co-design and co-implementation.”

Currie said Philips have made a significant impact on service delivery for hospitals.

She gave the example of a virtual ICU in Western Australia, which is monitoring patients using technology and has team members on the other side of the world working the night shift, allowing greater use of available resources to delivery high quality care.

Jensen said: “I'm thrilled that digital health is one of the six key priorities of Te Pae Tata and we need to all embrace it as that recognition has not always been there in the past.

“I want to see innovation moving forward, as it is one thing to say it, but now we have got to deliver it.”

Watch the 2022 Year in Review webinar here.