Individual Healthcare Identifier (IHI) is little used outside of scant interactions with the PCEHR. New Zealand does like to boast that competition for scarce health dollars means that only projects likely to succeed get off the ground, with interactions between government and the relatively small group of clinical software vendors seemingly more collaborative, although I’m sure goodwill on both sides of the fence is periodically tested. The almost universal market adoption of a single secure messaging solution in New Zealand has facilitated the transmission of a broader range of electronic clinical messages than occurs in any significant volume in Australia, allowing for closer integration between primary and secondary care. Unfortunately, despite the tens of millions of dollars and years of effort that have been expended trying to make secure messaging interconnectivity between competing vendors in Australia a reality, the fruits of this effort are yet to be realised. There are several projects that New Zealand has managed to successfully implement that stand out to this Australian author, with comparisons to current eHealth activity on the west side of the Tasman able to be drawn. The first is the TestSafe system first implemented at Auckland’s Middlemore Hospital, which over the years has become a clinical data repository for lab results, diagnostic images, medications, clinical documents and electronic orders. It is accessible to authorised hospital clinicians and to individual patients’ GPs, and consumer access is on the cards too. TestSafe is in use in the three Auckland DHBs, is rolling out in Northland, and a TestSafe South system has been set up in Canterbury to act as a single repository for the whole South Island.
“New Zealand does like to boast that competition for scarce health dollars means that only projects likely to succeed get off the ground.” Simon James
Another project is the National Health IT Board’s Shared Care Program, variations of which exist in Auckland and Canterbury, which provide access to a shared record for clinicians caring for patients with chronic illnesses. There is also GP2GP, which has developed technology to allow a patient’s electronic medical record to be transferred quickly and easily to a new practice when the patient moves or swaps providers.
target is likely to take longer to realise. With this in mind the government has recently offered up some money to help with the roll-out, but the cost per practice of implementing portals, both financially and in terms of disrupted workflow, means it might have to come up with some more, or do a better job of selling the associated benefits of such portals to the reluctant providers.
Perhaps it is only in the area of telehealth that New Zealand lags Australia – at least in terms of the number of pilot projects – but even that is changing. While New Zealand certainly does not suffer the extremes of remoteness that its bigger cousin does, there are areas where telehealth can help improve access to care for people living outside of the major metropolitan cities and in underpopulated areas, particularly in Northland, the west coast of the South Island and the Bay of Plenty.
In this issue of Pulse+IT, we take a look at progress in some of those projects. We talk to Sue Wells, a lecturer at the University of Auckland and former GP who is helping to guide the introduction of patient portals, as well as the team from Patients First, which has released a briefing paper on current availability and barriers to implementation of the technology.
While in Australia the ongoing topic of discussion is the personally controlled electronic health record (PCEHR), in New Zealand it is currently about providing patient portals directly to general practice clinical systems, an area where there is a great deal of disagreement and where the government might have to step in. The National Health IT Board would like to see patient portals offered by general practices to all New Zealanders by the end of the year, although at less than 25 per cent coverage as of this month, this ambitious
We also take a look at the Telehealth Demonstration Project, which is testing out how to link GPs with Maori health centres and visiting nurses in the East Cape of the North Island, and we talk to New Zealand’s highest profile health IT company, Orion Health. Back in Australia we are still consumed with interest over the federal government’s determination to introduce a GP co-pay. Fiercely opposed – in its present state at least – by the medical community, it also has consumers worried. Peter Brown from the Consumers eHealth Alliance explores not what it will cost the hip-pocket, but what it will cost to administer.
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