John Peters Nelson Marlborough DHB

1. THE H EALTH M ANAGEMENT S YSTEM C OLLABORATIVE Collaborating for the Nation’s Health … the 7 (10) DHBs

5. Issues for Health “ New Zealand is striving to … more efficient management of chronic conditions, the big clinical challenge of an ageing society …” “ ... to rationalise the hospital sector to assure its clinical viability” “… a need to improve efficiency incentives and information” “ hospital spending could be cut further, perhaps dramatically, by greater use of community services” “ Another concern is the sustainability of the health care service delivery model in the face of rising demands and looming health workforce shortages ” (OECD Economic Surveys : New Zealand 2009)

6. Issues for Health “ It is becoming generally accepted that continuing to deliver health care to New Zealanders using today’s model of care will, at best, become increasingly challenging and may, in due course, cease to be viable” (National Institute of Health Innovation 2008) “ We are reaching the limits of what we can achieve for chronic condition outcomes with a fragmented system” (NZ Ministry of Health 2008)

8. No Easy Answers “ When physicians use health information technology to its full potential, the result is fewer deaths, fewer complications, and lower health care costs” (Amarasingham, M.D; Powe, M.D)

9. And very few of which can be enabled by current ICT systems All of which represent major service transformation

10. “ ICT diffusion could help the clinical revolution by: i) managing fast-changing medical best practice in a centralised database made available to all doctors..” ii) allowing shared electronic records of patient information, so as to allow new models of patient-centred delivery that minimise error and duplication” (OECD Economic Surveys : New Zealand 2009)

11. There is an even bigger picture Health is a key component of individual, societal and national success “ Health costs will impact national competitiveness” (OECD) The challenge for health is no less than national success An efficient and effective ability to exchange of information is only a part of the answer – but it is an essential part

12. Health Management System Collaborative Vision is to establish an individual-centric health information management service by “ wrapping the Health Management System around the individual” ...... rather than the provider.

13. “ Individual decision making by 21 DHBs may be too fragmented to make rational and coherent capital allocation plans; more regional and national collaboration is called for.” (OECD Economic Surveys : New Zealand 2009)

15. A major transformation… source: MoH

17. HMSC - Procurement Drivers * - MidCentral, Wairarapa & Whanganui Time Frame Driver 2007/08 NMDHB & SCDHB - scope was for wider patient-centric vision than “traditional” hospital provider based PMS. Reluctance to “catch up to the back of the pack”. Issued RFI 2008 Central Region DHBs* Group – issued same RFI with same patient-centric vision (and had agreed on a common hosting approach.) 2008 NDHB commences planning for replacement of PMS and achieving wider vision for Northland. Dec 2008 HMSC formed, creating scale needed to attract new solutions / vendor thinking. Aggressive timeline for RFI and RFP

21. Strong Media & Industry Interest IT takes a back seat in shared health system evaluation Computerworld, 9 Apr 2009 DHB CEO backs collaboration on health software Computerworld, 3 Apr 2009 Better health services the goal The Nelson Mail, 7 Mar 2009 Health Collaborative reassures local vendors Computerworld, 7 Mar 2009 Patients to add to own health records Dominion Post, 3 Mar 2009 DHBs to develop shared records NZ Doctor, 25 Feb 2009 Health IT collaboration open to new members Computerworld, 21 Jan 2009

25. Challenges - Privacy Clearly still to be resolved However… Much of the necessary exchange happens now, with paper or fax based records NZ has good privacy laws in place – High principle, low regulation Recognises role of technology in information availability and that controlled sharing is critical to the economy

27. Challenges Existing New Zealand vendors feel threatened - or at least challenged No apology for that … NZ Health should not be behind the rest of the world Might have misread their customer’s need and vision? Instead - relish the opportunity… If vendors feel challenged, imagine what it feels like from here!

28. Instead of being challenged, we should seize an opportunity - for New Zealand, for the sector, for the vendors …but most of all for the health of the people of New Zealand, and the potential contribution to the country’s prosperity

30. Thank you

34. HMSC Governance Structure Chair – John Peters CEOs – Karen Roach, Julie Patterson, David Meates, Chris Fleming, Joy Cooper (Tracy Adamson), Stuart Wilson (for Murrray Georgel) Clinicians – CMAs Nigel Miller (CDHB) & Andre Nel (NMDHB) & Martin Wilson (Pegasus & CDHB) MoH – Alan Hesketh CIO – Nick Lanigan (NMDHB) Simpl – Bennett Medary OSC Chair - TBA