HINZ 2009 CIO Panel

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Steve Rayner, Grant Taylor, Alex Wheatly, Phil Brimacombe
Regional DHB CIOs
(1/10/09, Forum, 1.30)

Published in: Health & Medicine
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HINZ 2009 CIO Panel

  1. 1. HINZ 2009 CIO PANEL
  2. 2. Outline of the session <ul><li>Introductions </li></ul><ul><li>State of the nation </li></ul><ul><li>DHB CIOs response to MRG Report </li></ul><ul><li>Questions and answers </li></ul>
  3. 3. State of the nation: health system NZ <ul><li>Organisationally, health care in NZ is a system construct not a single service </li></ul><ul><li>Hence 21 DHBs, 80+ PHOs, multitude of NGOs and so on, all separate entities and many of them having multiple components as well </li></ul><ul><li>For the system to work effectively in delivering services, all entities and components must mesh well, have complementary processes and a clear picture of the whole </li></ul><ul><li>In other words, appear like a corporate entity without being one </li></ul>
  4. 4. Where are we up to? <ul><li>Against that expectation, health information management in this system is significantly dysfunctional and e-health is largely immature </li></ul><ul><li>This is true in the face of basic requirements and even more so against rising expectations </li></ul><ul><li>We have no clear and common basis on which to plan or act systemically </li></ul><ul><li>Instead we beat the drums louder and think up more things that need to be done </li></ul>
  5. 5. Where are we up to? <ul><li>This is now a political issue for us all </li></ul><ul><li>We have fallen well behind the leaders and are failing our population </li></ul><ul><li>Having the NHI and 90% of GPs with computers is not now a compelling story </li></ul><ul><li>No breakthrough initiative in 15 years </li></ul><ul><li>OECD rating on electronic health records </li></ul>
  6. 6. Shaping our destiny <ul><li>We are about to be seriously shaken up; </li></ul><ul><li>Will we also be stirred up enough to make some major steps forward rather than stuck with years of unfinished business? </li></ul><ul><li>Regardless of resultant organisational form we need three key things, systemically: </li></ul><ul><ul><li>Leadership and cohesion across the sector </li></ul></ul><ul><ul><li>Directed, prioritised and focused effort </li></ul></ul><ul><ul><li>Policy, strategy and architecture </li></ul></ul>
  7. 7. Shaping our destiny some more.. <ul><li>None of the immediate things are new; they have all been mentioned today </li></ul><ul><ul><li>National architecture </li></ul></ul><ul><ul><li>Clear policy position and community understanding on privacy and information sharing </li></ul></ul><ul><ul><li>Core infrastructure – Connected Health and national Directory Services </li></ul></ul><ul><ul><li>Core patient records available to all providers </li></ul></ul><ul><ul><li>Good business case on e-everything done once, signed off, and a national plan for implementation </li></ul></ul><ul><ul><li>Prioritised approach to everything else </li></ul></ul>
  8. 8. And most of all <ul><li>Cohesion amongst the leadership </li></ul><ul><li>PowerPoint slides with common statements are not an agreed plan </li></ul><ul><li>Action and accountability </li></ul><ul><li>And remember, it’s a political matter. </li></ul>
  9. 9. DHB CIOs response to the Ministerial Review Group report.. <ul><li>Unanimous that the sector needs to make significant changes to meet the challenges </li></ul><ul><li>We strongly support the position expressed: “ Health professionals across the different institutional settings would find it much easier to provide seamless care if they shared easy access to a common patient record.” </li></ul><ul><li>This is the keystone statement on shared care and patient centricity. It should be the basis for the prioritisation of investment and implementation of initiatives that follow from it. </li></ul>
  10. 10. More response… <ul><li>We recommend work on a national architecture with local, regional, and national requirements be finished urgently </li></ul><ul><li>The basis of this work is the desired health care model and new models of care described in the report </li></ul><ul><li>Polarised debate on enterprise solutions vs. distributed interoperable systems is an unhelpful distraction to the main event </li></ul><ul><li>Practitioners are looking for an approach which addresses the solution continuum, especially when you think “enterprise” likely means ‘multi-provider’ and ‘regional’ solutions to support clinical networks </li></ul>
  11. 11. Yet more response… <ul><li>CIOs support the definition of a core patient summary record to support key clinical processes </li></ul><ul><li>Also support the focus on primary care systems, especially if this is progressed in the context of primary-secondary shared care and systems integration </li></ul><ul><li>It is important to understand that half of the ‘primary care related IT projects’ listed in the report are primary-secondary projects and can only be fully effective if undertaken in an integrated way </li></ul>
  12. 12. But wait, there’s more <ul><li>The report was largely quiet on the topic of business (clinical and delivery) processes and standards </li></ul><ul><li>Work on these across the health system are a necessary pre-requisite to implementing shared systems </li></ul>
  13. 13. Organisation restructuring <ul><li>Moving components like HealthPAC, national collections needs to be accompanied by rationalisation and clear delivery goals </li></ul><ul><li>Strong support for National Health IT Board and one common source of direction – this should be established urgently </li></ul><ul><li>Also support the integrated Investment Committee </li></ul>
  14. 14. Organisation restructuring <ul><li>National Health Board accountability should extend beyond the centre </li></ul><ul><li>A national shared services agency would be better placed as a subsidiary of the NHB </li></ul><ul><li>Need a more formal requirement for planning and provision of ICT shared services regionally </li></ul><ul><li>Essential for supporting regional service plans </li></ul><ul><li>Districts and providers participating in these will need to commit to shared systems as well as services to get clinical and commercial benefits </li></ul>
  15. 15. Clinical engagement <ul><li>And who could (would?) argue with the emphasis on clinical leadership and participation? </li></ul>
  16. 16. Questions from the conference <ul><li>The ones you asked beforehand </li></ul>
  17. 17. What you asked for… <ul><li>What is the strategy and practicalities of linking clinical to patient management systems across the primary, community and secondary care sectors to realise e-health as an enabler? </li></ul><ul><li>How does this work on an individual, regional and national basis? </li></ul>
  18. 18. Other things you asked… <ul><li>What is the CIO group’s view on IT as one of the “back office” functions mentioned in the Horn Report? </li></ul><ul><li>Specifically would CIOs support moves to consolidate ICT infrastructure on a shared services basis as recommended by the report? </li></ul>
  19. 19. And more… <ul><li>Assuming the recommendations of the Horn Report are adopted, what are the two most important steps you think we should take to speed up innovation and safe adoption of new technology? </li></ul><ul><li>What is the opinion of the CIOs to the Horn Report’s recommendation to concentrate only on PAS for Hospitals but develop integration with other provider systems? </li></ul>
  20. 20. And more… <ul><li>One recommendation from the report is for the implementation of a Consumer Health Portal. What role or participation and priority would this require from the DHBs and do the CIOs have an opinion with respect to ‘ownership’ of this capability? </li></ul>
  21. 21. And more… <ul><li>What are the main barriers to the implementation of national health information strategies in New Zealand and what will the CIOs do to make tangible progress over the next couple of year? </li></ul><ul><li>Where do you glean views for strategic direction? For example </li></ul>
  22. 22. And to conclude the questions… <ul><li>Where do you glean views for strategic direction? For example </li></ul><ul><ul><li>Analysts (Gartner et al) </li></ul></ul><ul><ul><li>Other CIOS </li></ul></ul><ul><ul><li>Colleagues </li></ul></ul><ul><ul><li>Influentials recognised by yourself </li></ul></ul><ul><ul><li>Influentials recognised by industry </li></ul></ul><ul><ul><li>Influentials recognised by clinical community </li></ul></ul><ul><ul><li>Industry vendor material </li></ul></ul><ul><ul><li>General experience </li></ul></ul><ul><ul><li>I do as I’m told </li></ul></ul>

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