The document summarizes discussions from several CIO forums around New Zealand. It discusses regional health information system initiatives and collaborations across multiple district health boards. Key areas of focus include standardizing systems, sharing clinical information, regional strategic planning, and leveraging existing infrastructure to improve health outcomes through integrated care. Challenges mentioned include reducing data fragmentation and bringing together primary and secondary clinicians.

1. CIO Open Forum Rotorua 30 October 2007

2. DHB Activity Northland Taranaki HawkesBay Whanganui MidCentral Wairarapa Hutt Cap. & Coast Nelson/Mal Canterbury Westcoast Sth Cant. Otago Southland Auckland hA Waikato Tairawhiti BoP Lakes AZ1 - network AZ2 - NHI AZ3 - HPI AZ4 – e-Pharms AZ5 – e-Labs AZ6 - Discharges AZ7 – Chronic AZ8 – e-Referrals AZ9 - NNPAC AZ10- Prim, Info AZ11 – Nat.Systems AZ12 - Anchoring

3. Northern Region DHBs Progress with HISNZ Action Zones Effecting Change for Better Health Outcomes HINZ – October 2007 Darren Manley – NDHB Johan Vendrig – ADHB Phil Brimacombe – WDHB, CMDHB & hA

4. Northern Region DHBs Focus Collaboration to reduce complexity & cost Sharing of Clinical Information to improve outcomes Standardisation of Corporate Information to improve performance Regional IS Strategic Plan Auckland Regional ISSP 2004 Northland joining in 2008 Review District, rather than Provider focus

5. Key Regional Activities (including HISNZ Action Zones) Regional Privacy Advisory Group for alignment of Privacy & Security Diagnostic repository since 2004 ADHB, CMDHB & WDHB Labs reporting and sign-off Community lab reporting GP access to TestSafe (October 2007) Regional Community Pharmacy Dispensing Record (2008) Connectivity PHO uptake of broadband driven by Predict CDV & Regional Pharmacy Dispensing Record Health Intranet, Healthlink & Dedicated lines

6. Key Regional Activities (continued) (including HISNZ Action Zones) CV & D risk assessments via Predict in all of Auckland Region Single Auckland Regional Mental Health Information System Planning eReferrals phased approach – leverage Hutt Valley experience Continued focus on improvement of NHI Quality Use of HPI in regional GP portal (used for TestSafe repository) Regional Clinician Order Entry Strategy Discharge Summaries well established – focus on quality improvement Selection of a Regional Public Health Information System Progressing outpatient & primary care data collections Regional alignment of corporate information taxonomy & policy

7. Effecting Change for Better Health Outcomes Key Challenges/Opportunities Security is an enabler of information sharing not a barrier Reduce fragmentation of data & systems (national and regional) Patient participation E.g. Health IT cluster pilot with Patient Portal in Auckland (Procare/MedTech/SIMPL) Bring Primary & Secondary clinicians together to drive integrated care Bring CMO and CFO (Service Managers) together to drive clinical and financial outcomes in partnership.

8. Effecting Change for Better Health Outcomes Linking Clinical and Financial outcomes Real time data is used to inform clinicians/staff at the point of care Cross Boundary – the above not hindered by organisational boundaries

9. Midland Region Chief Information Officers Effecting Change for Better Health Outcomes through Collaboration 30 th October 2007

10. Bay of Plenty DHB – Owen Wallace Lakes DHB – Alex Wheatley Tairawhiti DHB – Harry Barber Taranaki DHB – Darren Douglass Waikato DHB – Alan Grainer Midland DHBs

11. Collaboration underpins the regional approach A culture of collaboration exists Multi-DHB up to region-wide Based on alignment of local priorities, budgets, opportunities Midland CIO group is well established. Links to: General Managers, Planning and Funding Regional Planner Primary Care groups Generic collaboration framework Regional Collaboration principles Collaboration

12. Regional ISSP National Health and Disability Strategies Health Information Strategy IS Vision Improved population health outcomes through the provision of timely integrated information Integrated Shared Information Support for regional business strategies Maximise investment, mitigate risks, share developments IS Strategies Regional Strategic Outcomes IS Goals

13. Systems Convergence A key strategy is convergence of systems Incrementally, “opt-in” Cost savings through economies of scale Common contracts, simplified vendor engagement Hosted infrastructure where appropriate

14. Clinical Workstation (aligns with AZs 6 and 8) Standardisation on the Healthviews product Midland Development Group established to own operation of the clinical workstation standard and provide effective vendor engagement Patient Management System Standardisation on the iPM product Implemented in Waikato DHB Strategic RFI issued and evaluated Human Resources/Payroll Joint procurement and standardisation on Northgate Payroll Telecommunications (Aligns with AZ 1) Regional negotiation with mobile telecommunications supplier Regional negotiation and standardisation on data network provider Delivered cost savings Financials Joint procurement and implementation of hosted Oracle Financials system at Waikato and Bay of Plenty DHBs Regional Successes - Completed

15. Patient Management System Implementation of iPM in progress at Lakes and Tairawhiti DHBs Telecommunications (Aligns with AZ 1) Waikato DHB to issue telecommunications RFP Implementation of regional data network provider Defining regional requirements across primary and secondary stakeholders Digital Radiology Joint procurement and implementation of PACS/RIS at Waikato and Bay of Plenty DHBs Clinical Data Repository (Aligns with AZ 5) Implementation of Healthviews at Lakes, Waikato and Tairawhiti DHBs Regional Successes – In progress

16. Thank You

17. Mainland DHBs and HIS-NZ Canterbury, Chris Dever Otago/Southland, Grant Taylor West Coast, Wayne Champion South Canterbury, Russell Standeven Nelson Marlborough, Nick Lanigan

18. Key Focus Interoperability, rather than convergence on specific systems Leveraging existing infrastructure and scale

19. HIS-NZ Discharge summaries being issued by all to vary degrees Otago DHB running ePharmacy pilot in hospital CDHB éclair will form basis of eLabs for some DHBs

20. HIS-NZ Network in place across South Island, including some non DHB members Radiology, Labs available All clinical systems to be made available Link to CCDHB to be in place shortly Various initiatives connecting primary underway

21. HIS-NZ All DHBs watching pilots closely Very keen to not re-invent the wheel

22. HINZ Forum & Exhibition 2007 Rotorua Central Region Distict Health Boards

23. RollCall of the guilty (District Health Board CIOs) Hawkes Bay – Jo-Ann Jacobson MidCentral – B1 & B2 (Bananas in Pyjamas) Whanganui – Steve Rayner Wairarapa – Gary Ireland Hutt Valley – Tony Cooke Capital & Coast – Peter Satterthwaite Central Region Technical Advisory Services – Zoran Bolevich HiQ – Pat McShane MidCentral – Barry Morris & Brian Woolley

24. The unsung heros PHOs MSOs NGOs GPs Iwi Services Pacific Island Services Rest Homes Pharmacies Traditional Healers Voluntary Organisations Church Based Organisations Local Interest Groups Private Sector Physios Osteopaths Optometrists Social Services

25. The unsung heros PHOs MSOs NGOs GPs Iwi Services Pacific Island Services Rest Homes Pharmacies Traditional Healers Voluntary Organisations Church Based Organisations Local Interest Groups Private Sector Physios Osteopaths Optometrists Social Services Our Patients and their Whanau

26. Effecting Change for Better health Outcomes Regional Initiatives Local (District) Initiatives

27. Central Region Initiatives Premises Individually we cannot do everything Collectively we can achieve anything Issues Tradition Parochialism Tribalism Promises First Class service Delivered by our first class clinicians Timely manner Accessible to the patient

28. Central Region Initiatives Central Region Clinical Services Plan Cardiology Services Plastics, Burns and Cranio-Maxillo-Facial Renal Regional Cancer Network Long term Conditions & Chronic Care Management Regional Workforce Regional Information Infrastructure

29. Central Region Initiatives Regional Information Infrastructure Blueprint for a Regional Electronic Health Record Based on the Canadian implementation The same model can be applied to District, Regional or National Seamless delivery of clinical information where required Work in progress Two schools of thought – regional database or a messsaging solution.

30. Local or District Initiatives (Examples from a very long list) General Practitioners with Special Interest (Hawkes Bay) E-Referrals (Hutt Valley) Management of Diabetes (Whanganui)

31. Local or District Initiatives Management of Diabetes (Whanganui) Unique in that PHO holds contract PHO manages patients on behalf of GPs Hospital is a sub-contractor to PHO