Kathy Farndon discusses New Zealand's vision for electronic health records by 2014. The vision is for New Zealanders to have a core set of personal health information available electronically to them and their treatment providers regardless of setting. This will enable high quality, integrated healthcare and improve patient safety. Specifically, it will allow people to access test results, receive messages from providers, use tele-monitoring, access health information and reminders, and see care recommendations from all providers for more open communication and coordinated care. Realizing this vision will require collaboration between clinical and IT professionals, leadership investing in suitable IT solutions, and enabling the role of the National Health IT Board.

1. What’s on the horizon for NZ beyond 2014?
Kathy Farndon, Health Information Solutions and Standards.

2. Enabling an Integrated Healthcare Model
eHealth Vision
To achieve high quality health care and improve patient safety, by 2014 New Zealanders
will have a core set of personal health information available electronically to them and
their treatment providers regardless of the setting as they access health services.

3. Shared care (KF personal view)
I would like:
• to be able to access my latest test results
• my GP to be able to leave me a message to contact him/her if they are concerned
• To be able to use tele-monitoring if I had a condition where that would be of help
• to have access to helpful health information/links to useful sites
• receive reminders
• be able to see what my other carers are recommending i.e. community
nurses, specialist visits basically open/transparent communication from people
involved in my health care.
• Ability to make personal health notes and reminders

4. KF thoughts on an ideal record
Health info
Select All
info
Moderate and
relevant info
Some
All information Few

5. Shared health information
-You will be able to log on to a
computer and see your core
health information
–View a set of alerts and
allergies relevant to your
health
–You won’t always have to
repeat your medical history
when you see someone new, or
have test repeated
–Better and safer care will be
provided

6. The Destination is:
Person-Centred, Integrated Care
Clinical and IT Professionals in co-production
Leaders of health organisations have confidence
to invest in health IT solutions that fit into the
wider eco-system
The role of the National Health IT Board is to enable (the above)

7. Clinical Integration
 Long term conditions
 Wrap around services for older people
 Urgent and unplanned care
 Maternity and child services
 Integrated family health centres
Patient centric care:
Needs good reliable IT systems and infrastructure, clinical leaders developing
strong clinical networks, clinical change leaders, regional
cohesiveness, primary/secondary/tertiary all working together.

8. Cardiac health
Patient
Best clinical outcomes
Cardiac Clinical network
Cardiologists
Cardiac interventionalists Cardio-thoracic surgeons

9. • Urgent and Unplanned care
- Acute Coronary Syndrome (ACS)
• Child and maternity
- Congenital conditions affecting paediatrics
- Maternity cardiac health
• Long term conditions
- Rheumatic heart disease, CVD, Diabetes etc.,
• Wrap around services for older adults
- many patients are in the autumn/winter of their lives.

10. Challenges and things to consider – this is not a comprehensive list
• Portals - design, standardisation?
• Interoperability - be populated with relevant info
• Authentication and delegation levels for access
• Privacy concerns – access, and limited viewing rights
• Data storage – format?
• Image storage – format?
• System upgrades and subsequent migration of data to be viewable by
existing systems
• ?????????? There will be many more.

11. No-one has all the answers or can solve it on their own
There needs to be much more collaboration between
primary, secondary, tertiary and community health,
A more holistic view of health - including housing, education etc., rather than
the current focus on episodic illness events
Vendors will probably need to work in partnership to be able to deliver on some
of the projects that will evolve.
There will be a need for skilled change management, particularly clinical
Care must be patient centric and they must be included in the design of services
and solutions
Focus must include continuous quality improvement.

12. Thank you.
Kathy Farndon. 21st June 2012