Published on the 10/12/2020 | Written by Heather Wright

While Bluetooth finally arrives for CovidTracer app…

New Zealand has a new weapon in the war against Covid, with the Ministry of Health implementing a fully digital, integrated Covid border control system.
The Border Net solution, which tracks new arrivals through their stay in managed isolation including testing, has been dubbed world-leading by some in the sector.

Michael Dreyer, Ministry of Health group manager national digital services, data and digital, told iStart Border Net is speeding up the processing of people returning to New Zealand at airports and into managed isolation or quarantine (MIQ) facilities, as well as the laboratory testing and health checks, and also ensuring that people are accurately matched with their test results through the use of the National Health Index, which provides them with a unique health identifier.

“Information is needed to give health professionals and government agencies confidence that the risk of Covid-19 entering the country is low.”

Knowing who is arriving, where they are staying, whether they have Covid-19 when they arrive or if they subsequently test positive for the virus, and identifying when they have medical clearance to leave a managed isolation or quarantine (MIQ) facility, is an essential part of managing the border and keeping New Zealanders safe, he notes.

“Information, held confidentially, relating to all parts of that journey, from the point of departure overseas to arrival in New Zealand and through to the end of a stay in MIQ, is needed to give health professionals and the government agencies involved in the pandemic response confidence that the risk of Covid-19 entering the country is low,” Dreyer says.

The Border Net system is part of the Ministry of Health’s National Contact Tracing System, built on Salesforce and Amazon Web Services with help from Deloitte, and extended in July to manage the risk of Covid-19 entering New Zealand via the borders.

It’s made up of a number of technology systems and services, including a new Border Clinical Management System (BCMS) currently rolling out to MIQ facilities.

Using the Indici patient management system, the BCMS links arrivals with their health information and will store health and wellbeing data – including non-Covid related clinical care and ePrescribing – for everyone in MIQ while also connecting with testing laboratories nationally.

Information collected on arrival at the border is fed through to the MIQ via the BCMS, enabling MIQ staff to verify the new arrival. The new arrivals are also provided with a National Health Index number barcode, which is presented whenever they are tested, ensuring verification of data is accurate. Nurses can can the NHI barcode via their mobile device to ensure patient identification. A completed swab is scanned, sending an eOrder off to the lab. When tests are processed the results are sent to the system confirming a test has been done. Negative results are sent, via test message, to the MIQ ‘guest’ while positive results are handled by the contact tracing team.

“One of the benefits will be the ability for guests to move between MIQ facilities (for example, if they test positive for Covid-19 and need to move to a quarantine facility) and having their confidential health information effectively move with them,” Dreyer says.

The BCMS system, which started going live in late November, extends beyond ensuring efficient monitoring of arrivals, however.

BCMS is integrated with the collection and testing of Covid-19 swabs, and includes electronic ordering, enabling the sharing of samples within the network of labs.

“This means that laboratories nearing the limits of their capacity to process samples will be able to easily allocate these to another laboratory, with a single national view of the data,” Dreyer says.

He says an extension of the lab electronic ordering function to include electronic ordering systems used by district health boards, community testing centres and GP orders is planned.

Border Net also includes the National Border System, which tracks people arriving by air and sea and their completion of health checks, and the Border Worker Testing Register which is used to ensure the regular testing of border workers.

Dreyer says Border Net and the BCMS are a collaboration with a range of government and health sector organisations including the Ministry of Health, DHBs, Public Health Units, the Ministry of Business, Innovation and Employment, and ESR.

Bluetooth drops in Covid Tracer upgrade
The BCMS rollout comes as the Covid Tracer app also gets an upgrade, with Bluetooth tracing, via the Apple and Google Exposure Notification Framework, finally added – nearly seven months after the ‘digital diary’ app first launched.

From today, Covid Tracer users can turn on Bluetooth tracing on most iPhone and Android phones, enabling the system to detect other nearby phones. In theory, that means if you or another app user you’ve been near tests positive for Covid-19, the other app users can be quickly notified – even if they hadn’t scanned in somewhere using the QR code.

The Bluetooth tracing is anonymised and doesn’t record location, meaning that scanning of QR codes showing where you’ve been is still necessary, according to Covid-19 Response minister, Chris Hipkins.

“QR codes allow us to create a private record of the places we’ve been, while Bluetooth allows us to create an anonymised record of the people we’ve been near,” the Ministry of Health Covid site says.

iPhone users need to have iOS 13.5 or higher installed, while Android 6.0  or higher is required for other phones, along with support for Bluetooth Low Energy and Google Play Services.

While the Bluetooth functionality has long been called for, its addition comes as the number of Kiwis using the Covid Tracer app declines with less than 200,000 active devices on Monday – down from nearly one million in early September, when Auckland was in the throes of a community outbreak.

That low usage may well render the proximity tracing next to useless.