Published on the 08/12/2022 | Written by Heather Wright
As MoH ponders precision health…
Te Whatu Ora, Health New Zealand, has begun the search for a provider for its planned national data platform to ‘simplify and unify’ the New Zealand health sector’s multitude of data environments, reducing cost and duplication.
The agency says it is seeking to establish ‘a nationally consistent system of data capture, analytics and intelligence that supports the use of health intelligence and insights to ensure equity of access and outcomes from all health services across Aotearoa New Zealand’.
The 2022 Budget saw $600 million allocated for data and digital infrastructure and capability for the health sector. It followed the launch of Health New Zealand and the Maori Health Authority, replacing the 20 previous district health boards.
“The establishment of a NDP is a crucial enabler in the context of the health system reforms.”
Core to the planned system is a federated data platform, made up of a suite of integrated technology products. At its centre will be national datasets, ‘organised into an integrated conformed data model’ – the National Data Platform. At the periphery will be self-governing zones where Health NZ, its districts and regions, the Maori Health Authority/Te Aka Whai Ora, and ‘potentially’ some other organisations can manage their own data, complemented by data sharing to and from the central data model.
The ROI says the platform will provide nationally-extensible data ingestion, storage, transformation and cataloguing tools with connectivity to core business intelligence tools.
Health NZ, the Maori Health Authority, the Ministry of Health/Manatu Hauora will all access the platform, which could also scale to include primary and community providers, the Ministry of Disabled People, the Cancer Control Agency and other NGOs.
“We require a suite of tools which integrate well with each other and enable connectivity to a range of other tools (BI, AI, data science) and existing district data environments, to make data sharing and analytics easier as districts and other health sector organisations connect or migrate to it,” Health NZ says in the ROI document.
iStart has repeatedly requested interviews with Health New Zealand about their plans to revamp the IT across the sector, but the agency has, as yet, failed to provide an interview.
The Te Pae Tata New Zealand Health Plan 2022 by Health New Zealand and the Maori Health Authority, which was released earlier this year, noted the need for a single health system and greater use of digital services.
That’s an issue that has long plagued the New Zealand health IT landscape.
The Health Plan identified the need for creating and implementing national consistency in data and digital capability and solutions including streamlining duplicate legacy systems inherited from DHBs and shared service agencies to improve intra-operability and reduce operating costs.
A recent Ecosystm study, conducted for InterSystems, found healthcare organisations across New Zealand and Australia are struggling to harness data and analytics to improve clinical and patient outcomes due to the inability to bring together and analyse data across multiple sources, and give access to seamless, real-time, actionable insights.
“The establishment of a NDP is a crucial enabler in the context of the health system reforms and forms part of a suite of related initiatives already underway on matters of data governance, data standards, and identity and access management,” the ROI says.
Precision driven health
At the same time, New Zealand’s Ministry of Health has released a consultation document on precision health – a growing filed aiming to use emerging technology and all available information, including an individual’s genome, biophysical measures and environment, to predict, prevent, diagnose and treat disease more precisely.
It’s an are the Ministry says is ‘underdeveloped’ in New Zealand, compared with other countries.
“We also have no national strategy or system-wide effort to coordinate initiatives exploring aspects of this topic,” it says in the consultation document.
“As a result, our health system has generally not been able to adapt as well or take advantage of current precision health options to the same extent as some other countries, such as Australia and the United Kingdom. This also means we are less prepared than we could be to consider future precision health opportunities,” it says.
“A national approach to implementing precision health is likely to offer opportunities to achieve consistent access to and economies of scale in health services. It will also help us to focus on the complex ethical, social and legal issues in this area that we need to address — particularly those relating to Te Tiriti o Waitangi and equity.
Orion Health, Te Whatu Ora Waitemata (previously Waitemata District Health Board) and the University of Auckland have had a joint venture, Precision Driven Health (PDH), since 2016.
Kevin Ross, PDH chief executive, says the field is leading the healthcare sector towards ‘the ability to take into account every piece of data known about someone, in order to give them exactly what they need’.
“There’s a nirvana that precision health is aiming for: a patient comes to you; you’ve got access to all of the data about them; and you use that to both specifically give them the advice that they need, and not waste time and resources on things that will clearly not work for them. The ‘precision’ piece is about being quite specific,” Ross says.
But as the Ministry of Health notes, data access and privacy, along with ethical and social issues, will be key issues to overcome.
“Exploring these issues therefore provides an opportunity to test how acceptable these technologies are to our communities – and what some implications may be for those who do not want to participate.”
