News letter from the Data and Digital team at the Ministry of Health. April 2021
Kia ora koutou
Welcome to the first issue of a regular newsletter from the Data and Digital team at the Ministry of Health.
We will provide updates on key pieces of work and profile some of the amazing work under way in our sector to create a modern data and digitally-enabled health and disability system delivering equitable health outcomes for all New Zealanders.
In this issue we look at:
- technology enabling the vaccine rollout
- health information when you need it
- HSAAP embarks on transformation
- a strategy for health and disability data and information
- partnership at the heart of a community technology trial
- online death documents making a difference
- HISO is looking for new members
- interRAI update
- abortion law reform data collection
- health identity platform updates.
I look forward to hearing from you.
Ngā mihi, Shayne
Deputy Director-General, Data & Digital
Technology enabling the vaccine rollout
Technology is part of the engine room for New Zealand’s largest ever immunisation programme, with the implementation and rollout of the web-based national COVID-19 Immunisation Register (CIR), a significant achievement for the Ministry and our many sector and vendor partners. The first phase of vaccinating border and MIQ workers is under way.
The CIR allows vaccinators to quickly and accurately capture all aspects of the immunisation event. For the initial phase, people can book vaccinations via local booking systems. These are an interim solution while we implement a national booking system. There has been some publicity about a recent issue with a local booking system and the Ministry is very keen to work closely with any DHB developing or implementing a public facing interim booking system to help limit the chances of any similar issues (https://www.health.govt.nz/news-media/media-releases/1-case-covid-19-managed-isolation-and-1-historical-case).
Alongside this, we are developing a digital consumer channel to provide information about the vaccination programme, as well as access to services such as booking, vaccination status, updating identity details and post-event monitoring.
Engaging effectively with a range of digital health suppliers is an essential part of this work. The CIR is the national repository for COVID-19 immunisation records. That information needs to be available to health practitioners such as GPs and community health providers. In partnership with HealthLink and Patients First, we have engaged with patient management system providers to connect a GP notification service from the CIR for vaccines given to their enrolled patients and to record adverse events.
We are working in partnership with sector organisations such as New Zealand Health IT (NZHIT) and the DHBs’ Digital Leaders forum. We highly value these relationships with digital health suppliers and peak bodies – the vaccine rollout requires a collaborative approach, with everyone playing an important role.
The delivery of the vaccines is sequenced into a series of population cohorts. To achieve this, identity data quality is critical, particularly for the health workforce. Ensuring the workforce data is complete and can be easily matched to National Health Index (NHI) data makes the operation of the CIR more effective and avoids manual effort for the busy vaccinator teams.
Health data and information when you need it
We’re working with the sector to develop a national Health Information Platform (nHIP) that will transform access to and use of health and disability information. Our shared vision is for a connected and equitable health and disability system, with people in control of their own health information and clinicians able to securely and safely access what they need for good decision-making.
COVID-19 undoubtedly put some of that work on hold but it’s now gathering momentum again in partnership with the sector, other agencies, and industry.
A programme business case has been considered by Cabinet for potential inclusion in the 2021 Budget, and work is also under way on a business case to release funding specifically for tranche one of the programme. Tranche one will improve access to data across service providers, leading to more accurate and timely information sharing, and less risk of errors occurring. The focus will be on medicines, immunisations, identity, interoperability, consumer and provider digital channels, Community Service Card entitlements, demographics and primary care data (GP only).
As part of tranche one work, consumers will have the ability to view and update their demographic information held in the NHI, view their COVID-19 vaccinations, and the medicines that have been prescribed and dispensed to them by different providers.
nHIP will draw together a person’s latest health information as needed to create a single view of that information – a virtual electronic health record, rather than a single electronic health record. It involves building an ecosystem of digital services and data across the health and disability sector, and delivers key components of the Ministry’s Digital Health Strategic Framework. The work we’re doing with the sector on interoperability and development of a data and information strategy for health and disability are also part of the Digital Health Strategic Framework.
Our sector is awash with data – programmes like nHIP will help us access it and make sense of it to help our whānau and communities lead lives of health and wellbeing.
For more information about nHIP, contact Darren Douglass at Darren.firstname.lastname@example.org.
HSAAP embarks on transformation
The Health Sector Agreements and Payments (HSAAP) system enables the management of agreements and distribution of payments on behalf of the Crown and district health boards through a centralised function at the Ministry of Health, in Sector Operations within Data and Digital.
The purpose of the HSAAP programme is to introduce much needed change to the current sector agreements and payments model, ensuring processes and systems to manage provider payments are simpler, easier and able to be paid in a more timely and efficient way.
We have embarked on a transformation initiative that sets a course away from the current legacy agreements and payments system to one that responds to the changing needs of the sector and New Zealanders, and will address the upcoming recommendations of the current Health and Disability System Review.
The current system processes approximately 90 million transactions a year and is responsible for annual payments of $10 billion with weekly payments ranging from $100 – 390 million.
A programme business case has been considered by Cabinet for potential inclusion in the 2021 Budget. If approved, the following three years will see the programme completely revamp these processes and systems, delivering more stability, flexibility and improved data sources to the benefit of the entire sector.
Developing a strategy for health and disability data and information
The Ministry of Health is working with the sector and other experts to develop a strategy to guide the way health and disability data and information is acquired, used and managed.
The first step has involved engaging with the sector to understand the data issues people and organisations are facing to identify what should be included in the strategy. We heard from people working in the health and disability sector, facilitated in-person and video discussions with existing data-focused groups, sought feedback from selected consumer forums within district health boards, and sought input from Māori data specialists.
What we found out
Sector organisations reported issues with access and data quality, manual processes to capture information, lack of sharing between different sectors, and clinicians not being able to see clinical data and information across the continuum of care.
Messages from our engagement with other groups, experts and consumer bodies have emphasised the importance of complete and relevant health records supporting health care in different settings as well as the value of consumers being able to access, manage, and contribute to their own health records to support improvements to their health and wellbeing.
We have identified the following enduring themes for the data strategy:
- equity and data sovereignty
- people and leadership
- data accessibility
- data foundations
- consumer participation.
We are now preparing a strategy and accompanying roadmap to share with the sector and all interested in better use and management of health and disability data and information.
Karen Blake, Head of Clinical Informatics at healthAlliance, says the strategy will help accelerate change and innovation in the sector around the use of data.
“It’s about providing guidance and strategic direction for the use of data and information, and supporting organisations,” she says.
“It’s been a collaborative process based on mutual respect and working together for the good of the whole health and disability system.”
For more information, please contact Simon Ross at the Ministry of Health, email@example.com.
Partnership key to community technology trial
A community trial of a contact tracing card was held in Rotorua last year as part of New Zealand’s COVID-19 response. This involved working in partnership with Te Arawa, the universities of Otago and Waikato, and Lakes District Health Board. About 1200 people from the Ngongotahā community signed up to participate in the trial.
We worked with community leaders and iwi to ensure the trial met local needs. We wanted to understand:
- how the cards worked in a community setting
- how they would integrate with the national contact tracing system
- if people in communities would accept and use the card technology.
What we learnt from the trial
The cards worked but will only make a real difference if they can work together with other technology such as the NZ COVID Tracer app. The trial results indicated that participants could not always recall their movements accurately or would sometimes leave out information.
The trial emphasised the importance of working with communities from the start to:
- uphold Te Tiriti principles and committing to partnership and co-design
- allow space for community leadership and a 'by the community, for the community' approach.
Working in partnership wherever possible helps achieve good outcomes for all.
Online death documents
Putting certificates of cause of death and cremation forms online is making a world of difference for New Zealand’s funeral directors and the families they work with.
Funeral directors can now search online for the documents they need – and they say this is quicker and easier, with less chance of error, than the old paper-based system.
It’s the result of work by the Department of Internal Affairs (DIA), Ministry of Health, and funeral directors to make it simpler to complete and access the medical documents required when someone dies.
Funeral directors are legally required to view a certificate of cause of death before they can bury or cremate a body. The old system meant they spent a lot of time chasing up missing certificates, including driving around to GP practices, rest homes and hospitals. Now they can search for the certificate online and if it’s not available at that time, they can receive an email alert to let them know when it has been completed.
As well, they no longer have to struggle to decipher the names and medical terms handwritten by doctors and nurse practitioners on paper certificates. Instead, it’s just a case of copying and pasting the typed causes of death and the certifier’s details into the appropriate sections of the online death registration form.
David Moger, Chief Executive of the Funeral Directors Association of New Zealand (www.funeraldirectors.co.nz), says the online Death Documents project is an excellent example of something put forward by the Funeral Directors Association and then picked up by government agencies to work through.
“This is a fantastic example of technology being put into practice in a way that makes an actual difference,” he says.
“Funeral directors get calls 24/7 from grieving families wanting to know where things are at with the documents that need to be completed, and now we can easily check online. As an industry we really feel we have been listened to, and the positive process has strengthened the relationship between funeral directors and government.”
About 80% of deaths from medical causes are now certified online in Death Documents. The removal of paper cause-of-death certificates has led to an increase in requests for access to Death Documents by different occupational groups that need to view the online certificates. Mortuary technicians will soon be the next group (after funeral directors and medical referees) to receive that access.
GP Richard Medlicott from Wellington’s Island Bay Medical Centre says the online service is working well.
“A patient of mine died recently and it was great being able to do all of the certification on my phone when I visited their family.”
More information about the online death documents project is on the Ministry’s website at https://www.health.govt.nz/our-work/regulation-health-and-disability-system/burial-and-cremation-act-1964/death-documents-project/about-death-documents-project.
New members sought for HISO
HISO is the kaitiaki and governing body of data and digital standards for the New Zealand health and disability system. We work closely with health providers and their industry partners to set and drive the adoption of standards for data, identity, security and interoperability.
Currently, we’re looking for public-spirited clinicians, researchers and health administrators who can be our champions for the use of data and technology standards to improve the consumer experience and patient safety.
HISO meets monthly in person or remotely, and attendance and travel is paid in accord with the Cabinet Fees Framework.
Terms of reference: https://www.health.govt.nz/about-ministry/leadership-ministry/expert-groups/health-information-standards-organisation/terms-reference-health-information-standards-organisation
Current membership: https://www.health.govt.nz/about-ministry/leadership-ministry/expert-groups/health-information-standards-organisation/health-information-standards-organisation-committee-members
We are supporting a programme in response to the recommendations in the recently completed Service Design report, available at https://www.interrai.co.nz/news/.
The report includes a number of recommendations that relate to data and improving service delivery with improved technology services.
Both shorter-term and immediate adjustments to the service’s current technology supports are being considered, alongside the longer-term options for interoperable assessment data in New Zealand.
Abortion law reform data collection and reporting
Refinement work on this online form is underway to make it easier to use and to improve the quality of the data being received by the Ministry.
Integration options to enable more automated data flows in future are being considered as part of supporting changing requirements driven by the Ministry’s Quality Assurance and Safety team.
Health Identity Platform updates
The Health Identity Platform (HIP) upgrade and migration projects are progressing well with the project team recently deploying a number of components into a new sector facing, cloud-based User Acceptance Testing (UAT) environment.
The HIP upgrade includes the following key initiatives:
- Planned component upgrades and maintenance - bringing the databases, operating systems, and Master Data Management software underpinning the National Health Index (NHI), Health Provider Index (HPI) and ancillary systems up to modern, supported versions.
- Cloud re-platforming - adopting a 'future-proof' infrastructure platform for hosting new Fast Healthcare Interoperability Resources (FHIR) services, which is a new standard for exchanging health information electronically.
- Data model updates - extending the NHI and HPI data models to meet new business requirements.
Work is continuing to migrate HIP services into the UAT environment, as per the schedule below, so that sector integrators can undertake regression testing.
Production migration dates will not be confirmed until the Ministry has sufficient confidence that the UAT services are performing as expected.
If you have any queries regarding the upgrade projects or require further information, please email WS_Integration@health.govt.nz.
Schedule to migrate HIP services