The late Queen Elizabeth II once described a particularly trying year in her family’s life as her “annus horribilis”, and you can’t really go past that description of a quite disastrous year for the beleaguered staff of Health New Zealand – Te Whatu Ora’s Data & Digital division. Detailed plans for deploying some major foundations for a modern health system also got the heave-ho and there is still a great deal of confusion about what the future will bring.
But for pure rhetorical content, nothing could beat it. The annus horribilis included an ugly baby, an old banger, technical gobbledygook and “putting King Herod in charge of babysitting services”. And despite the rending of garments and gnashing of teeth, there are a number of people in the wider health IT industry – albeit a minority – who are very much in favour of the big reset and doing better with resources already at hand.
There were some bright spots, with New Zealand leading the world with its development of the NZ Patient Summary, although even this work – most of it done by HL7 New Zealand – is now under threat. There are also some very interesting plans under way at the new Dunedin Hospital for digital wayfinding and patient flow management that should survive the budget clampdown.
AI also took off, with GPs in particular embracing Nabla Copilot for medical speech to text – which GPs are actually paying to use – and some very exciting new developments from PMS vendor myPractice and its fabulous new Second Opinion technology.
Auckland PHO ProCare’s roll out of digital assistants to relieve administrative burdens for general practices now includes five “robots” that focus on inbox management and cardiovascular disease risk assessments.
But the PMS sector was a bit overshadowed by the showdown between rival vendors Medtech and Indici, which has seen much time and money spent not on new feature development but lawyers’ fees.
Things all started out swimmingly in 2024 with global health IT vendor InterSystems testing out a FHIR-based API for the National Health Index that was developed by Health NZ as part of the Hira program. InterSystems worked with Health NZ on using the NHI API in real-life scenarios, including the build of a new cloud-based patient administration system being implemented for Te Toka Tumai Auckland (formerly the Auckland District Health Board).
Te Tai Tokerau Northland continued its promotional roll out of patient portal access to hospital and GP records through the Manage My Health and Health 365 portals, commandeering a bus to travel the region in February to promote digital health. The Digital On-Road Access (DORA) bus is part of a long-term initiative to involve people in their own care through access to their records.
Health NZ ran into a bit of trouble with revelations that a former IT staffer had been charged with leaking information about vaccine injuries to an anti-vax conspiracy website, including the names of 12,000 people – most Covid-19 vaccinators, as well as some patients – claiming that Covid vaccines had caused millions of excess deaths around the world. The man is still facing a prison sentence.
In late February, then-chief of data and digital Leigh Donoghue gave a highly informative presentation at the Digital Health Association’s (DHA) annual general meeting on the digital modernisation program that was to be the focus over the next three years for the Data and Digital division of HNZ as part of its 10-year digital transformation program.
Memorably describing the NZ digital health system “an ugly baby”, Mr Donoghue warned that NZ faced a future of very constrained financial resources, but waxed lyrical about the potential of the Hira program, such as the new My Health Account digital identity service and the My Health Record patient record project. He also looked ahead to the AI revolution, mentioning the speed with which AI such as Nabla Copilot for medical speech to text had been embraced wholeheartedly by GPs in New Zealand.
His view didn’t receive universal claim at the meeting, with Orion Health founder and former CEO Ian McCrae taking exception to the vast sums of money that have been touted over the years as being required to fix New Zealand health IT, when homegrown vendors were perfectly capable of doing the job. The Hira program came in for some withering scorn, including from GP PMS vendor Medtech Global CEO Geoff Sayer, who asked quite pertinently what it could ever offer GPs.
Health Minister Shane Reti couldn’t say he wasn’t warned about the parlous state of HNZ’s IT, with a briefing to the incoming minister clearly outlining what it called a fragmented data and digital environment with over 4000 clinical and business system applications, many of which have reached or are beyond end of life with high technical debt.
The future of the GP2GP patient record transfer system, innovative in its day, was under a cloud all year. GPNZ called it “failing technology” with a need for a more modern way to transfer information when a patient moves between practices or if a practice changes PMS. While short-term fixes were worked on during the year, a survey in June found that up to half of all transfers failed. And a longer term plan to replace GP2GP with technology using Hira capabilities appeared to come to nought as well.
One of the big to come out of the Hira interoperability program was New Zealand’s own My Health Record, which provides consumers with access to their immunisation history. The idea was to build on this capability to gradually provide more information straight to consumers, including to view dispensed medicines and drug allergies as well as an app for mobile access, and to align it with the New Zealand Patient Summary (NZPS), using HL7’s International Patient Summary as the foundation. By the end of the year, the future of this work was still up in the air.
A new report on the state of healthcare analytics and interoperability, conducted by advisory firm Ecosystm and sponsored by InterSystems, was released in March, surveying 240 healthcare executives in Australia and New Zealand, most of whom said they were planning to play with FHIR. However, a significant amount were holding their horses until they understood the benefits more.
As AI made its revolutionary march into healthcare, in April HNZ released a warning that large language models (LLMs) and generative AI tools have not been validated as safe and effective for use in healthcare, and users should proceed with caution. Its National Artificial Intelligence and Algorithm Expert Advisory Group (NAIAEAG) currently advises a precautionary approach due to risks around breach of privacy, inaccuracy of output, bias, lack of transparency and data sovereignty.
Telehealth was also on the agenda during the year, with a stocktake of public hospitals showing a mixed-bag of telehealth readiness across the country, with no DHB completely equipped to adopt telehealth as business as usual. Expert group the NZ Telehealth Forum called for more investment in training and technical support for clinical and non-clinical workforces as part of a wishlist for telehealth improvement. In August, HNZ cut its funding. Health NZ also upset GPs with a wild claim that half of GPs’ work could be done by teleconsultation.
Then came the big whammy in the budget in late May, when the NZ government cut more than $330 million in funding that had been allocated to healthcare data and digital in previous budgets, with unspent funds put aside for the Hira program and data and digital foundations returned to the treasury. This was despite advice given to Health Minister Shane Reti that significant near-term effort and investment was needed to even keep the lights on. The ramifications of the budget cuts would cloud the rest of the year.
In June, we took a look at some of the digital patient journey technologies that will be rolled out at the new Dunedin Hospital, despite concerns over the hospital’s construction. Digital infrastructure delivery partner NTT brought together technology from Five Faces, Olinqua, MazeMap and Oneview Healthcare for wayfinding services, check-in kiosks and information displays. In October, Dr Reti’s office insisted that there would not be cuts to the $200 million over 10 years budget for digital systems at the hospital, despite a report suggesting the whole project’s specification and scope could be changed.
Dr Reti kept the surprises coming in July, deciding to sack the whole board of HNZ and replacing it with a single commissioner in Lester Levy, tasked with a savings objective of approximately $1.4 billion. He then confirmed that the flagship Hira health information sharing project was being paused indefinitely while insisting that the government remained committed to supporting data and digital. Savage job losses announced at the end of the year said something different.
It was then revealed that funding originally earmarked for Health NZ’s data and digital program had been diverted to upgrade its payroll system.
User testing for the massive new TrakCare patient administration system from InterSystems at Auckland City Hospital and Starship Children’s Hospital was underway in August, all set for a go-live date in December.
The argy-bargy between rival PMS vendors Medtech and Valentia continued in the courts throughout the year, with Valentia getting a couple of minor wins including an overturned injunction and some costs awarded, but Medtech upped the ante by writing to all practice managers using its PMS to highlight what it alleged was over-extraction of data by Valentia, including staff user names and passwords. Medtech said a judge had found there was a serious question to be tried and that Medtech had a tenable claim on all of its pleaded causes of action.
Still in general practice, and a survey by the newly formed AI in primary care group found just over half of respondents had used AI, while nearly a quarter use it daily, mainly for administrative purposes and automating routine work. Super users were using a range of AI technologies daily, including note-taking tools, AI-powered diagnostic tools, chatbots for patient inquiries, and predictive analytics for patient outcomes.
While HNZ was touting a breakthrough in integrating data from across the former DHB systems into the new National Data Platform (NDP), a project led by chief data officer Kari Jones, she was soon gone, along with a host of top brass. This included Health NZ’s chief data and digital officer Leigh Donoghue, who had only taken up the role in May 2023, was ousted, along with chief people officer Andrew Slater. Director sector digital channels Michael Dreyer, who had overseen progression of the New Zealand Patient Summary (NZPS), bunked off to the ACC.
The loss of Mr Donoghue was accompanied by revelations that Health NZ had a target to find savings of $100 million in the data and digital division alone, despite Health Minister Shane Reti having been warned that the $330 million in cuts made in the May budget could lead to cyber security risks and project shut downs. Health NZ’s director of strategy and investment, data and digital, Darren Douglass, had to come out with an assurance that Health NZ was “confident” in its current level of data safety.
Another big whammy came at the end of November, when it was leaked that 653 full-time equivalent jobs in Health NZ’s data and digital team would go, amid yet another restructure the beleaguered division would have to endure.
Things are looking grim for 2025.
Some of the more interesting software, apps and new players in the market that caught our eye this year included:
Health NZ Waikato rolled out a non-clinical version of Alcidion’s Smartpage communications platform to attendants and orderlies, replacing a legacy attendant task management solution. Smartpage was first developed in New Zealand by clinical messaging firm Oncall Systems, which was acquired by Alcidion in 2017 and integrated into is Miya patient flow and bed management platforms.
Healthcare rostering technology specialist Core Schedule launched a new virtual care solution tailored for the needs of the telehealth sector. Core Schedule partnered with Aspen Medical’s Aspen Health division to roll out the scheduling technology, aiming to streamline operations and enhance service delivery.
We followed the development of a clinical management system tailored for the treatment of inflammatory bowel disease (IBD) called the Crohn’s Colitis Care (CCCare) system. Data is added to the CCCare system via a linked EMR and clinical quality registry. In September, developer CCCure announced it was building a consumer app that will link patient-reported data to clinical data, in order to help people with IBD self-manage, and with the ability to carry their health data, treatment history and care program over time and between clinicians.
In May, PMS vendor Medtech worked with radiology communications specialist Zed Technologies on a real-time API connection that can deliver radiology reports directly to doctors’ inboxes, eliminating the need for the previous store-and-forward method and reducing errors.
There was a bit of money around for tech, with Heath NZ issuing a request for proposal for a non-clinical task management solution for all 10 of the Northern region hospitals, which are all currently or have adopted the Medtasker solution for clinical role-based task management. There is the potential for other districts to adopt the solution.
It was a big year for Spark Health, which in July signed a memorandum of understanding with the University of Waikato to collaborate on health innovation. In November, Spark Health teamed up with Kiwi messaging app Celo to offer its technology to healthcare customers, and then announced it was bringing Australian telehealth equipment vendor Visionflex’s virtual care solutions to customers, with a number already signed up.
When Valentia Technologies wasn’t battling it out in court, it was announcing it would roll out its Nurse Support System (NSS) for Breast Cancer Foundation (BCFNZ) in a new program to encourage adherence to therapy. The system is primarily a telehealth platform designed to clinically manage cases within a telehealth context, but it can be integrated with EMR and PMS systems through standard-based integrations such as FHIR and HL7.
Auckland PHO ProCare rolled out a series of digital assistants to help relieve administrative burdens for its general practices. They are integrated with a GP’s inbox using robotic process automation (RPA), technology that enables configuration of software to capture and interpret existing applications for processing a transaction, manipulating data, triggering responses, and communicating with other digital systems.
Aged care and retirement living provider Ryman is running a pilot of the PillDrop online prescription medication delivery service at its New Zealand retirement villages, allowing residents to order directly through the company’s myRyman app. PillDrop is licensed by the Ministry of Health as a full-service digital pharmacy, a first of its kind in New Zealand. It packages and pre-sorts medications by date and time and delivers across the country.
And finally, a Starlink satellite receiver mounted atop a Toyota RAV4 has eliminated troublesome mobile internet black-spots for some of New Zealand’s most remote healthcare workers. Hawkes Bay staff such as district nurses, midwives and physios are using the technology, which is powered by a power box in the boot of the car which charges while driving. An internal aerial provides internet coverage and staff can use their laptops and phones inside a patient’s home to access and upload data.
