The ongoing struggle to manage the COVID-19 pandemic in the community continued in the first half of 2022 with a number of technology innovations rolled out, but as the pandemic response wound down and traffic lights were lifted, attention turned to repurposing these systems for future use, particularly as part of the national immunisation program and the national immunisation register.

The integration of remote patient monitoring and telehealth in the community started to take off in a practical sense in New Zealand, with innovative projects like the trial of BioStickers for home monitoring, digital solutions developed by the Ministry of Health for self-monitoring at home and the acceptance of telehealth in day-to-day primary care notable achievements.

Other big topics for the year were funding for the Hira national health information platform, a new federated data platform, and the constant battle against cyber intrusion. Dominating everything, however, was the fundamental restructure of the New Health system and the early days of Te Whatu Ora – Health New Zealand.

January kicked off with the announcement by residential aged care managed services provider Third Age Health that it would roll out locally developed secure messaging app Celo’s collaboration tool to its clinicians to prepare for the expected widespread Omicron outbreak in New Zealand. It was a big year for Celo, which having entered the Australian market also set its sights further afield and joined forces with fellow Kiwi firm Core Schedule to offer a combined solution for healthcare organisations.

February saw a number of approaches to market by what were still then known as DHBs, including a tender for the six North Island DHBs for a smart eReferrals, intelligent scheduling and appointment booking platform; and a replacement for the Jade community care solution for Northland DHB, with the intention of eventually rolling out the new system to the Auckland metropolitan area.

The Ministry of Health announced in mid-February that it was live with a suite of digital solutions to help COVID-19 positive people self-manage in the community, despite a few hiccups with the national COVID-19 clinical care module (CMMM) following the country’s move to phase 2 of managing the Omicron outbreak.

The CCCM has been adapted for use from the Border Clinical Management System (BCMS) developed by Valentia Technologies using its indici PMS, and is designed to create visibility of the care provided so that people with COVID-19 can access care when they need it. The ministry had to apologise for some teething problems with the CCCM reported by GPs, but insisted it was working on a resolution.

As these dramas continued, the NZ government was beginning a phased reduction in pandemic restrictions, announcing in late March that it would begin the phase out of the requirement to use the My Vaccine Pass system and scan in QR codes when entering businesses.

While it is now owned by a US company, one of New Zealand health IT’s most useful assets was still making news long after its sale by Orion Health. Integration engine Rhapsody was sold to British private investment firm Hg and is now owned by Lyniate, which this year merged with identity resolution and enterprise master patient index system vendor NextGate to form a new powerhouse in interoperability solutions. Both Rhapsody and NextGate’s systems continue to be widely used in New Zealand.

There was plenty happening in interoperability in the primary care sector this year as well, with HealthSoft and Valentia joining forces with Whānau Tahi to work on better health outcomes for Māori using technology. The agreement between the three organisations involves developing a collaboration framework to enable Whānau Tahi to incorporate advanced technologies from Valentia and HealthSoft for their iwi and whānau support services.

Meanwhile, leading practice management system vendor Medtech launched a new integrated payments platform called Medeor Pay by Link (PBL) in its Medtech Evolution system. Medtech Medeor PBL is an online, fully integrated payment solution that enables practices to issue auto-populated invoices and receive immediate online payments. Medtech has big plans for Medeor in 2023.

In a year of massive change for the health system and constrained budgets following the pandemic’s vast expenses, data and digital rated a big mention in the May budget. There was significant funding to improve data and digital infrastructure, including ongoing investment in tranche two of the Hira national health information platform. Money was also allocated for the new Dunedin Hospital’s IT needs along with a population health and disease management digital capability for general practice. According to the budget papers, investment priorities will be aligned to broader New Zealand Health Plan (NZHP) objectives and will include data and intelligence; digital enablement and innovation; tranche two of the Hira project; and data and digital foundations. This is part of a multi-year process and will involve $220m in operational costs and $100m in capital costs.

Telehealth provision in New Zealand continued to grow, with Auckland PHO ProCare announcing in July that it had chalked up over a thousand telehealth consultations for high-needs groups through the Ministry of Health’s UnifyHealth digital enablement program, which helps high-needs patients access healthcare when they are unable to be seen at their local practice. In August, Te Whatu Ora – Health New Zealand (HNZ) confirmed it plans to fund bespoke rural telehealth services (RTHS) in a rapid roll-out designed to alleviate pressures on rural general practices and enhance rural community access to primary care services. And Tū Ora Compass Health and Pinnacle Midlands PHOs set up a new telehealth after-hours service for network GP practices and patients, covering Wellington, Lower Hutt, Palmerston North and New Plymouth. Practice Plus was launched in February and offers additional virtual access options to after-hours GP care on weekday evenings from 5-10pm and weekends 8am-8pm.

The top story this year in New Zealand digital health this year was the news about the BioSticker trials that Te Whatu Ora – Health New Zealand is running with US firm BioIntelliSense. The technology involves a medical-grade wearable device that enable continuous, multi-parameter monitoring of a range of vital signs and physiologic biometrics for up to 30 days on a single use device. Vital signs such as skin temperature, heart rate and respiratory rate are transmitted through the cloud to a healthcare team to monitor conditions such as COVID-19 infection and for at-risk patients with chronic diseases such as diabetes, cancer and congestive heart failure. They are undergoing two, six-month trials with HNZ, one in Auckland for COVID-19 and one in Timaru to see whether they can help care for rural people at home.

In September, a new vaccinator portal was added to the Aotearoa Immunisation Register (AIR) to give pharmacists views of their patients’ vaccine history and to record vaccines delivered by pharmacy. The ImmuniseNow portal that is currently used by pharmacy and connects into the National Immunisation Register (NIR) will be closing as both the NIR and the COVID Immunisation Register (CIR) are consolidated into a single platform. The NZ government invested $23 million in a National Immunisation Solution in 2021 to replace the legacy NIR. It built the CIR as a temporary solution to handle the needs of the pandemic, with a longer term view to consolidating all adult and paediatric immunisations on one register using the same platform.

The South Island’s Health Connect South (HCS) and HealthOne platforms continued to expand, with nurses at aged residential care (ARC) facilities given access to their residents’ data. The HCS shared electronic clinical record contains discharge summaries, clinic notes, progress notes, outpatient letters and shared care plans and is linked to the HealthOne primary care information system, which includes data on dispensed medications and general practice encounter notes. The South Island has been rolling out both systems over the last decade, with HCS formerly known as eSCRV. Both are built on Orion Health technology and have adopted FHIR application programming interfaces to speed up data exchange.

In October, the big news was the cyber attack on Pinnacle Midlands Health Network, which saw some data including commercial and personal details exfiltrated. Data relating to the use of hospital services, ACC claiming information, and immunisation and screening status for individual patients was stolen and uploaded to the internet.

Rounding out the year, Te Whatu Ora Health New Zealand announced it is planning to establish a nationally consistent system of data capture, analytics and intelligence and is looking for registrations of interest (ROI) from organisations to help design and implement this system as the country’s National Data Platform (NDP). The NDP is described as a federated data platform made up of a suite of integrated technology products, which has at its centre national datasets organised into an integrated, conformed data model. It is expected to become a central data model from which the new self-governing zones set up with the restructure of the old District Health Board system will be able to manage their own data while sharing with and reporting to the NDP.

And finally, 2022 saw some big names in healthcare and digital health make some moves. Director-General of Health Ashley Bloomfield, who led the country’s response to the pandemic, announced in April that he would be moving on from the role a bit earlier than expected. He has been replaced by Diana Sarfati. Health Informatics New Zealand (HiNZ) stalwart Kim Mundell announced in May that she would step down after eight years. She was joined that month by the Ministry of Health’s director of digital and data, Shayne Hunter.

And the legendary Ian McCrae announced in July that he would retire from the company he founded and built into a digital health powerhouse over 30 years, Orion Health. The company has extensive contracts in New Zealand, Australia, the US, Europe and the Middle East and was at one stage listed on the Australian and New Zealand stock exchanges with a valuation in the billions. Mr McCrae continues as an executive director with a focus on products.

Primary care

New Zealand’s leading primary care patient portal vendor ManageMyHealth added a new function to its system, allowing patients and GPs to keep track of COVID-19 symptoms when being cared for at home. My Health Diary lets patients go online and fill out information boxes about their symptoms, which can then be monitored by their GP, if necessary. About half of all New Zealand practices use ManageMyHealth as their portal.

A big one to watch in 2023 will be Webtools and its Centrik platform, which launched in late 2021. The platform provides a streamlined process to handle appointments, pre-appointment triage, repeat prescriptions, patient access to health data and lab results, messaging, virtual consultations, and payments. It started off being used by several Waitaha Primary Health practices in Christchurch before rolling out further, and is now being adopted by Green Cross Health and its 58 medical centres. Centrik and its consumer app Well look set to take on the patient portal market, with the platform one of Medtech’s ALEX partners, providing secure and standards-based integration to the patient’s health records.

Meanwhile, online and in-person primary healthcare provider Tend Health took a 50 per cent stake in South Island general practice group Better Health, which will see Tend roll out its technology platform and model of care to 14 Better Health medical centres. Tend provides telehealth and electronic prescription services along with in-person GP care at three medical centres in Auckland. The new partnership involves more than 90,000 patients across Christchurch, North Canterbury and the lower South Island.

The big take-up by general practices and pharmacies of the NZ ePrescription Service (NZePS) during the COVID-19 pandemic continued, with the Ministry of Health announcing in August that it intended to expand the service to include controlled medicines and to make electronic prescribing easier. That came to fruition in December, with Class B controlled medicines now able to be prescribed electronically without the need for a physical signature in the prescriber’s own handwriting.

The adoption of the Health Care Home model continued apace in New Zealand, with Gore Medical Centre (GMC) becoming the first general practice in Otago and Southland to be credentialled as an HCH practice. WellSouth PHO’s Southern HCH program will see more than 30 practices in Southern taking part in the program, which uses a range of technologies and new models of care to help improve patient access and experience of care, as well as promoting quality improvements within the practice.

Acute care

Waitematā District Health Board announced it would roll out the Pinga online appointment booking system at North Shore and Waitakere hospitals, initially in its cardiology clinics followed by a wider roll-out between April and December across most outpatient clinics. Pinga, developed by technology firm Sorsix and distributed in New Zealand by Aceso, is a modular, cloud-based solution that in addition to patient appointment booking, includes roster and scheduling, eReferral management, patient reminders, operational dashboards and an integrated telehealth service.

The four Te Whatu Ora Health New Zealand Northern region districts began rolling out the Medtasker mobile hospital communications platform, which will see legacy paging systems and paper-based task management solutions replaced. Medtasker’s platform will effectively support all critical communications to emergency services as well as implementing its administrative applications, which include task management for orderlies, cleaners and security. It integrates with hospital systems such as PAS, EMR, pathology, radiology, paging systems and Active Directory, and has the capacity to take orders from electronic medical records. The system was first implemented in New Zealand at Te Whatu Ora Whanganui. The new contract adds eleven hospitals to the solution’s user base.

Waitemata’s North Shore Hospital announced it is rolling out touchscreen check-in kiosks for outpatients, joining Christchurch and Auckland City hospitals in implementing the technology. The new kiosk is the first of two planned for North Shore Hospital in the near future and a third is due for installation at Waitakere Hospital. The rollout is in NZ’s largest health district, with Waitakere and North Shore hospitals receiving a total of around 20,000 outpatient visits a month.

Some of the more interesting software, apps and new players in the market that caught our eye this year included:

• It was a big year for ASX-listed Kiwi firm Volpara Health, which announced in June that it was collaborating with Microsoft on a new R&D project looking at using Volpara’s mammogram software to potentially identify cardiovascular issues. The two companies have worked together for over a decade, with Microsoft’s SaaS and cloud products supporting Volpara’s AI algorithm.
• Australian medication management app and pharmacy services software vendor MedAdvisor signed a deal with NZSX-listed pharmacy and medical services provider Green Cross Health to make its technology available to 350 community pharmacies under Green Cross Health’s Unichem and Life brands, comprising about 40 per cent of the NZ market.
• A clinical trial of Christchurch-based oVRcome’s smartphone app and virtual reality platform has shown it can help people with phobias and anxiety about heights, spiders, flying and dogs when paired with a virtual reality headset and cognitive behavioural therapy.
• Aged care provider Summerset completed a six-month pilot program trialling the PainChek pain assessment technology, which is integrated into Summerset’s VCare clinical management solution. Summerset now plans to roll out the solution to all 24 of its care centres, hoping to reduce duplication for clinical staff and allow them to spend more time each day with residents.
• The technology behind Auckland AI specialist Soul Machines is being explored to see how its ‘digital people’ concept can be used to advance New Zealand’s digital health research system.
• The remote 24-hour urgent care service Emergency Consult set up a new operations centre in Hamilton to help manage its growing user base, including aged care facilities, small EDs and rural health services. Emergency Consult was set up in 2020 and now numbers 60 clinical staff, including a number of emergency medicine specialists and registered nurses.