How shared records could revolutionise NZ healthcare - Cecilia Robinson

What was once a world-leading health system in the early 2000s is now a tangle of outdated technologies, writes Cecilia Robinson. Photo / Michael Craig

For years, successive health ministers have underestimated the scale of New Zealand’s outdated digital health infrastructure. It’s often not until the end of a minister’s term that the true fragmentation becomes apparent.

That’s why it’s encouraging to see this issue finally receiving the urgent attention it deserves, kickstarted by new Health Minister Simeon Brown.

Over the past five years, digital health strategy has felt like a game of ping-pong: shifting priorities, rebrands and stop-start initiatives have left the sector uncertain about where to invest or how to plan. What’s needed now is a clear, consistent, long-term digital roadmap that gives clinicians, providers, innovators and vendors the confidence to build for the future, not just respond to the present. Encouragingly, that now appears to be under way.

Because the reality is this: our digital infrastructure is in crisis. People often reference the leaking pipes at Middlemore, but if that’s the state of our physical plumbing, our digital systems are even worse. Think of a hospital with an electrical system short-circuiting across departments, dangerous, dysfunctional and long overdue for repair.

Thousands of applications don’t talk to each other and many are so old they’re no longer supported. This isn’t a foundation for the future, it’s digital quicksand.

That’s why the Government’s announcement of a Shared Digital Health Record (SDHR) is more than welcome; it’s essential. With an initial $4 million investment, the SDHR aims to unify clinical records nationwide, improving continuity of care and enabling smarter, more connected services, including the rollout of 24/7 telehealth.

To fully realise its potential, further funding will be needed, particularly to expand the data set to include all clinical information and to ensure access for first responders, hospitals and specialists. But this initiative marks a critical step forward in streamlining care and improving patient outcomes.

The success of the SDHR will rely on HealthNZ clearly communicating how and where patient information will be shared. Fortunately, the experience of the South Island’s HealthOne system shows that most patients are more than willing to share their health information when it leads to safer, better care.

The real risk lies not with patients but with the mindset of some individual practice owners who treat this vital health data as if it were their own intellectual property or competitive advantage, locking it away from other parts of the health system where it could genuinely save lives.

Earlier this week, I saw the consequences of our fragmented system firsthand. A close friend was admitted to Auckland Hospital. The attending doctor entered, followed by a trainee buried by a stack of folders, the only source of patient information. There was no access to recent medical history from primary care, no digital notes available at the bedside, no AI assisting with note taking, and when a nurse later entered, they recorded vitals on a paper napkin. I wish I were joking.

This kind of disconnection is unacceptable. Our clinicians are working hard, but they’re being failed by a system that denies them the tools they need to deliver safe, high-quality care.

As a Swewi (Swedish-Kiwi), I was shocked when I first arrived in New Zealand and saw how disconnected the health system was. Countries such as Sweden have had integrated digital records for years. Sweden’s national system, NPO, allows authorised providers to access real-time data across hospitals, GPs and specialists, reducing admissions, accelerating emergency care and empowering patients. Estonia has gone even further, with 99% of its health system digitised.

A well-integrated SDHR would transform New Zealand’s system. It would connect GPs, telehealth providers, emergency responders, hospitals and specialists, allowing faster, safer and more accurate care, especially in urgent situations. It would also spare patients the exhausting and often distressing experience of repeatedly retelling their medical history. And crucially, it would support better public health planning, using anonymised data to track trends, target interventions and inform long-term strategy.

The combination of SDHR and 24/7 telehealth is a powerful one. With remote providers able to instantly access medical histories, care becomes not only more efficient but also more equitable.

The initial investment is a strong start. Now, we must continue and commit to building a modern, connected, patient-centred health system. One where the right information is available at the right time for every New Zealander.