Waikato DHB has reinstated some of its IT services one month after a sophisticated cyber attack brought its systems to its knees.
The DHB restored a number of services in the past week, including diagnostics from its laboratory and radiology services, the ability to enter data and track patients' movements through its hospitals and giving clinicians access to patient files.
The attack left the DHB having to employ hundreds of additional IT experts as it attempted to rebuild all its systems.
The outage affected Waikato Hospital and outlying hospitals in Thames, Taumarunui, Tokoroa and Te Kuiti.
The hackers sent threats to the DHB demanding money - but the DHB refused.
Waikato DHB chief executive Kevin Snee said a significant number of services went online on Friday and worked well over the weekend.
However he said they were not fully functional so asked people to bear with them.
"It was a big step forward for clinical care in the organisation," Snee said.
"We still have a long way to go which will take a number of weeks."
Snee said they were now moving away from crisis management and into recovery mode this included dealing with patient backlog that had accumulated over the past month.
Medical director of medical services Dr Graham Mills said last Friday was a "change point" for them and now they had most of the clinical data on patients. There was a gap of about three to four weeks but work was under way to fill this.
Colleagues now felt from a clinical care perspective they were able to work at about 90 per cent of what they could do.
"All and all we are on track, but we are not back to normality yet."
The DHBs dictation services were not up and running and its ability to communicate with primary care services was also still down so the DHB was relying on telecommunications and the mail service.
Radiation services would be back to full capability by the end of next week.
Outpatients who had missed appointments or surgeries were a focus and work was underway to prioritise and rebook them.
Waikato DHB hospital and community services executive director Chris Lowry said they would have to outsource some of the backlog and work with other DHBs to help.
Additional staff would also be brought in to help where possible.
Snee said they had lost very little data except for the 24 to 36 hours before the systems went down.
He thanked the 8000 staff who had done a great job in a difficult circumstance and its partner DHB and MoH for also providing health and support over the past month.
Snee said it would take months but not an entire year to clear the significant backlog caused by the cyber attack.
"Week by week we will see more functionalities return," he said.
"There are many more applications that need to come back online."
The DHB had stopped diverting cardiology patients and the radiotherapy patients who had been redirected to Tauranga and Wellington would be moved back to the Waikato by the end of next week, Snee said.
Staff have been relying on manual systems including handwriting patient notes as they continue to treat as many patients as they can.
An ED nurse told the Herald several systems had been restored and they finally had access to the Vocera communication system and some computer applications. Staff were also able to access their emails again too.
She said not everything was back online, but it was a big improvement on previous weeks.
While it was great that the systems were getting back online, she was still aware of the other pressures facing the department, such as a staff shortage and overcrowding, which was not being addressed.
The DHB has several hundred servers, many major network sites and many thousands of workstations, numerous mobile devices and specialist medical equipment.
The DHB was working closely with international specialist services to systematically test and secure all devices and systems before each one was reinstated.
Patient Rights Advocacy Waikato spokesperson Carolyn McKenzie said members had been extremely understanding about the crisis facing the DHB and the organisation had not received any more complaints than usual.
"I can say they have shown a fair bit of resilience working through the whole awful business."