Waikato DHB is warning there will be more disruption to surgeries and clinics over the next few weeks as it continues to work around the clock to get its entire IT system back online.
Almost a week after a sophisticated attack on Waikato DHB's IT systems which has wreaked havoc on Waikato, Thames, Tokoroa and Te Kuiti hospitals, experts are still trying to restore its services.
Waikato DHB won't comment on the details of the ransom request which is being investigated by police, but chief executive Kevin Snee has previously revealed he wouldn't be handing over any money to the attackers.
He has also dubbed the security incident "the biggest in New Zealand's history".
The DHB is unsure when its system will be restored, but it is unlikely to be this week.
Today, Snee said staff would be paid appropriately this Wednesday and if there were any problems they had a process in place to correct them.
"We did have some processes in place that we've learnt from and we expect this week to run far more smoothly."
Waikato DHB executive director hospital and community services Chris Lowry said services were still being provided to outpatients and those requiring elected surgery.
Some 2776 of the 3378 outpatients appointments due to be carried out between Tuesday and Friday last week had gone ahead.
While 299 patients of the 359 scheduled for elective surgery still had those procedures carried out.
The DHB would be looking to reschedule the deferred patients in order of clinical priority.
The appointments and surgeries would be rescheduled once the issues were resolved.
Snee said there was no evidence at this stage that the information had been accessed by the perpetrators or that there had been a privacy breach.
The hospital was continuing to work with the National Cyber Security Centre and police to understand what had happened.
He told anyone with concerns about what had happened to seek ways to protect themselves and urged anyone who had previously engaged with the DHB to be aware of any unsolicited communications claiming to be from any Government organisation.
Snee said the Waikato DHB backed up files on a daily basis so the vast majority of the files should be recoverable.
"It is possible that there is a very small number of files that we can't recover."
Snee said he was taking advice on whether there was a chance the backups could have also been hacked.
"I'm really not hearing there's likely to be any major problem as yet, but I really couldn't comment any further on that."
Snee said the cyber attack could have a financial impact, but they were insured for some costs.
"At this stage, it is uncertain what the cost of this will be."
While parking was free at the moment it also meant a loss of income to the DHB.
Currently, the email and telephone systems were not working and they were able to use stand-alone dedicated computers to access summary patient information, but the "great majority" was still not working.
Snee likened it to going back 20 years to when he started as a house officer in the 1980s.
"I think people forget that so much of the systems that we run and clinical equipment we run is dependent on software - increasingly so."
Because staff couldn't transfer documents digitally, they were having to physically deliver information by foot. One nurse had walked 10km in a day just delivering referrals and other medical documentation.
Lowry said while the DHB still had a lot of manual processes in place, it was important the emergency department be kept free only for patients who needed immediate or urgent care only.
People with non-urgent issues should contact their GP, call Healthline or visit their local urgent care centre.
Waikato DHB's phone lines are experiencing high volumes and people who might find their calls drop out were urged to keep trying.
Waikato DHB was transferring 17 category 1 radiation therapy patients to be treated by a private provider in Tauranga so as not to disrupt their treatment.
They were also finding alternative treatment providers for other patients in their care to ensure they also wouldn't have their treatments delayed.
Lowry said while it was an inconvenience for people, the patients were pleased to know it would not impact their treatment.
More to miss out on surgery as Waikato DHB rebuilds IT system
Meanwhile, the DHB can only manage 80 per cent of the 1500 operations scheduled and who gets seen depended on how much laboratory and radiology services were required for their surgery.
''We will be reviewing what has been booked to ensure that the services can cope with the workload, as well as the impact on laboratory and our radiology services," Snee told RNZ.
About 20 per cent of outpatient clinics were also being cancelled.
The DHB knew the number of clinics and patients booked, but staff were having to manually track down names and vital clinical information.
Patients could check on clinics on the DHB website, but could also phone to double check.
Extra staff would be needed to put the patient notes into the new IT system once it was up and running.
The DHB was confident its five hospitals had suitable plans in place for patient care for the coming week.