Connected healthcare information should be treated as essential national infrastructure, says Orion Health – not a series of short-term IT projects.
Imagine you’re in another city when you suddenly fall ill. You’re rushed to the emergency department of the nearest hospital for treatment.
The only problem? The clinician treating you, who you expect to make the right call based on your medical records, can’t access all the information held by your usual health providers.
“Patients just assume that we’re doing this, but we’re not,” says Orion Health chief executive Brad Porter.
In this situation, you may have to repeat your medical history while frightened, in pain or seriously unwell. The clinician may need to track down your medicine lists, test results or discharge summaries held elsewhere.
For Porter, this points to a much larger national question. Why does New Zealand treat roads, energy and telecommunications as essential infrastructure, but not the digital systems carrying information through healthcare?
Ahead of this year’s election, Orion Health has released a manifesto calling for that to change.
“Connected healthcare is a public good, and we should invest accordingly in it,” Porter says.
A Healthier New Zealand: From promise to practice argues New Zealand doesn’t lack healthcare information – it just lacks connection.
Digital health has often been funded as a series of projects that can be delayed, scaled back or cut as priorities change, Porter says – but treating it as infrastructure would require the adoption of common standards, ongoing maintenance and clear accountability.
Health NZ’s 2023/24 annual report counted more than 6000 consumer, clinical and business applications across the health system. Not all hold patient records, but the figure illustrates the complexity of the digital environment.
The consequences of this fragmentation extend beyond individual appointments. Fragmented data can make it harder for health leaders to see demand and direct staff, funding and services where they are most needed.
Orion Health points to an NHS survey from Hampshire and the Isle of Wight, England, as evidence of what a shared care record can deliver. It found 85% of clinicians reported saving time, while 93% believed the system improved patient care. The Mid and South Essex NHS region found the average reported saving was 22 minutes per clinician each day.
“Clinicians want to care for patients. They don’t want to be searching through data.”
Using the health workforce effectively will become increasingly important as New Zealand ages. Statistics New Zealand projects that about 1.5 million people could be aged 65 or older by 2051 –nearly one in four New Zealanders.
“Our healthcare delivery, once you get into the system in New Zealand, is very good. It’s actually very, very good. But we could do better, and we should strive to do better,” Porter says.
“Healthcare transformation is more than digital. But if we want a connected healthcare system, digital is a key enabler – so system-wide thinking is required to solve this challenge.”
New Zealand will still need more clinicians, hospital capacity and community services alongside changes to funding, service design and equity.
“We’re going to have to move care out of the hospital into the community, closer to people’s homes, and you can only do that if you have data that flows with the patient wherever they are receiving care.”
The manifesto identifies four foundations: a national shared care record, a simple digital entry point to help people navigate services, data tools built into care and planning, and secure modern infrastructure.
Its roadmap begins with commonly needed information such as medicines, allergies, care plans and discharge summaries within 12 to 18 months.
Over the following 18 to 36 months, care would become more joined up across services. Over five years and beyond, the aim is a more preventative system able to identify pressure and risk earlier.
There has already been progress. Electronic prescribing is widely used, while Health NZ’s Health Digital Investment Plan sets out a path for digital investment over the next 10 years.
“We’ve got significant clinical systems, national services. We’ve got digital expertise to make this happen,” says Porter.
According to the company, its technology underpins a digital care record system in Saudi Arabia covering about 35 million people and drawing together data from more than 5000 government and private healthcare providers.
Although Saudi Arabia’s health system and political structure differ from our own, Porter says its experience shows what national direction and sustained investment can achieve.
Any New Zealand system would need clear rules covering privacy, consent, cybersecurity and Māori data sovereignty. Offline options would remain necessary for people who could not or did not want to access care digitally.
Orion Health is a commercial health technology company and could benefit from greater government investment. It points to international experience in making its case. The company says it supports more than 60 public and private sector customers whose systems cover about 145 million patient lives worldwide.
Porter says the manifesto is intended to start a national conversation rather than promote a particular product. Its immediate proposal is a basic national shared-care record.
“Start simple, start with the basics – and then build on it.”
Read the New Zealand Health Reform Roadmap for Orion Health’s full proposal for a more connected health system.