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Roadmap To Accelerate Shift To Interoperable Digital Health System

A new Interoperability roadmap outlines how to accelerate the shift to a, “fully interoperable digital health ecosystem that enriches the experience for consumers and the health and disability workforce through better connectedness and use of information”.

Published by The Health Information Standards Organisation, the roadmap identifies four themes and each section details milestones to hit over the next two years.

The foreword from deputy director general data and digital Shayne Hunter says interoperability is a key part of the Ministry’s digital health strategic framework and HiSO will set the standards needed and promote their adoption.

“The Ministry will look at the barriers and settings, including incentives, that will drive alignment across the health and disability system to the interoperability requirements outlined in this roadmap, as well other parts of government such as social and education services,” Hunter says.

The roadmap says some of the forecast change is in scope for the planned national Health Information Platform (nHIP) ecosystem, with its own investment and commercial frameworks, while other parts will be delivered separately.

The first theme is ‘connecting and identifying’, which involves work on digital identity, cybersecurity and national systems such as the Health Provider Index (HPI) and National Health Index (NHI).

It says HiSO will establish standards-based NHI and HPI Application Programming Interfaces (APIs) using the HL7 FHIR standard with a draft data set published next month and finalised in January 2021.

In April next year a digital identity framework will be published. In July the New Zealand Business Number will be introduced to the HPI and in April 2022 the HPI will be extended to Kaiāwhina and non-registered health workers.

The second area of focus is titled ‘using the same languages’ and has a goal of semantic interoperability.

It describes an environment of predominantly unstructured data and a patchwork of different data standards with low adoption of key terminology and code set standards where these have been determined.

The document says HiSO will implement common identity, demographic and eligibility code sets in all foundational services and national systems, accelerate the move to key international standards for terminology and replace legacy approaches.

The organisation is committed to using SNOMED CT as the principal standard for terminology and the SNOMED NZ Edition will be released next month.

A timeline shows SNOMED will become mandatory in Emergency Departments from July 2021 and Read Codes will be withdrawn from primary care in July 2020.

Under the theme ‘unblocking access to data’ the doucment says that, “for consumers to have access to their own information and for clinicians to have all relevant information about the patient, the data held at source must be readily accessible.”

However, currently consumers often have to retell their information at every encounter and information systems are fragmented, making it difficult for clinicians to get a coherent view of a patient’s health status.

The roadmap says HiSO will drive an open standards and open source approach to interoperability and build an API infrastructure as part of the digital health ecosystem, mainly using the FHIR standard.

It will require APIs on all new systems and retrofit APIs to renewable existing systems, including key national systems.

Next month, HiSO will publish a draft open API participation agreement to promote investment in APIs and an API marketplace and this will be finalised in April next year.

The fourth key area focuses on joining up services around the consumer. This will involve defining standards for e-referral, transfer of care and shared care plans, with finalised specifications due by October next year.

Also, collaborating with other agencies on joined up health and social services.

The roadmap says interoperability is key to enabling healthy futures for Māori as “we can ensure that insights and evidence are used to identify inequity and protect and build the knowledge base for Māori health and wellness, including mātauranga Māori”.

The steps outlined will “need to be progressed in partnership with the networks, projects and communities that have responsibility and authority in different functional areas,” it says.

“Consumers, health professionals and other end users will need to be fully part of this.”

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