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Organisation To Ensure Success of Health IT

New Information Standards Organisation To Ensure Success of Health IT

HEALTH Minister Annette King today launched a new Ministerial Committee that will oversee the development of health information standards in the sector, providing an essential component in its future direction.

The New Zealand Health Information Standards Organisation (NZHISO) will put in place the building blocks for current and future Health information developments, especially those stemming from the Working to Add Value to E-Information (WAVE) report. NZHISO's role will include identifying, developing, publishing and monitoring New Zealand's health information standards.

"Consistent health information standards are essential to achieving a connected health sector, so we develop the services New Zealanders need," Ms King said.

"NZHISO will assist in making software and systems more compatible nationally, reduce costs and allow more services to be provided for our health dollars."

"I'm very pleased that NZHISO is being set up now," said Ms King.

Debbie Chin, The Ministry of Health's Deputy Director-General of Corporate and Information, said NZHISO is being initially funded by the Ministry of Health so it can start quickly, which is essential given work on the WAVE priorities is already underway.

"The establishment of NZHISO will benefit everyone in the health and disability sector, from patients to practitioners, funders to researchers," she said.

"The standards developed will mean GPs, for example, will have the opportunity to book inpatient appointments with specialists while the patient waits, instead of sending a letter and waiting days for a reply."

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"Consumers will also find benefits. Patient care requires information, and these days more of this is information is able to be accessed electronically. National standards will mean more information is available of a better quality, so more informed decisions can be made."

"The appropriate exchange of health information will mean patients won't have to repeat basic information and fill out the same forms every time they see a new provider. For example, x-rays and lab tests won't have to be unnecessarily repeated when visiting a GP, a specialist and the hospital," said Ms Chin.

"And ultimately, consumers will eventually be able to access their own electronic health records."

With the new initiatives will also come the development of enhanced security protocols to make sure the transmission of all health information is secure, ensuring confidentiality.

"In fact this is one of the key functions of NZHISO. As more health data becomes available in electronic form, NZHISO's establishment will help ensure that it's protected."

The NZHISO will also have strong links with the local branch of Health Level Seven, which is the leading international health information standards developer. This will help ensure that New Zealand's innovative software industry can continue its growth as a key element in New Zealand's knowledge economy.

"I also know that national standards will add significant economic value to the health IT industry. Our systems are already leading edge, and this will further advance our software development expertise and contribute to the growth of the knowledge economy," said Ms Chin.

"The establishment of NZHISO is an initial step that will continue New Zealand's journey towards becoming the world's 'shop window' for e-health applications."

NZHISO's committee membership will draw from experienced ranks from a range of organisations across the health sector. This is seen as crucial, given the importance NZHISO will have in the future direction of the New Zealand health system.

"Senior leaders from the sector need to be involved to provide authority, so the sector itself supports the process. Previous attempts to set up health information standards bodies haven't been effective, in part because of the absence of senior sector decision makers being members," said Ms Chin.

The committee of up to 10 members will be appointed by the Minister of Health early in the New Year. It's expected their first meeting will be held in February 2003.



Why do we need a Health Information Standards Organisation? NZHISO forms a critical part of the Working to Add Value through Electronic Information (WAVE) report. That report was produced in late 2001 by a committee set up by the Ministry of Health to facilitate the development, and acceptance of, a blueprint to improve the management of information in the health sector.

The major recommendation of the WAVE report concerned the establishment of an organisation to lead and coordinate the development of health information standards. The ministerial committee on Health Information Standards Organisations, which was set up to review the implications of establishing a non-statutory health information organisation, reinforced this goal.

The Working Group report, released today, reported that a health information standards organisation was needed to provide sustainable stewardship in this area. Previous attempts to coordinate and developed health information standards had not been successful and an organisation with the characteristics of NZHISO was considered to needed.

NZHISO will be an independent vehicle reporting to the Minister of Health, but responsible to the sector. NZHISO will provide a forum where key sector interests can be represented to plan, development and promote the health information standards needed to implement e-health.

How will NZHISO standards differ from other standards? NZHISO will be responsible for overseeing the development of a standards development process that is specific to the health and disability sector. In some areas of health, it will be possible to use general standards like Internet Protocol Security (Ipsec) and those developed by the State Services Commission's E-govt unit, but adoption will still have to be managed and coordinated. In other instances such as for security and messaging, existing standards may need to be modified for common use in the health and disability sector.

Why are these standards needed? Standards are key foundation blocks for the development of e-health. If we want information management systems to talk to each other and to be understood by one another we need to have national standards. Without widely used health information standards, we will not achieve a connected health sector. We need to work to avoid incompatible systems, duplications and reduce costs to obtain more services for our valuable health dollars.

As more coordinated care initiatives are implemented, around diabetes and other health issues where a team-based approach is needed, standards are becoming essential. Standards are required to ensure that data can be exchanged in a safe and secure way.

The development of agreed standards will result in better quality information resulting in improved decision making in all areas of the health and disability sector. it will make it easier to introduce and improve health care delivery projects that have an information management component and make compliance costs for health providers cheaper in the long term.

What are the objectives of the NZHISO? The NZHISO Committee's overall objective is to lead the development and implementation of Information Management and Information Technology standards required for the health and disability support sector.

The core functions of NZHISO include ensuring that relevant health information standards are identified, developed, published and monitored. Unlike most standards organisations, NZHISO will have vested interest in ensuring that standards it adopts are implemented.

The scope of standards development activities that the Committee will be involved in includes activities associated with: Records structure and content - data formats Vocabulary - codes for medical and other healthcare terms Messaging - standards used for the interchange of data Security - how access is controlled.

What is NZHISO's priorities be? As mentioned below, the Ministry, in conjunction with the sector, has developed a draft health information standards plan. The standards plan highlights the standards that the sector has identified as being necessary to assist initiatives that are underway and that need to be developed to allow further initiatives to occur. An example is a sector data dictionary. This will help ensure data elements are common and comparable, allowing data to exchanged without loss of data 'meaning'. The plan will be presented to NZHISO for review and adoption.

Who will pay for its setup and running costs? Because of the need to get NZHISO up and running right away, the Ministry of Health will fund the initial setup, with $225,000 allocated for the 2002/03 financial year. The following year the Ministry will fund the running costs of the committee, with the health and disability sector contributing towards activities that develop standards, as it begins do receive the benefits of the NZHISO. In 2004/05 the sector will fully fund the committee and its activities.

What benefits will there be for Health Providers? The results of NZHISO handling information standards are expected to make things easier for health providers in the long term. It will enable information to be used by teams of people providing health and/or disability services to a person or their whanau in a safe way. It will enable providers to develop better ways of delivering services including more innovative service delivery models associated with coordinated care. Providers will also have better quality information to make better informed decisions for their patients.

Decision making on the effectiveness of existing services will be improved as standardised information becomes available to service developers. Patterns of service access will be able to be analysed and this will assist in the development of more appropriate services. Maori, Pacific Peoples and other groups who do not access the same services as the majority of New Zealand's population will be able to have services tailored for their needs. More efficient use of services will result in more services being available to be put into health and disability services.

Standardisation will also contribute to reducing compliance costs as the technology and systems used becomes more uniform across the health sector. When health information systems are introduced or modified, it will mean less time spent on making the necessary system changes. Initiatives like the Health Practitioner Index will provide a single identifier when dealing with agencies like DHBs and ACC.

What's in it for the Health Consumer? While the actions of the NZHISO will be 'in the backroom', the results seen from its governing of the way information is handled will be an improved capability for providers to deliver quality health services. This includes appropriate, faster and easier access to information. It will mean that lab tests don't have to be repeated because information from the first tests will be available. New functions will become possible like GPs booking in patient appointments to specialists in real-time, not sending a letter and waiting days for a reply. Decisions support systems linked to pharmaceutical ordering will help avoid prescribing incompatible drugs to patients. People who receive services should gradually expect to see the quality and quantity of services that receive increase.

Who will be on the NZHISO committee? The Minister of Health will appoint the committee, with members nominated from the following interest groups:

The Ministry of Health ACC District Health Boards New Zealand (DHBNZ). The DHBNZ CEO's Group Independent Practice Association Council (IPAC) Royal NZ College of General Practitioners Nursing Council New Zealand The Minister of Health may also appoint up to three members to reflect other sector interest groups.

When will the NZHISO be operational? The appointment process will start early in the new year. It is expected that NZHISO will have its first meeting in February 2003.

How will NZHISO develop standards? NZHISO itself will provide the strategic coordination to ensure that the right work is being done. The actual standards will be developed by working groups consisting of experts to know about the particular standard being developed. Once they have agreed, NZHISO will endorse their recommendations and work actively to ensure that it is implemented. The working groups will consist of software development vendors, clinicians, consumers, policy analysts and other health and information management specialists.

What is the Health Network Code of Practice? A Health Network Code of Practice will provide a security framework that organisations using the Health Network will need to follow to show that they are managing health information in an appropriately secure manner. It's implementation will be one of the first standards monitored by NZHISO. The code is based on the ISO 17799 standard and was commissioned by the Ministry of Health and developed by Standards NZ.

What is the draft Standards Plan about? Initiated by the Ministry, the draft plan has been developed with sector input. The draft standards plan provides a comprehensive overview as to what information standards need to be developed to help health care delivery initiatives like electronic hospital discharges. The plan also details the processes that the sector will follow to develop standards - a working group model is being recommended.

To enable the NZHISO to be up and running as soon as possible, the plan will be presented to NZHISO as a draft for their review and adoption. As noted in the plan, work is underway on a number of the standards mentioned and this work will continue and be merged into NZHISO's final workplan.

Where can I find more information about the WAVE report? A copy of the WAVE report can be found on the Ministry of Health's website, Progress on WAVE implementations is regularly provided via the Ministry's Health E-news electronic newsletter which is also posted on the Ministry's website.

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