1. Thomas Bowden CEO, HealthLink Ltd

2. The views expressed in this paper do not necessarily reflect the official position of the New Zealand government. Government officials have been consulted extensively during the preparation of this paper. The presenter is not an official spokesperson.

3. IF New Zealand was a US state… 24 South Carolina 4,479,800 25 Louisiana 4,410,796 26 Kentucky 4,269,245 New Zealand 4,173,460 27 Oregon 3,790,060 28 Oklahoma 3,642,361

4. An environment that works collaboratively... Many IT vendors Three Health-system Integrators A strong industry association Government leadership/sponsorship Vigorous experimentation and debate = a Learning Environment

5. Key Aims Support efficient primary care Automate routine processes Building on existing functionality Good working relationships..... We have a clear health reform strategy

6. Hospitals Specialists Pharmacies Laboratory Services Ancillary Professionals Radiology Services Referrals Status Reports Discharge Summaries Development of New Zealands Electronic Health Records System 1993-2012 On-Line Queries ORDER ENTRY -Pharmacy -Laboratory -Radiology -Hospital -Specialist -Pharmacy ALL HOSPITAL DOCUMENTSALL HOSPITAL DOCUMENTS Patient Connection to GP EMR Access Multiple specialised chronic care services Electronic Messaging Services (50 million messages per annum) Practice Support Systems 1100 General Practices Any authorized provider may send a structured online query to any EMR system 4.5 million patients NB: This is still a work in progress… Online Referrals

7. Electronic Clinical Transactions (Per Month) National Child Immunisation Register

8. Number of electronic partners (monthly average per general practice) 100% EMR UPTAKE100% EMR UPTAKE

9. 100% EMR UPTAKE100% EMR UPTAKE

10. Building clinical messaging applications VALUEVALUE EASE EASE

11. Our Views on.... Incentives and regulatory requirements to promote implementation? Incentives? As long as they are aligned with the overall drivers, Regulatory requirements? Clear cut but light handed. · Vender certification and technical assistance? Light handed certification and encouraging development of a market for technical assistance. · Strategies for national standards and interoperability? Clear easy to implement standards, gradually lifting the bar, An environment that makes interoperability desirable.

12. . The role of a national health integrator? Why not open it up to anyone that can chin the bar? · Privacy and confidentiality safeguards? It is absolutely critical to have a strong underpinning understanding of privacy and the fundamental importance of privacy to the human condition. · Use of public/private partnerships to support innovation? PPPs are a low-risk way of enabling specialised/core bits of infrastructure to be delivered efficiently and in a disciplined, well controlled manner. Ideally innovation is encouraged not contracted for

13. CURRENT FOCUS Electronic Referrals – online submission of very detailed information directly into a hospitals electronic medical record system Emergency room access to GPs EMRs – immediate, complete and up-to-date information Gradually pushing the agenda forward

14. tom.bowden@healthlink.net