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NZ explores IT in asset management programme for district health boards

District Health Boards (DHB), under the Ministry of Health, are responsible for providing or funding the provision of health services in their district.

According to the Ministry, the National Asset Management Programme (NAMP) is part of a government-wide focus to improve capital funding decisions, capital investment plans and asset management, and to ensure investments deliver the best value for New Zealanders.

The document explores the state of DHB assets and is the first consistent nationwide report on the condition and clinical fitness for purpose of DHB facilities and buildings.

The report noted that DHB IT is largely focused on core hospital systems, with asset management practice constrained by a short-term planning focus. Investments of around $2.3 billion is required over the next decade to address issues with legacy systems and to invest in technologies that enable services to transform to new models of care.

New Zealand has lacked the investment levels necessary to embrace rapid changes in health IT technologies. It is estimated that DHBs spend 2.3% of their operating budgets on IT, with 90% going to support aged and outdated systems and infrastructure.

It needs to shift to 4.6%, with 75% spent on maintenance and 25% on new investments. In the last few years, health professionals have changed from acceptance of departmental legacy systems to expectations that systems support the clinical workflow. It includes support to view and update an integrated patient record, on-the-move, across all care settings and on various devices.

A significant lift in investment of around $2.3 billion is necessary to deliver this digital health environment.

The report quoted a survey from 2018 that revealed an 800% growth in applications, mostly in clinical areas, in little over a decade.

The growth included a high dependency on Wi-Fi and mobile phones with applications seen as critical to service delivery and patient safety.

The Ministry of Health’s Health Information Standards Organisation (HISO) oversees the development and adoption of all standards for interoperability in health care. However, adoption by the health sector has been slow and inconsistent.

Work to improve core information systems and compliance with data standards, through the clinical workflow, is required to realise benefits from operating a more digitally enabled health system.

DHBs are moving towards having regional data centres managed by specialist providers. They are also moving to ‘as a service’ and cloud-based services for some of their clinical repositories at an organisational or regional level.

Data centres can be vulnerable due to the condition of the buildings and site infrastructure and the data centre design and conditions. This design includes flooring, climate control, uninterruptable power supplies, cabling, and server racks.

The report suggests the following as solutions to DHB’s current issues:

  • sitewide infrastructure (eg.pipes and electrical power)
  • building operability (eg.passive fire separation)
  • mental health and intensive care units, including CFFFP, condition, and maintenance
  • core IT applications, including financial management, patient administration, and pharmacy management systems.

To date, the government has invested $3.5 billion into DHB capital projects. Over the ten years, DHB infrastructure expects to require $14 billion in funding.

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