An important report for the NZ Health System was released a few days ago by the Health Minister.
Ministerial Review Group Report released
Health Minister Tony Ryall has released the report of the Ministerial Review Group, set up to recommend how New Zealand might improve the quality and performance of the public health system.
"'Meeting the Challenge' is a comprehensive report, with 170 recommendations on how to reduce bureaucracy, improve frontline health services, and improve value in the public health and disability sector," Mr Ryall says.
"The Ministerial Review Group included some of the leading clinicians and managers in the health sector. Many of their recommendations have been well discussed in the sector already."
"The report recognises that to improve frontline services we need more input from frontline staff, and there are recommendations to strengthen clinical leadership and clinical networks."
The report proposes consolidating back office functions across the 21 District Health Boards (DHBs) to harness the power of bulk purchasing. It also proposes reducing the number of committees that advise the Ministry of Health from 157 to 54.
Mr Ryall says the recommendations require careful consideration.
"The Government is not interested in supporting any recommendations that increase bureaucracy or don't improve patient service."
"Government is under no obligation to accept the report's recommendations.
Cabinet will be considering the report over the next couple of months and feedback from the public and the health sector is welcomed. People can download the report from the Beehive website and send me their thoughts."
The full press release is found here:
http://www.beehive.govt.nz/release/ministerial+review+group+report+released
The important thing for readers in Australia and an interest in e-Health are the key recommendations in that area. These were found in Appendix 3.
The report and appendices are found here.
- MRG Report Meeting the Challenge.pdf (pdf, 261 Kb)
- Annex1 Current and Proposed Structures.pdf (pdf, 42 Kb)
- Annex2 Clinical Leadership and Quality.pdf (pdf, 138 Kb)
- Annex3 Infrastructure capacity and planning.pdf (pdf, 109 Kb)
- Annex4 Value for Money.pdf (pdf, 193 Kb)
- Annex5 Commentary on Enhancing Clinical Leadership.pdf (pdf, 103 Kb)
- Annex6 Report Recommendations.pdf (pdf, 121 Kb)
The recommendations from this are as follows.
The MRG recommends that:
(a) An interim governance group be set up for both NSDP and KD to reprioritise and reduce the number of NSDP and KD projects with a focus on (a) addressing the risks in the payments system and (b) supporting the implementation of the distributed approach to a safe sharing and transfer of patient electronic information amongst providers,
(b) The Refresh HISNZ project of KD should cease and the Safe Sharing of Health Information Community Dialogue and Education project of KD should be slimmed down and utilise the existing HISAC consumer forum,
(c) All primary care related IT projects such as GP to GP Notes Transfer, PHO Performance Programme, Qi4GP, electronic referrals, electronic discharges, electronic medication, and electronic laboratory should be integrated and rationalised under a new primary care information system initiative,
(d) The Grants Scheme project of KD be reviewed to support projects related to the primary care information system initiatives,
(e) The PHO Performance Programme be scaled back and savings be redirected to support the development of Qi4GP as part of a broader primary care information system initiative,
(f) That the interoperable and connected distributed approach rather than the single sector-wide enterprise system be confirmed as the preferred approach for the development of a safe sharing and transfer of patient electronic health information for the New Zealand health sector,
(g) The HMSC initiatives by seven DHBs revise their scope to concentrate on replacing the PAS for hospitals. This revised scope be implemented using a distributed approach for the development of a safe sharing and transfer of patient electronic health information, using interoperability standards set by HISO to ensure integration with primary care and other providers’ systems,
(h) The roles and function of the Ministry of Health ID be reviewed and focused solely to support the IT needs of the Ministry,
(i) The national payments and contracts management systems provided by Sector Services (with a budget of 272 FTEs) should be moved out of ID to a national shared service agency. While work is being undertaken to establish the legislation to set up a national shared service agency, this function should be transferred to a single NHB subsidiary,
(j) All other current responsibilities of the Ministry ID be transferred to the NHB,
(k) A National Health IT Board be set up within, and report to, the NHB and replace the current HISAC. This board will provide a strategic leadership role for national health IT strategy and planning as well as governance over national collections and systems,
(l) The National Health IT Board will, on behalf of the NHB, work with the sector to develop a national IT Plan (including a national IT architecture framework) to advance HISNZ. This plan will be a rolling plan with local, regional, and national views, and a short, intermediate, and long-term perspective that it is aligned with the National Health Workforce Plan and National Health Capital Plan,
(m) The National Health IT Board will be represented on the NHB single Investment Committee responsible for planning and funding IT and facilities programmes,
(n) The National Health IT Board will ensure there is strong sector clinical manager and governance leadership of IT projects,
(o) The National Health IT Board will work closely with the HSMC initiative and the proposed primary care information system initiative to advance:
(i) The implementation of a safe, shared and transferable patient electronic health record for New Zealand health sector, using a distributed approach based on interoperability standards set by the HISO, and
(ii) The implementation of a consumer portal.
--- End Recommendations.
I have emphasised ( in italics) what seem to me to be the key points.
There is useful analysis (with an explanation of the various acronyms) here:
Health report pushes for national shared service agency
Key projects, including the Health Management System Collaborative, could be deferred or canned
By Rob O'Neill, Auckland | Monday, 17 August, 2009
The Horn report into the New Zealand health system, released yesterday, is recommending a major shake-up in the delivery of IT and other services to the sector.
The report recommends the establishment of a national shared services agency, modelled on Pharmac, which it says has done well in containing pharmaceutical cost growth.
It also finds the current strategic leadership of IT to be lacking, both at the DHB and the ministry level. The report also recommends the Health Management System Collaborative (HSMC) project, backed by seven DHBs, not go ahead as currently proposed.
Yesterday, speaking on TVNZ's Q&A programme ahead of the report's release, health minister Tony Ryall said duplicated systems and services needed to be consolidated in order to push more resources into front-line health.
The report recommends transferring the planning and funding of national services from District Health Boards (DHBs) and the Ministry of Health to a Crown health funding agency, provisionally called the National Health Board (NHB).
This includes shifting the monitoring of DHBs from the Ministry to the NHB, so the new entity has a complete view of health service planning and funding. This would bring together activities associated with "strategic planning and funding future capacity (IT, facilities and workforce) at the national level".
Much more here:
http://computerworld.co.nz/news.nsf/news/3D20CD4DAD168336CC257614007019C1
This article summarises the key changes this way.
“To get greater benefits from IT there needs to be:
• Clarity on who has a national strategic leadership role for national health IT strategy and planning;
• Confirmation on the preferred approach (interoperable and connected distributed systems or a single sector-wide enterprise system) and an architecture for a safe, shared and transferable patient electronic health record for the New Zealand health sector; and
• A higher level of ‘strategic leadership and ownership‘ from clinicians, managers and governors of IT projects. This call recognises the significant and integral part this information plays in determining how health services are delivered.”
Does this all remind you of what is needed on this side of the ‘ditch’! It sure does me!
Enjoy!
David.
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