Industry View: The importance of health IT standards

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Regular column by Scott Arrol, NZHIT CEO

Standards are key to NZHIT’s vision of digital technology enabling world-class health and wellbeing for all New Zealanders.

NZHIT’s vision is that there will be world-class health and wellbeing for all New Zealanders fully enabled by digital technology. This is supported by NZHIT’s purpose to provide an open environment that enables a co-ordinated, informed voice that maximises health, social and economic value for New Zealand through digital technology.

Standards are a key enabler for achieving this vision and purpose as they create consistency, set levels of expectations and provide the ability for various digital systems to interoperate, exchange data and support clinical decision making. NZHIT supports the work underway within the Ministry of Health, and across New Zealand’s health agencies, to partner in the strengthening of standards as they relate to health IT solutions.

Need for collaboration to ensure appropriate standards

It is very important that policymakers, healthcare providers, funders, researchers and industry partners work together in this regard so that standards are fit for purpose, sustainable and enduring over the long run. In addition, all standards adopted in this country must have international applicability that supports export opportunities, as well as enabling global operators to view New Zealand as a stable market within which to invest.

Raising the bar when it comes to standards is a two-edged sword. On one edge there is the need for industry to recognise the importance of investing in (and conforming to) a set of mutually agreed standards while, on the other edge, healthcare providers and funders must equally recognise this by purchasing to the standards. This means that, where a standard or set of standards are required to be met or conformed to, the purchaser will only contract with those who demonstrate they have made the commitment to these standards.

This also places an emphasis on all parties working together to ensure there is a consistent and efficient marketplace in operation that encourages innovation, development of new business models and eliminates repetitive (and often times onerous) practices and associated costs.

Similarly, where a mutually agreed standard is in place it is important that policy and purchasing processes remain consistent to this standard, just as the software provider must maintain its conformance to that standard as well.

Challenges for existing market players and new entrants

In this way, industry will adopt new ways of operating that rewards innovation and implements business models that enable more efficient and effective ways of servicing the sector. This goes for both existing market players and new entrants, as each has the ability to identify opportunities and develop solutions to support changing health and wellbeing services.

The challenge for the former is to be prepared to let go of (or modify) historical business and cultural practices that restrict the ability to meet their customers changing needs and ever constrained budgets.

New entrants are less encumbered as they often enter the market with the intent to transform or disrupt, so their business models are generally quite different from the outset. However, this also may mean that the sector finds it hard to recognise this new way of operating, and can’t adjust how it is paid for, so the new entrant struggles to achieve scalability (witnessed by the proliferation of pilots or proofs of concept that generally only last for a short period).

Current practices favour the status quo

Regardless of whether an existing industry partner or new entrant, the current procurement and funding practices in New Zealand encourage the status quo and will clearly have to be addressed. Standards are a way to lever consistency and best practice, but they must be partnered by joined-up policy and procurement practices operating within a fair and competitive market environment.

The Health Information Standards Organisation plays a very important role in supporting and promoting the development and adoption of fit-for-purpose health information standards for New Zealand’s health and disability sector.

NZHIT supports HISO and is pleased to be partnering with them to provide the leadership that both organisations bring to the sector, especially as standards will have an increasing influence on the development of digital technologies based on strong and stable foundations.

John Carter to join HISO committee

To this end, NZHIT is very pleased that HISO has recently accepted the nomination of John Carter to join the HISO committee as the industry partner’s representative. This builds on an already strong relationship and will enable NZHIT members to further engage and participate in this very important area.

John is the chief technology officer for HealthLink (an NZHIT founding member) and has more than 25 years of health information technology leadership experience. Originally from the United States, John joined HealthLink in 2017, having been vice president at Apelon Inc, a US-based professional services firm specialising in the implementation of data standards and controlled healthcare vocabularies. While at Apelon, he worked on projects for government agencies in the US, Canada, Australia, France and the Philippines, along with numerous US and international NGO and commercial clients.

John is on the board of HL7 NZ and is an active participant in standards development activities, most recently being a member of the interoperability working group. He has a very strong business and informatics background, holding an MBA Finance from Webster University (St Louis, USA) and was a US National Library of Medicine Fellow in medical informatics at the University of Utah.

HealthLink’s support for John’s industry representative role is also important, as they have made his time and expertise available to HISO and to the sector. As a committee member, John is bound by its terms of reference. He will work closely with me to ensure industry partners have an opportunity to engage and influence the development of standards.

We both look forward to engaging collaboratively with all stakeholders on this crucially important piece of work.

Scott Arrol is the CEO of New Zealand Health NZHIT.



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Anna Arrol

Administration Assistant

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