Identity in a Connected Healthcare System

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Identity in a Connected Healthcare System New
Zealand Brendan Kelly Chief Advisor Health
Information Strategy and Policy
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New Zealand

• Scenic wonderland
• 4.1 million people
• Approx 80,000 registered health professionals
• Approx 200-300,000 people working in health and
  disability sector

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A day in the lifein NZ
157 babies are born 73 people die 105,000
prescriptions are filled 50,000 people take a
cholesterol-lowering drug 50,000 people take one
of the new antidepressants, e.g. Prozac 40,000
laboratory tests are analysed 1,167 people are
admitted to our hospitals 4,000 outpatients
visit hospitals for care 432 people have
elective surgical operations 1,960 people are
seen in Emergency Departments 27 people are
admitted to hospital with asthma 50,000 people
visit their GP 21 people have heart attacks 19
people are diagnosed with diabetes 637 children
are immunised 2,124 children and adolescents
have a dental check up 3,000 new claims received
by ACC
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Health Information Strategy for New Zealand12
National Action Zones

• National Network Implementation
• 2. NHI Promotion and Use
• 3. Health Provider Index (HPI) Implementation
• 4. ePharmacy
• 5. eLabs
• 6. Hospital Discharge Summaries

• Chronic Care Disease Management
• Electronic Referrals
• National Outpatient Collection
• National Primary Care Collection
• National System Access
• Anchoring Framework

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• Distributed Electronic Health Information
• New Zealands electronic health information
  direction
• Distributed and federated
• Not centralised
• Depends on
• Accessibility/Connectivity
• Clinical information standardisation
• Patient/Recipient Identity
• Provider identity
• Key for
• Clinical information
• Clinical governance
• Administrative information
• Policy, strategy and national planning
• Research

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• Accessibility and Connectivity
• Extensive national information systems
• Statistical collections
• Identity
• Service Support
• Payments
• Health Network
• since 1999
• All public hospitals
• 95 of GPs
• 99 0f GPs computerised
• 99 of pharmacies computerised

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• Patient/Recipient identity
• NHI online since 1993
• 5.5 million records in the NHI
• Embedded in hospital PAS systems
• Online lookup via Health Network
• Telephone access for non-connected providers

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• Provider identity
• Three data elements required
• Practitioner
• Facility the physical location
• Organisation the legal entity

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• Provider identity the solution
• The Health Practitioners Index - HPI
• A central directory of
• Registered Health Practitioner
• Facility
• Organisation
• Workforce
• HPI came on stream in October 2006
• 3rd attempt over 15 years
• HPCA Act 2003 made the difference

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• HPI the Practitioners
• All data sourced from Statutory Registration
  Authorities
• Central directory not the legal source only a
  copy
• Central directory assigns a unique identifier to
  each person
• Unique identifier returned to Registration
  Authority
• Approved Privacy Impact Assessment
• No access for general public
• Approved users must sign legal access agreement

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• HPI the Facilities and organisations
• All data sourced from central government
  databases
• Quality assured
• Central directory assigns a unique identifier to
  each facility and organisation
• No access for general public
• Approved users must sign legal access agreement

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• HPI the direction forward and the benefits
• Embedded in national claims and payments
  processes
• Incorporation into Hospital and primary care
  information systems
• Retiring existing multiple identifiers (up to 17)
• Enabling electronic interactions to support
  collaborative health service provision
• Ensuring privacy and security of shared
  electronic health information

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• New Zealand
• Top two in health information
• (with Denmark)
• Top two in primary care
• (Commonwealth Fund findings)
• World class outcomes at acceptable cost
• for a small economy

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• The way New Zealand
• uses health information
• Contributes to this outcome
• Accessibility/Connectivity
• Clinical information standardisation
• Patient/Recipient Identity
• Provider identity
• HPI one of the four information keys