Health Information Standards Organisation (HISO) operates under Standards New Zealand to convene the national mirror committee for the ISO/TC 215 Health informatics technical committee of the International Organisation for Standardisation (ISO).
We received nominations from the sector and our proposal to form the national mirror committee was ratified by the Standards Approval Board in March 2021.
The Standards Approval Board is an independent statutory board set up under the Standards and Accreditation Act 2015. The Board commenced in March 2016 and is responsible for approving the membership of standards development committees and standards that are developed by these committees.
Being a participating member allows us to have input to international data and digital standards that can be adopted in New Zealand to improve our health and disability system.
The ISO/TC 215 Health informatics national mirror committee has responsibility to:
- Monitor all ISO/TC 215 work items, drafts and ballots
- Review the technical content of documents out for comment and formulate a national position
- Inform Standards NZ of the position reached on ISO/TC 215 work proposal (NP), committee draft (CD), draft international standard (DIS) and final draft international standard (FDIS) documents
- Work with Standards NZ to enter a vote on all NP, CD, DIS and FDIS documents
- Provide a valid technical justification for any negative vote
- Inform Standards NZ of the position reached on ISO standards under systematic five-year review
- Consult with stakeholders in forming a national position on international matters
Susanne is an independent health IT consultant with Melete Ltd. She is associated with SNOMED International and is an HL7 New Zealand member. Susanne has deep experience working with health information in the USA and New Zealand including:
- Streamlining reporting for Washington state health programmes, insurance plan procurement, oversight of contract actuarial services and legislative proposal analysis
- Operations management and quality improvements for internal clinical advice at the NZ Accident Compensation Corporation (ACC), including reviews of how diagnosis coding is used and interpreted for treatment
- Development of the ACC SNOMED to Read mapping table and update process, and contract oversight for external review and expansion. This included leading a clinical project team, and liaising with the NZ Ministry of Health and other users and stakeholders
- Primary care support, including implementing forms, software and other improvements that move information transmission from manual, paper-based processes to automated data capture.
Her postgraduate education includes:
- Master’s degree in Public Administration, University of Washington
- Post graduate diploma in Primary Health and General Practice (distinction)
- SNOMED Foundation and implementation courses.
- Presentations about SNOMED and ACC’s clinical terminology use to Health Informatics NZ, NZ private hospital representatives, allied health stakeholders and the Practice Managers and Administrations Association of NZ.
Dr Michael Mair
BA Mb BChir DO FRCS FRANZCO
Qualified as a medical doctor in 1971, following a first degree in Social Anthropology in 1968, both from Cambridge University, and after early experience in Ophthalmology in 1973 in West Africa I achieved the Diploma in Ophthalmology in 1974 from the Royal College of Surgeons in 1974. Since then I have continued with both interests, studying human interaction from 1974-1977 supported by the UK Social Science Research Council. I spent two years back in Cambridge UK from 1979 -81 working in both Neurology/Neurosurgery and Ophthalmology at Addenbroooks Hospital, then back to London for the residency program in Ophthalmology at Moorfields Eye Hospital from 1981-84. I emigrated to NZ in 1985, first as Senior Lecturer in Ophthalmology at Otago in 1985, then as solo Ophthalmologist in Timaru from 1988 until I retired in 2015. I have been involved in locum Ophthalmology work since.
From 1989 I began work on an EHR and in 1993 produced my first version for Cataract, Glaucoma, and Diabetic retinopathy screening. I produced the first General Ophthalmology record in 1995 when I went paperless in both public and private practices in Timaru. From 1998 I began working with Standards NZ then led by Mr Proctor and with Lindsay Stewart of the MOH working up my ‘immunological model’ of access control to the EHR. After an HL7 International meeting in 2001, I modified my project to become the ‘Immunological Model for access control to the CDA’, and presented this at HL7 meetings. I also represented NZ at the first meeting of ISO/TC 215, and presented the same ideas at that forum, and delivered a keynote address on EHR standards at the World Ophthalmology Congress meeting in the year 2000 in Sydney
In 2020 I became involved in the HL7 project to create a FHIR Implementation guide -IG- for Ophthalmology which is still running and am a co-author of a paper accepted for the forthcoming ARVO the Association for Research in Vision and Ophthalmology in May 2021.
I recognise that a successful resolution to the long running arguments about EHR communication standards is now very urgent, and the NZ ISO /TC 215 group may be a forum for me to help and hopefully quite soon now complete the project of getting a global, practical and facilitatory EHR currency.
Micah Davison is a Senior Advisor in Te Whatu Ora’s Data and Digital Standards team. He manages a portfolio of health data standards, with a focus on identity, privacy, trust and data governance, where he is a subject matter expert. Micah has led work to introduce a new edition of the Health Information Security Framework as well as updates to the Consumer Health Identity Standard and mental health data collection standards.
Prior to joining Te Whatu Ora, Micah led the development of the Stats NZ data standard for gender, sex and variations of sex characteristics, which is now a mandated data standard for all of government.
He enjoys working collaboratively with a range of stakeholders to create inclusive and future focused standards to support Aotearoa’s health system and the priorities set by Te Pae Tata Interim New Zealand Health Plan.
As part of his role, Micah has supported the ISO/TC 215 IRG by coordinating the response to the recent ISO/TC 215 Sex and gender in electronic health records ballot, as well as liaising with HL7 and other international forums on sex and gender. He has completed education courses on SNOMED CT and HL7 FHIR and helps to manage the NZ Health Terminology Service operated by Te Whatu Ora.
Micah is part way through a Master of Health Sciences, with a focus on bioethics and health information management.
Dr Koray Atalag
MD, PhD, FAIDH
Koray is a medical doctor with a PhD in Information Systems and a Fellow of the Australasian Institute of Digital Health (FAIDH). Having significant experience in digital health, in particular electronic health records (EHR) and interoperability, he is passionate about making ICT reach its full potential in healthcare. Koray serves as CIO and Chief Scientist at The Clinician, a health IT company, that has created an interoperable platform to engage patients, collect patient reported outcome/experience measures (PROMs and PREMs) to create actionable insights and drive value-based care.
Koray holds an honorary academic appointment as senior research fellow at the Auckland Bioengineering Institute of the University of Auckland. His main research areas are electronic health record and interoperability standards, clinical decision support systems and computational physiology. Koray taught the Healthcare Decision Systems course (HLTHINFO 730) as part of the Postgraduate Diploma in Health Informatics Programme at the University of Auckland and supervise Masters and PhD students.
Having been deeply involved in HL7 and openEHR (a global health informatics standards for electronic health records and interoperability), Koray seeks to improve software maintainability and enable interoperability by tackling the complexity and changeability of health information using computable models – called Archetypes.
Koray co-authored the New Zealand Interoperability Reference Architecture, published as a HISO standard in 2012, and led technical evaluations of major health IT innovation projects. He has served as an elected member of the openEHR Foundation Management Board, past vice-chair and now an HL7 New Zealand Board member.
Samuel is VP Products at Vensa Health and co-chair of the NZHIT Virtual Health Industry Group.
Samuel Wong has been involved in the healthcare sector for over 20 years. His experiences in health informatics and health standards spans across a wide range of sectors covering clinical record management in hospitals, and working in senior analytics lead or data governance/architect roles in primary health organisations, national emergency ambulance services, and national telehealth services. Supplementary projects also involved data collaborations with most of the directorates at the Ministry of Health, ESR, R&D in Medtech/Biotech industry and most recently, joining the Health IT industry. His current role is the VP Product Innovations at Vensa Health, one of the national patient portal providers. In addition, he also serves as the Chair of NZHiT’s Virtual Health Industry Group, and part of the NZ Telehealth Leadership Group.
In his various roles, Samuel has been accustomed to managing and advocating health information standards, in trying to create interoperability between various systems for patient care and health system management purposes. Understanding care of a patient has to involve the use of clinical terminologies, like SNOMED CT, related codes such as NZ Formulary, NZULM and Pharmacode, or diagnostic/procedure codes found in ICD-10-AM, READ and LOINC. Patients also require standards to describe occupations, ethnicities, industries, identity and gender/sexual orientation. Through his senior roles, he was also completed training on service provisions for quality (e.g. ISO9001, ISO13485) as well as national/international privacy standards and sector-wide data governance. The range of integration between understanding these standards has helped provide opportunities for using data towards AI-based contextual learning models to improve care pathways which is in line with the direction of ISO/TC 215.
Samuel has attained a BSc (Biomedical Sciences) and a PGDipSci (Medical Sciences) at the University of Auckland. For clinical practice, he has qualified for the National Diploma in Ambulance Practice. In 2018, he completed the LEAD:Corporate Innovation Certificate from Stanford University.
Nathan is an information systems analyst and digital product owner at Auckland District Health Board. He holds a Master of Science in Health Informatics from the University of Edinburgh. He has over 12 years clinical experience and has served within a wide range of medical and surgical dietetic specialties both in community and acute care settings, across three continents. He continues to hold New Zealand Dietetic Registration and got involved with HL7 when working with the American Academy of Nutrition and Dietetics in developing Electronic Nutrition Care Process Record System Functional Profile, to establish conformance to the HL7 International EHR-S Functional Model Release 2. Subsequent to this he has been involved with the SNOMED Nutrition Care Process Terminology Clinical Project Group, which is working through the addition of Nutrition terms to the international version of SNOMED.
Nathan is a former board member of Health Informatics New Zealand (HINZ), and has helped to organise the annual HiNZ conference, present topics and chair sessions.
Angela is the Manager of Data Management, National Collections in the Data and Digital Directorate at the Ministry of Health. She holds graduate and post graduate qualifications from Victoria and Massey Universities in econometrics and business management. She has worked in various health data collection and distribution leadership roles in the New Zealand Health Information Service (NZHIS) and the Ministry of Health over the last 20 years and prior to that in other government departments.
In her current role Angela leads a team of data quality analysts and data management engineers to support those organisations that supply data to the national collections and those who use the data. She has been part of many sector and IT change projects relating to data collection and reporting. Since 2016 Angela has been the New Zealand representative on the Australian Independent Hospital Pricing Authority (IHPA) Diagnosis Related Groups (DRG) Technical Group and also sits on several health sector and cross government working groups. She is also involved in Ministry data privacy and stewardship processes. She has worked with both Statistics NZ and HISO on the development and implementation of data classifications and standards.
As Chief Standards Advisor, Alastair is the functional lead for data and digital standards at the Ministry of Health, responsible for the development and adoption of standards for an equitable, data-driven and digitally-enabled New Zealand health and disability system. Alastair works with clinical, consumer and industry groups to identify, develop and lead the adoption of standards, implementation guides and regulatory requirements.
He publishes and oversees the implementation of an interoperability roadmap for the health system, working with district health boards, primary health organisations, health providers, the software industry, other government agencies and standards development organisations to improve interoperability through standards. He oversees all significant ICT investment by district health boards to ensure conformance to standards.
In his current role, he chairs the Health Information Standards Organisation (HISO) committee. Alastair previously chaired the Health Sector Architects Group from 2013 to 2017.
Alastair has been the SNOMED International representative for New Zealand since 2017 and chaired the SNOMED International Member Forum from 2019 to 2021. He led the New Zealand hosting of the SNOMED International conference for 2016. He has also been Global Digital Health Partnership (GDHP) representative for New Zealand since 2018. Alastair chaired a Standards New Zealand committee in 2019 for the identical adoption of 10 ISO/IEC automatic identification and data capture standards.
Alastair is convenor of the ISO/TC 215 national mirror committee.
Dr Inga Hunter
Inga Hunter is an Associate Professor and Director of the Health Services Management programme Massey University. Her research interests include health informatics, in particular using digital technology to support models of healthcare delivery. This research has an applied end-user focus, translating end-user research into clinical practice/health sector policy.
Inga Hunter is an Associate Professor and Director of the Health Services Management programme Massey University. Her research interests include health informatics, in particular using digital technology to support models of healthcare delivery. This research has an applied end-user focus, translating end-user research into clinical practice/health sector policy.Inga is a medical doctor with an MPhil (Information Systems) and is a Fellow of the Royal New Zealand College of General Practitioners (FRNZCGP), Fellow of the Australasian College of Health Informatics (FACHI), and Foundation Fellow of Health Informatics New Zealand (FHiNZ).
Inga now works fulltime at Massey University but until 2019 she worked for 20 years part time in clinical medical practice and part-time at the University. She has 30 years clinical experience in a variety of clinical settings in general practice, primary, secondary, and tertiary care in Ireland, Australia and New Zealand, along with 20 years research and teaching experience in health informatics, information technology and health services management.
Inga has served on a variety of international, national, regional and local groups and boards within the health informatics domain, most recently:
- NZ Telehealth Forum
- IMIA Telehealth working group
- NZ representative, Asia-Pacific Medical Informatics Association (AMIA) and International Medical Informatics Association (IMIA)
- Health Research Council College of Experts and peer reviewer
- Australasian Institute of Digital Health (AIDH)
- Strategic ICT Governance Group/Clinical Reference Group, MidCentral DHB
- National Information Clinical Leadership Group
- Health Information Governance Expert Advisory Group
- Health Informatics New Zealand (HiNZ)
She has more than 100 publications including the HISO standards HISO 10029:2009 Health Information Security Framework and HISO 10064:2017 Health information Governance Guidelines.
Dr Derek Buchanan
Derek is a medical doctor and digital specialist who has more than 15 years of experience in the health sector. He has a strong interest in various standards and has been part of international working groups including HL7, SNOMED CT and BPM+ Health. He holds active membership with ITPNZ, BCS, HiNZ and is an associate of ISC2. He has completed degrees in medicine, software engineering and business and holds several industry certifications. His past work experience includes roles across a range of health specialities from primary to tertiary healthcare with current membership to RNZCUC and RANZCP. His past informatics work includes the HIKER group and HealthAlliance. He continues to work in both clinical and non-clinical roles.
In health tech, he has completed HL7 FHIR Proficiency Certification and SNOMED CT courses (Foundation, Authoring 1 and Implementation). His interests in health technology are varied, but range from cybersecurity, precision medicine and AI/Machine learning, to the use of cloud technology and IoMT. Outside of health technology, he has been involved in projects in agritech, edutech and soctech. He has experience working in governance, consultancy and advisory roles - participating in several initiatives relevant to New Zealand. He continues to be involved in the not-for-profit and social enterprise space. Derek is a strong believer in standards and supports the role of the ISO/TC 215 IRG in the New Zealand health ecosystem.
Terms of reference
Terms of reference for the Health Information Standards Organisation (HISO).
Last revised June 2023.
Next review due by June 2024.
HISO was established in June 2003 and continues today as kaitiaki (steward) for health information standards – paerewa pārongo hauora – in New Zealand.
HISO is a committee operated by Te Whatu Ora and accountable to the Chief of Data and Digital.
HISO’s purpose is to ensure that data and digital standards contribute to the unified, smarter, sustainable and equity-led health system described by Te Pae Tata Interim New Zealand Health Plan 2022.
HISO oversees the selection, development and adoption of data and digital standards for the health sector.
Standards mahi includes tracking, evaluating, selecting and adapting international standards, and commissioning new standards, for national use. Successful adoption is achieved when the published standards are used productively in widely implemented solutions.
HISO is responsible for ensuring that standards are:
- co-designed with Hauora Māori groups and supportive of Māori data governance
- designed to improve health equity
- aligned internationally and based on best clinical practice evidence
- consistent with the national strategic and architectural direction
- introduced in consultation with the sector
- promoting collaboration and innovation
- published and proactively maintained
- supported by implementation guides and tools
- adopted widely and adding measurable value.
The strategic context is defined by:
- Te Whatu Ora Data and Digital Strategy
- Te Pae Tata Interim New Zealand Health Plan 2022
- He Korowai Oranga: Māori Health Strategy
- Whakamaua: Māori Health Action Plan 2020-25
- ’Ala Mo’ui: Pathways to Pacific Health and Wellbeing
- Strategy for a Digital Public Service.
Te Tiriti o Waitangi
In all data and digital standards mahi, HISO commits to the five Te Tiriti principles of tino rangatiratanga, equity, active protection, options and partnership set out by the Waitangi Tribunal Health Services and Outcomes Inquiry (Wai 2575) and Manatū Hauora’s Te Tiriti Framework.
HISO is a committee of up to ten members, including the chair.
Members are chosen to represent a range of stakeholder interests to oversee our system of data and digital standards for health.
Committee positions are openly advertised and draw from organisations such as:
- Te Whatu Ora, Te Aka Whai Ora and Manatū Hauora
- Hauora Māori organisations
- Whānau Ora providers
- Primary and community health and social care organisations
- Clinical Informatics Leadership Network, national clinical groups and health professional organisations
- Whaikaha – Ministry of Disabled People
- Te Aho o Te Kahu – Cancer Control Agency
- Pharmac – Te Pātaka Whaioranga
- Accident Compensation Corporation
- HL7 New Zealand, Digital Health Association and health software industry partners
- Health consumer groups.
The makeup of the committee at any time may vary depending on suitable
candidates being available and the appointment process.
Members are expected to be influential in their respective organisations and communities and able to drive standards adoption.
Additional members may be co-opted to the committee as subject matter experts for a set purpose and term. These members are subject to the same rules and provisions as other members.
The Chief Standards Advisor, Data and Digital chairs HISO as an ex officio member.
The chair may select another member as vice chair to help plan and run meetings.
Members are appointed and may be reappointed for terms of up to two years at a time.
All appointments and reappointments are made by the Chief of Data and Digital.
Nominations for positions on the committee are openly advertised when vacancies arise.
New appointees receive letters of appointment from the Chief of Data and Digital. Appointees are required to acknowledge their acceptance in writing, declaring any conflicts of interest and agreeing to meet their obligations under the terms of reference.
Members are always expected to exercise sound professional judgement and to act in good faith, impartially and with reasonable care to support the sector and the public interest.
At their discretion, the Chief of Data and Digital may remove a HISO member. The member will receive a letter stating the reason for the decision and the date of effect.
HISO members may resign their term at any time by writing to the chair.
HISO has bi-monthly meetings that are sometimes held in person but more often by videoconference. The chair may call additional meetings as necessary. Usual meeting protocols are followed.
A quorum is half the current membership including the chair. Meetings may continue without a quorum provided no decisions are sought.
HISO uses consensus decision making. The chair may call a simple majority vote on any unresolved issue.
Proceedings are documented, including the agenda, minutes and any papers presented. An executive summary of each meeting is produced to communicate key messages to stakeholders.
Attendance, conflicts of interest, action and decision registers are maintained.
The chair is responsible for inviting guests to attend and present to the committee. Observers may also attend with the chair’s approval.
Disputes and liability
HISO members are expected to act constructively and in good faith to resolve any dispute. The chair may bring in a mediator where a dispute cannot be resolved with best efforts.
No member is legally responsible or liable for any act or omission of Te Whatu Ora.
No member can be held legally responsible or liable by Te Whatu Ora for any act or omission of their own provided the member has acted responsibly as required by these terms of reference.
Conflict of interest
Members shall comply with Te Whatu Ora’s conflicts of interest rules and guidelines.
Members shall promptly declare to the chair any actual, potential or perceived conflict of interest in relation to a matter under consideration. The chair determines whether any conflicted member can continue to participate in discussions or voting on matters relating to the declared conflict.
The chair may declare certain documents or matters confidential. Members should not disclose any information declared confidential, except as required by law. Members are expected to publicly support any consensus decision or refrain from commenting on it.
HISO forms working groups in partnership with subject matter experts to evaluate, develop and review standards and lead their implementation.
HISO’s chair approves working group terms of reference and membership and appoints the working group chair.
HISO uses open forums for engagement and consultation with the sector.
HISO maintains important relationships across government and with international organisations, in addition to its health sector links.
Government system leads:
- Government Chief Data Steward
- Government Chief Digital Officer
- Government Chief Information Security Officer
- Government Chief Privacy Officer
- Standards New Zealand.
- Global Digital Health Partnership (GDHP)
- World Health Organisation (WHO)
- Australian institute of Health and Welfare (AIHW) for ICD-10-AM and related standards
- HL7 International
- SNOMED International
- GS1 International
- Regenstrief Institute for LOINC
- Joint Initiative Council for Global Health Informatics Standardisation.
HISO engages with and seeks the views of key clinical, consumer and health provider service management stakeholder groups.
HISO partners with relevant stakeholder groups as co-stewards of standards
HISO’s standards development and adoption priorities are agreed with the Chief of Data and Digital and tracked in a quarterly work plan.
The Chief of Data and Digital may direct the committee to advise on other matters as they arise.
Standards advisors in the Data and Digital directorate support HISO and its working groups, do research, provide advice, help to draft standards, support and monitor adoption and maintain the work plan.
Te Whatu Ora has financial authority over HISO. HISO has no power of its own to direct the work of health and disability sector organisations, employ staff, enter contracts, make loans or commit expenditure.
Fees and expenses
Fees paid to committee and working group members are determined in accordance with the Cabinet Fees Framework for members appointed to bodies in which the Crown has an interest. HISO and its working groups are classified among ‘Group 4: All other committees and other bodies’. Fees are paid for preparation, attendance and travel in relation to scheduled committee and working group meetings. Fees are not paid to salaried public servants.
Fees payable to members per meeting are:
- a meeting attendance fee of $560 including GST for any meeting of between six and eight hours; for shorter meetings, a fee of $560/8 per hour
- a meeting preparation fee of $280 including GST
- a travel fee of $280 including GST for travel of more than three hours.
Fees are categorised as honoraria and as such are subject to withholding tax pursuant to Schedule 4 Part B of the Income Tax Act 2007 No 97.
Te Whatu Ora reimburses members for actual and reasonable expenses in attending HISO meetings. Accommodation and travel must be arranged by Te Whatu Ora. Members may submit a travel expense claim for costs such as parking.
Te Whatu Ora is responsible for preparing and publishing approved HISO standards and related documents.
Copyright over all HISO documents and other intellectual property is vested in the Crown, under the Te Whatu Ora’s stewardship.
HISO documents are published under the Creative Commons Attribution 4.0 International licence.