What is Hira?

Hira is putting in place the foundations for My Health Record and other innovative digital health projects.

My Health Record is a secure website where people can view their immunisation records and COVID-19 test results. It is the first step in our plan to support New Zealanders to access their health information online. Over time, more information will be available, such as current and past medications, lab results and community services and high use card entitlements.

 

Connecting information via application programming interfaces

Information from My Health Record is made available through the interoperability put in place by Hira, using application programming interfaces or APIs. APIs enable two or more computer programs to communicate with each other using a set of definitions and protocols.

The APIs made available through Hira connect people’s health and wellbeing information – like the medicines they are on, the vaccinations they have had, and their lab results. They enable information to be pulled from different systems to create a personal health record.

 

Hira tranche one

The first stage of Hira to June 2024 – focuses on making available a subset of personal health information, called the New Zealand Patient Summary. After this, the focus will be on giving access to more information to create a full personal health record.

Hira will deliver:

  • A New Zealand Patient Summary – an app/website allowing healthcare consumers/whānau to see their health information in one place and update some of it.
  • A platform allowing healthcare providers to access and update patient data held in different databases.
  • A secure, carefully controlled digital ecosystem enabling vendors to build apps for healthcare consumers, whānau and providers, to help people manage their own health.

 

New Zealand Patient Summary 

By mid-2024, the Hira Programme is aiming to have the New Zealand Patient Summary available to consumers and healthcare providers. The New Zealand Patient Summary will enable access to some essential health information, including:

  • demographics
  • community dispensed medicines
  • vaccination status
  • entitlements (initially Community Services Card and High Use Health Card)
  • laboratory results (initially COVID-19)
  • other data, for example, allergies and conditions.

 

The New Zealand Patient Summary is a New Zealand adaption of the HISO International Patient Summary (IPS) with extensions that reflect our local nuances and cultural needs.

Additional datasets will be added over time, as we work towards delivering a personal health record.

Working with communities

The Hira team works closely with communities to find out what their health information needs are. This information is shared with those designing and building Hira. Insights are gathered to ensure that what is built matches what is needed. This includes understanding the current barriers for sharing and using health information, so these barriers can be addressed in the design of Hira.

Together with iwi, rangatahi, whānau, community groups and health care providers we’re building networks, setting priorities and exploring new ways for Hira to support hauora and enable mana motuhake and tino rangatiratanga.

Pātiki and Waharua Kōpito patterns

Hira Marketplace

This is where digital health vendors and professionals can access key health information databases through application programming interfaces (APIs), browse digital services that support or help use health data and information, and find out about Data and Digital services in the health sector.

Why we need Hira

  • Currently, health and wellbeing information is stored in different places, in different formats, and can be difficult to access and use effectively.
  • People and whānau often have to repeat their health information and history a number of times to different service providers and cannot easily access that information themselves.
  • Health care providers can’t always get a full picture of a person’s health to enable them and the consumer to make the best treatment decisions.
  • It can be difficult for policy makers, researchers and planners to get the latest information to base their advice and thinking on.

With Hira:

  • Health information will be able to be delivered to all New Zealanders where and when they need it, and allow people to have better access to their own health information.
  • Health care providers will be better supported to make care decisions, because they will have access to a person’s virtual health record, when they need it.
  • The digital health industry will have opportunities to use information and services in new and innovative ways, and to trial new approaches to delivering health services.
  • Better information will help policy makers, planners and researchers to improve equity and system performance.

Hira work programme

Hira is being delivered across three overlapping stages or ‘tranches’ with a completion date of around the end of 2026.

 

Tranche one

 

Tranche one will be delivered over two-and-a-half years. It will put in place many of the elements needed to lay the foundations for a digitally enabled health and disability system. This includes technology enablers such as digital identity and interoperability services. 

By mid-2024 the Hira Programme is aiming to have the New Zealand patient summary (based on the HISO International Patient Summary) available to consumers and healthcare providers.

 

Tranche two

 

Tranche two, if approved, will be completed by around mid-2026. It will extend the range of health data, eligibility and entitlement information covered by Hira and will include a focus on health literacy to support the adoption of Hira services, especially improving digital equity.

 

Tranche three

 

Tranche three will be completed before the end of 2026 upon the completion of tranche two and approved funding. It will connect Hira services more widely across the health and disability system and expand access to Hira datasets. It will also improve communication and collaboration to allow New Zealanders to access services in a seamless and consistent way.

News

Register for March 2024 ‘Ring of FHIR’ Connectathon

poster for Register for March 2024 ‘Ring of FHIR’ Connectathon poster for Register for March 2024 ‘Ring of FHIR’ Connectathon poster for Register for March 2024 ‘Ring of FHIR’ Connectathon

Registrations are open for a Connectathon being run by Te Whatu Ora, HISO and HL7NZ in Auckland from 20-22 March 2024. The Connectathon will run in parallel to a companion event in Australia.

 

The March event follows the success of the “IPS-athon”, focused on the International Patient Summary (IPS), at Digital Health Week 2023. The Connectathon will continue work on adapting the IPS to our unique cultural and health system settings to build a New Zealand Patient Summary (NZPS). The NZPS will enable consumers to tell their health story in digital form and vastly improves continuity of care.

 

The event will be held at Cliftons, Queen St, Auckland and will take place in two parts.

 

  • Symposium, 20 March: Digital health leaders in New Zealand, Australia and the Pacific will share the importance of standardisation with FHIR®, SNOMED and IPS to the digital health ecosystem we’re building. Our experts will explore models for increased collaboration across the region and focus on improved health equity through digital transformation.
  • Connectathon, 21-22 March: Participants will choose from several topic-focused tracks – either to further develop and prove the NZPS FHIR specification, develop product integrations with our marketplace APIs or develop interactive applications with FHIR questionnaires. There is also an education track that will explore the FHIR NZ base.

 

This event is for health software developers, service designers, clinicians and anyone interested in the digitalisation of our health system. All skill levels and job roles are welcome at this hands-on, participatory, and technical digital health event. Expert track leads will help guide each participant to the tracks that match their professional interests and skill level.

 

Attendees can choose from one of the following options:

 

  • Day one (Symposium only)
  • Days two and three (Connectathon only)
  • Days one to three (Symposium & Connectathon)

 

Registration is free. Future Connectathons are also being planned, and details will be available over coming months.

Seeking people for our technical standards community

Te Whatu Ora Data and Digital is looking to establish a technical standards community within the health sector, and is seeking expressions of interest. The community would provide feedback on API technical standards drafted by Te Whatu Ora before they are baselined and published via the Health Information Standards Organisation (HISO).

Feedback from the sector is very important when standards are developed, to ensure the standard is fit for purpose and easy to understand. Technology advocates come from various backgrounds, have diverse experiences, and offer broad perspectives. By listening and being open to different opinions and viewpoints, we can foster a rich and inclusive community that thrives through shared knowledge and collaboration.

We are in the final stages to release the following standards for review:

  • API Design and Development Standard
  • API Security Standard

 

Further work is taking place in the following areas:

  • API Publishing Standard
  • FHIR Decision Matrix – when FHIR is to be used versus an alternative.

 

Where a new standard is developed, or an existing standard updated, community members will be asked for input, following internal review. We’ve created a review forum to assess feedback provided and look to contact responders where further clarification on feedback is needed. Feedback on the standard will be online using GitHub. When we have completed the initial review and baselined the standard, the opportunity to provide feedback to a standard remains and amendments will be managed via change control.

Following internal and external review of the standard – and any amendments being made – it will go to the HISO committee for endorsement and publication. It will then go out via HISO.

People wanting to be part of the community can contact David Moon (David.moon@tewhatuora.govt.nz), for more information about the process.

Hira Programme Update December 2023

The December Hira Update has a snapshot of the latest Hira projects, and takes a closer look at the recent IPS-athon, API early adopter InterSystems,  and the National Events Notification Service.

These regular pānui aim to keep everyone with an interest in the Hira Programme up-to-date on our latest programme activities. This includes consumers, whānau and communities, health professionals, digital health suppliers, and others with an interest in digital health.

Hira Programme Update September 2023

The September Hira Update has a snapshot of the latest Hira projects, and takes a closer look at the Hira connector plane build, and the responsible use of health information.

These regular pānui aim to keep everyone with an interest in the Hira Programme up-to-date on our latest programme activities. This includes consumers, whānau and communities, health professionals, digital health suppliers, and others with an interest in digital health.

IPS-athon at Digital Health Week NZ 2023 a resounding success

One hundred and forty health software developers, service designers, clinicians and others with an interest in digital health took part in the fully-booked International Patient Summary-‘athon’ held as part of the recent HiNZ (Health Information NZ) Digital Health Week in Hamilton.

 

The IPS-athon was a joint undertaking from HL7 New Zealand and the Health Information Standards Organisation (HISO). The two-day event focused on building health data and information interoperability across Aotearoa and Oceania using the International Patient Summary (IPS). The aim was to feed into the development of the New Zealand Patient Summary (NZPS) – a set of core personal health information being adapted from the IPS.

 

Following the pōwhiri, attendees were given a problem statement, vision and goal and asked to develop solutions. They incorporated Pacific personas and health practitioners into their discussions, planning, and development of a NZPS product based on the IPS standards.

 

Attendees were asked to create a patient summary for the main persona –Iosefa Fuimaono, a 78-year-old Samoan man with several health issues and who spoke Samoan as his first language. Iosefa and other personas from his whānau were acted out by members of K’aute Pasifika Trust and the local community.

 

Iosefa is looked after by his fa’afafine (transgender) daughter Cindy, with Dr Tama and nurse Geena - also part of the care provided by K’aute Pasifika in Hamilton. These personas showed the challenges for Iosefa and his aiga/family in accessing health services and information to support their care and wellbeing.

 

Working in different topic groups or ‘tracks’, participants began to build solutions, based on the Fast Healthcare Interoperability Resources (FHIR) application programming interface (API) and SNOMED CT – standards that underpin the IPS. FHIR is a set of rules and specifications for exchanging electronic healthcare data. It is designed to be flexible and adaptable, so it can be used in a wide range of situations and with different healthcare information settings. SNOMED CT is a clinical terminology standard, which puts a code and name to all health conditions, situations and interventions.

 

FHIR inventor Grahame Grieve – also known as the father of FHIR – was a track lead, alongside other experts from the standards community and health software industry. There was a ‘spotlight’ talk on a specific topic each hour. 

 

By the end of the two days, a working version of a patient summary set to international standards,  had been created for Iosefa, and that was scannable via a QR code. Progress was also made towards a model for a patient story (“My Story”). A patient story helps set out what is usual for a person, how to support them, and what they want known about them up front.

 

HISO chair and Te Whatu Ora Group Manager for Data and Digital Standards Alastair Kenworthy says it was a remarkable two days, and showed what could be achieved when you had experts, innovators and people with lived experience in the same room, working on the same task.

 

“The New Zealand patient summary will see the international standard adapted to our unique settings, while offering full interoperability with other nations using the same standard for core personal health information. We will recognise any other countries’ patient summary built using the same standards.

 

“We don’t have all the answers, and implementation of standards is always a challenge. We need input across the health sector, using all our capability, to ensure we travel together in the right direction. The IPS-athon has been a great start. Ultimately, it’s about making peoples’ lives and health better.”

 

John Carter, HL7 New Zealand Chair and Te Whatu Ora interoperability expert, highlighted the importance of digital health as a tool that must be part of the solution for healthcare.

 

“Standards such as FHIR are enablers for the consistent sharing of health data and information, so people have more input into and control over their own healthcare. Healthcare providers will have a much wider range of information on which to base treatment and care.

 

“I’m proud and thankful for everyone who took part in the IPS-athon – the largest such event ever held in Aotearoa. We went beyond the usual HL7 technical workshop to connect deeply with patients and caregivers. By creating an IPS document for Iosefa, and showing how it could be shared with his whole care team – all using different computer systems – we met our goals and laid a path for future events.”

 

The New Zealand Patient Summary

 

The suggested composition of the NZ Patient Summary is shown below. It is a New Zealand adaption of the IPS with extensions that reflect our local nuances and cultural needs.

 

By mid-2024, the Hira Programme is aiming to have the New Zealand patient summary (based on the HISO International Patient Summary) available to consumers and healthcare providers. The NZ patient summary will enable access to some essential health information, including:

 

  • demographics
  • community dispensed medicines
  • vaccination status
  • entitlements (initially Community Services Card and High Use Health Card)
  • laboratory results (initially COVID-19)
  • other data, for example, allergies and conditions.

 

Additional datasets will be added over time, as we work towards delivering a personal health record.

 

National Event Management Service will improve the flow of health information

The National Event Management Service (NEMS) is currently being piloted. The pilot, due for completion in December 2023, focuses on delivering a ‘proof of value’ that will then be scaled into a production environment early next year.

 

NEMS will let healthcare providers know when information relating to a patient has changed (such as their address) or when they have had an interaction with the healthcare system (for example, they have been seen at an emergency department). The notifications are IT system to IT system. 

 

Gerard Keenan, Director Hira Programme and Technology Enablers, says the service will enable the right data to get to the right people at the right time – improving the currency and accuracy of health data and information.

 

“Each day there are over 700,000 data changes across the health system. For example, someone might change their address, be admitted to hospital or, sadly, pass away. This information is captured in one healthcare information system – such as a hospital’s patient administration system in the case of an admission. However, not all healthcare providers that need this information are alerted.

 

“This happens because of our diverse systems and technologies, and lack of interoperability standards. 

 

“With NEMS, the update is made once, in one system – the publishing system; and then communicated to the other systems – subscriber systems. Information systems subscribe to events, which they get when there has been a change in a person’s information linked to their National Health Index (NHI) number.

 

“Healthcare providers subscribe to the changes and events most relevant to them, and data changes and healthcare interactions are broadcast to all subscribing systems simultaneously.”

 

Gerard says the benefits of the service are multiple.

 

“Healthcare providers have much better visibility of what’s happening to patients and are notified of interactions outside their direct healthcare setting – for example, if a patient has gone to an afterhours clinic or they could be notified that a patient has received an abnormal result, and contact them to discuss the next steps.

 

“Updated information can be fed directly into health subscribers' systems using an API, and healthcare providers will need to spend far less time updating data manually.”

 

The work on the national events management service is being led by Te Whatu Ora Data and Digital, within the Hira Programme. Solace is the publish-subscribe message broker being used.

 

The New Zealand Patient Summary

The suggested composition of the NZ Patient Summary (NZPS) is shown below. It is a New Zealand adaption of the HISO International Patient Summary (IPS) with extensions that reflect our local nuances and cultural needs.

 

By mid-2024, the Hira Programme is aiming to have the New Zealand Patient Summary available to consumers and healthcare providers. The New Zealand Patient Summary will enable access to some essential health information, including:

 

  • demographics
  • community dispensed medicines
  • vaccination status
  • entitlements (initially Community Services Card and High Use Health Card)
  • laboratory results (initially COVID-19)
  • other data, for example, allergies and conditions.

 

Additional datasets will be added over time, as we work towards delivering a personal health record.

 

InterSystems becomes an early adopter of National Health Index FHIR API

InterSystems, a creative data technology provider, has become an early user of the Hira Programme’s application programming interfaces (APIs) developed by Health New Zealand – Te Whatu Ora using the HL7® FHIR® health data sharing standard.

 

APIs enable two or more computer programs to communicate with each other using a set of definitions and protocols. The Hira Programme is driving the move to using FHIR-based APIs for interoperability to enable New Zealanders to access their health information securely wherever it is stored.

 

Brian Biggs, customer relations and sales director for InterSystems New Zealand, says the company found out that new API functionality was being developed by Te Whatu Ora when his team started the discovery phase of a major patient administration system project.

 

InterSystems is delivering the patient administration system for Te Toka Tumai Auckland, part of Te Whatu Ora. Serving multiple facilities, including Auckland City Hospital, Starship Children’s Hospital and several community organisations, the system is due to go live in mid-2024.

 

“Our long-term goal was always to use the National Health Index API, but in any project of this scale, it can be a risk relying on technology that doesn’t quite exist yet,” says Biggs. “So, we started to work with Te Whatu Ora data and digital identity team, who were developing the NHI API, with a view to InterSystems being early adopters.

 

“Together, we took the theory and started to discuss how certain scenarios would be handled – for example, how we would work with patients – and put it in the real world.”

 

Biggs gives the example of managing the identity of a person only known by one name (a mononym) rather than a first name and a surname.

 

“Currently, the legacy NHI needs a first name and a last name. So, we needed to determine what would happen with the new service when someone had a mononym. The specification said to treat any single name as a mononym. Many systems, including ours, need at least a surname – but treating a single surname as a mononym may have impacts, including with patient identification, in downstream systems.

 

“These were the types of conversations we were having,” says Biggs. “We were very excited by the level of engagement we had with the Te Whatu Ora team – they were very pragmatic, open and collaborative.”

 

Biggs says using the FHIR-based APIs has several benefits for Te Toka Tumai Auckland’s new patient administration system, including the ability to reconcile data within the wider information systems environment.

 

The FHIR (Fast Healthcare Interoperability Resources) standard is a set of rules and specifications for exchanging electronic healthcare data. It is designed to be flexible and adaptable for use in various settings and with different healthcare information systems.

 

“We will know when a patient’s data was last accessed from the NHI, for example, and FHIR enables us to access other relevant information,” he says. “As well as demographic information, data is retrieved from the National Enrolment Service on the individual GP and GP practice a patient is enrolled with. Data is shared using Health Provider Index identifiers for the individual (HPI-CPN) and the facility (HPI-Fac).

 

“FHIR enables us to do multiple things at the same time. Whereas historically, you could just do one thing and then another, now you can pull them together into a bundle. Using FHIR resources, we can intuitively and seamlessly provide access to different services in the background without the user having to be aware of the complexities involved.”

 

The increased reliability and consistency of data will make a big difference to hospital administrators, says Biggs. And, because the patient administration system is the backbone of Te Toka Tumai Auckland’s healthcare information systems, there will be other benefits.

 

“The system will also benefit patients because the data that other healthcare information systems hold about them will be more up-to-date and reliable.”

 

Biggs says the InterSystems team appreciates the opportunity to work with Te Whatu Ora and run the NHI API through real-life scenarios.

 

“The team at Te Whatu Ora has been genuinely wanting our feedback, and being able to be an early adopter will pay longer-term dividends. It is great for the project, but more importantly, great for the sector.”

 

Te Whatu Ora Hira Programme Industry Engagement Director Russell Craig says the programme is very pleased with the outcomes of the partnership.

 

“InterSystems is in the vanguard of those adopting modern FHIR APIs as part of the digital transformation of our health system – transformation being enabled by Hira and other strategic initiatives such as the National Data Platform.

 

“As Hira continues to build Te Whatu Ora API-management capabilities and releases more FHIR APIs into production, we are looking forward to many more health digital service suppliers following in InterSystems’ footsteps.”

 

About InterSystems

 

Established in 1978, InterSystems provides next-generation solutions for enterprise digital transformations in the healthcare, finance, manufacturing and supply chain sectors. Its cloud-first data platforms solve interoperability, speed and scalability problems for large organisations around the globe. For more information, please visit InterSystems.com.

 

Hira Programme Update June 2023

These regular pānui aim to keep everyone with an interest in the Hira Programme up-to-date on our latest programme activities. This includes consumers, whānau and communities, health professionals, digital health suppliers, and others with an interest in digital health.

Thank you to the many groups and individuals who are so generous with their time, support, and advice as we continue towards our Hira goal of empowering people to see, manage, and contribute to their health and wellbeing information.

Ngā mihi nui
Ray Delany
Hira Programme Director

Hira will deliver:

  • A personal health record - an app/website allowing healthcare consumers/whānau to see their health information in one place and update some of it
  • A platform allowing healthcare providers to access and update patient data held in different databases
  • A secure, carefully controlled digital ecosystem enabling vendors to build apps for healthcare consumers, whānau and providers, to help people manage their own health

Updates to My Health Account

People can now use their My Health Account to log into the Manage My Health patient portal.

My Health Account provides digital health applications with an easy, secure and trusted way to understand who people are, all linked to their National Health Index number. It is a key component of the Hira Programme, and how people using the Hira platform will have their identity verified. My Health Account was initially developed to support the COVID-19 response and has been further supported by the Hira Programme.

Manage My Health is a patient portal that has over 1.5 million users in New Zealand. It enables patients to have secure access to health information, their health records, book appointments, order prescriptions, and communicate with their healthcare providers.

The integration between the two makes it quicker and simpler for people to sign up for Manage My Health, because their identity can be verified online. General practice workloads will also be reduced as they will be able to determine their patients’ identities with a reliable and verifiable process.

Rollout of medicines consumer view API

People will be able to access more of their medicines information, with the release of the medicines consumer view FHIR (fast healthcare interoperability resources) API (application programming interface). Hira partnered with the Data and Digital medicines team and, with them, jointly funded the build of the API.

The FHIR API, which provides access to the Medicines Data Repository (MDR), is now available for patient portal suppliers to access and integrate with. This will enable an extended range of medicines information to be available to people via their patient portal. Traditionally, patient portals are linked to a person's enrolled GP and their practice, meaning only information about medicine prescribed from that practice is available through portals. With this API, the information available to authenticated consumers has been extended to include all prescribing and community dispensing data available, based on information sent to the New Zealand electronic prescription service (NZePS).

People will need to be authenticated using their My Health Account digital identity before they can access the medicines consumer view. They will be able to view the medicines prescribed to them, the dosage and whether the medicine has been dispensed. They will also be able to see what medicines they have had prescribed in the past (based on what is stored in the NZePS/MDR).

For further details please contact the NZePS medicines team at onlinehelpdesk@health.govt.nz.

Event notification service goes to market

The Hira Programme has gone to market for an event notification service, with the tender notified on the GETS website (closed 5pm, 13 June 2023).

The tender is for:

  • an event notification service solution
  • a business partner to undertake the delivery of the solution in both product and service integration.

These may be the same or different providers.

The event notification service will let healthcare providers know when information relating to a patient has changed (such as their address) or when they have had an interaction with the healthcare system (for example, they have been seen at the emergency department). The notifications are IT system to IT system.

The service is a foundation of the Hira programme and will support the wider Hira interoperability and integration outcomes.

Hira workshops for digital health suppliers

Three Hira workshops for digital health suppliers have taken place recently. Digital health suppliers’ thoughts and feedback are critical to the development of Hira and will inform our approach and priorities.

Face-to-face workshops were held in Christchurch in April and Auckland in May. An online workshop was also held in May, which included a separate Equity by design session on a different day to allow more time for kōrero. The workshops, held in partnership with the Digital Health Association, focused on the Hira tranche one roadmap (see the story below for more detail on the roadmap). Over 320 people attended the events.

Attendees said they found the following useful:

  • Visibility of Hira roadmap: Seeing the road map gave attendees a better understanding of the Hira vision and goals, the journey and timeline, release dates and the future focus.
  • Networking: The opportunity for face-to-face information sharing and networking.
  • Progress: Understanding progress to date.
  • Interactive breakout sessions: Understanding different workstreams through interactive breakout groups.

Suggestions for improvement included:

  • More clarity on the purpose of Hira: Have clearer messaging and understanding about the goals of Hira and the problem it is seeking to solve.
  • More time for discussion: Have longer, more in-depth sessions and provide materials in advance.
  • Role clarity between Hira and vendors: Be clear on what only Hira can do, and what vendors are expected to deliver/contribute.

Below is a snapshot of feedback, covering a range of themes from across the workshops. This feedback will be themed and available shortly on the Hira webpages.

  • How will vendors build equity into what they are developing? It must be equity by design – giving consumers the choice of who they share their health information with.
  • Digital literacy and access, physical devices and connectivity are all important for equity.
  • Research undertaken for Hira should be shared, including the personas.
  • We need an environment in which vendors can build and innovate.
  • It would be good to have more detail on standards, conformance, certification and auditing.
  • How will Hira manage conflicts in data such as demographics and meds reconciliation – will it be the one source of truth?
  • Consider having a community marketplace where people can share and collaborate.
  • The personas and use cases are valuable – expand them and introduce further personas.
  • Care must be person-centred, not process and system-centred.
  • Clinicians are expected to use too many apps to access different datasets. Interoperability is key for simplicity.
  • How can we ensure that primary care/community care – kaupapa Māori providers and outreach workers/allied health can all access health information?

Hira tranche one roadmap

Understanding the Hira tranche one roadmap was the focus of the recent workshops for digital health suppliers.

Hira is being delivered across three tranches. By the end of tranche one, which runs to June 2024, the following will be able to accessed for a personal health record:

  • personal details
  • COVID-19 vaccinations
  • prescribed and dispensed medicines
  • health and wellbeing entitlements
  • summary primary care information
  • health service providers
  • diagnostic test results.

The tranche one roadmap sets out how these outputs will be achieved. It is a living document that is revisited quarterly. It will pivot in response to feedback, scope, timing of product development, outcomes sought and changes in the digital health ecosystem.

The roadmap has five workstreams:

  • Governance and oversight: Guiding, reviewing and monitoring the Hira Programme.
  • Change and adoption: Making sure what is built is adopted and meets needs.
  • Data and channels: Providing electronic channels through which data and healthcare information can be accessed and shared.
  • Foundation enablers: Providing the interoperability platform we need to implement a personal electronic health record.
  • Foundation guardrails: Making sure the right controls are in place for a secure and equitable personal electronic health record.

The input of all Hira stakeholders into the roadmap is critical to the development of Hira and will inform our approach and priorities. The workshops for digital health suppliers mark the start of seeking this feedback. Further input will be sought from whānau and communities, healthcare providers and others with an interest in digital health.

For more detail see the Hira product delivery model (PDF, 156KB) and the Hira value delivery summary (PDF, 1.2KB).

Questions or comments

We welcome your feedback, input and questions about Hira – please email us on contact@hira.health.nz.

Please also let us know if you would like to be added to the list of subscribers who are alerted when these monthly updates a

CatTrax providing valuable input into Hira

CatTrax is a cloud-based application that streamlines all aspects of cataract surgery and ophthalmic care. It’s an example of a product with enormous potential to reduce inequities, that could be supported by the Hira ecosystem.

 

CatTrax was founded by eye surgeon James McKelvie with company chief financial officer (CFO) Eddie Rosser and chief operating officer (COO) Andrew Emery. It is in use in the public health system in the Waikato and Lakes districts, and will soon be used at Auckland and Waitemata hospitals. It is used by private providers throughout the country.

 

Read more

Hira Programme Update April 2023

These regular panui aim to keep everyone with an interest in the Hira Programme up-to-date on our latest programme activities. This includes consumers, whānau and communities, health professionals, the digital health industry, and others with an interest in digital health.

 

Thank you to the many groups and individuals who are so generous with their time, support, and advice as we continue towards our Hira goal of empowering people to see, manage and contribute to their health and wellbeing information.

 

Ngā mihi nui

 

Ray Delany

Hira Programme Director

 

In this update

  • Hira: Focus on tranche one
  • Hira workshops for digital health suppliers
  • Hira enables a range of data and digital services
  • Event notification service going to market
  • Hira team takes part in datathon at Hack Aotearoa

 

Hira: Focus on tranche one

 

The Hira Programme, which runs to the end of 2026, is currently focused on tranche one. The workshops for digital health vendors (see below) are the start of engagement on the tranche one roadmap. This first tranche will put in place many of the elements needed to lay the foundations for a digitally enabled health and disability system. This includes technology enablers such as digital identity and interoperability services.

 

In time, Hira will deliver:

 

  • A personal health record – an app/website allowing healthcare consumers/whānau to see their health information in one place and update some of it.
  • A platform allowing healthcare providers to access and update patient data held in different databases.
  • A secure, carefully controlled digital ecosystem enabling vendors to build apps for healthcare consumers, whānau and providers, to help people manage their own health.

 

 

Tranche one of the Hira Programme runs to mid-2024.

 

Hira workshops for digital health suppliers

 

The Hira Programme, in partnership with the Digital Health Association (DHA), will hold workshops in April and May 2023 for digital health suppliers to discuss Hira tranche one. Registration is free.

 

The first workshop is in Christchurch on Thursday 20 April, and the second in Auckland on Monday 15 May. Both workshops cover the same content. There is also the possibility of further regional workshops.

 

Registration

 

 

The workshops will outline Hira progress to date as well as hear and seek to understand what digital health vendors need from Hira. For example, what would encourage them to innovate within the Hira framework? Digital health suppliers’ thoughts and feedback are critical to the development of Hira and will inform the approach and priorities.

 

Hira enabling a range of data and digital services

 

Work undertaken by the Hira Programme is enabling a range of activities across a number of other data and digital programmes and projects. These include the Zero Data project, My Health Account, and the NZ Health Terminology Service.

 

Zero Data

 

Enabling health consumers to access their health information and manage their health and wellbeing is a key focus for Te Whatu Ora and Te Aka Whai Ora. However, for people with limited or no data on their smart mobile devices, cost is a big barrier to accessing information.

 

Working across seven government agencies, Zero Data provides people with free access to health, social services, education, housing, justice and more, with just a few taps on their smart phone.

 

Hira has supported the recent upgrade of the technical capability for more Zero Data sites and will ensure consumer applications using the Hira interoperability platform have access to the service.

 

My Health Account

 

Enabling New Zealanders safe and secure access to their health consumer information is a critical outcome for Hira. The programme has supported the further development of My Health Account, which establishes a login service for health consumers, backed by a verified identity. Initially developed to support the COVID-19 response, My Health Account is how people using the Hira platform will have their identity verified.

 

My Health Account continues to evolve and is currently having functionality implemented to support whānau relationships. It will initially be able to link children who have a New Zealand birth certificate with any parent listed on their birth certificate. Over time this will be enhanced with the ability to establish other verified relationships.

 

New Zealand Health Terminology Service

 

The health sector uses terminology and coding standards to ensure health providers can  understand and use a health consumer’s information to diagnose and treat conditions. To do this, they must have access to the appropriate standards and their current releases.

 

The Hira-funded New Zealand Health Terminology Service provides application programming interface (API) connectivity to the standards, so applications can automatically check for and update the standards they use. This is so clinical and support staff will always have the most current release.

 

The use of the new service also means health consumers will potentially have more consistent terminology used in their health information, which will support them to better understand and manage their own health.

 

Event notification service going to market

 

The Hira Programme will go to market for:

 

  • an event notification service solution
  • a business partner to undertake the delivery of the solution in both product and service integration.

 

These may be the same or different providers. The tender will be notified on the GETS website in April/May 2023, after an internal approval process is completed.  

 

The event notification service will let healthcare providers know when information relating to a patient has changed (such as their address), or when they have had an interaction with the healthcare system (for example, they have been seen at the emergency department). The notifications are IT system to IT system.

 

The service is a foundation of the Hira programme, and will support the wider Hira interoperability and integration outcomes.

 

Hira team takes part in datathon at Hack Aotearoa

 

Members of Hira’s Digital Enablement and Engagement team (DE&E) team took part in the ‘datathon’ at the Hack Aotearoa event, held in Auckland recently.

 

The Hack Aotearoa conference and datathon was held in partnership with MIT Critical Data and hosted by the Faculty of Medical Health Science at the University of Auckland, and the Division of Health Sciences at Otago University. Digital health and data science is a key enabler for transformations within health systems, organisations, and models of care. The event brought people together to develop a greater understanding of their respective fields, focus on the opportunities to improve health outcomes and equity, and learn collaboratively through the datathon.

 

The datathon was an exercise using aggregated and deidentified health data sets to answer clinical and population health questions.

 

DE&E team members were involved in developing a predictive geographic information system (GIS) data model that helps encourage communities to vaccinate against measles, mumps and rubella (MMR). The aim of using the model is to spread knowledge, introduce urgency to act, and build momentum in communities – with health sector support – to escalate and mobilise vaccinations.

 

"While this was a training and learning exercise, we feel the model has the potential to make a real difference, if further developed," says Sarona Iosefa from the Hira team.

 

Questions or comments

 

We welcome your feedback, input and questions about Hira – please email us on contact@hira.health.nz.

 

Please also let us know if you would like to be added to the list of subscribers who are alerted when these monthly updates are published.

 

Workshops for digital health suppliers

The Hira Programme is holding workshops in April and May 2023 for digital health suppliers, to discuss Hira tranche one.

 

Tranche one will put in place many of the elements needed to lay the foundations for a digitally enabled health and disability system. This includes technology enablers such as digital identity and interoperability services.

 

When the programme is completed New Zealanders and healthcare providers will be able to access important health information, such as:

  • personal details
  • COVID-19 vaccinations
  • prescribed and dispensed medicines
  • health and wellbeing entitlements
  • summary primary care information
  • health service providers
  • diagnostic test results.

 

The first workshop is being held in Christchurch on Thursday 20 April 2023, from 9am to 4pm. A second workshop will be held in Auckland on May 15. Registration is free.

 

Registration

 

Focus on Hira tranche one

The workshops are brought to you by Te Whatu Ora Hira Programme, in partnership with the Digital Health Association. They will focus on the Hira tranche one roadmap.

 

We want to understand what digital health vendors need from Hira; what would encourage you to innovate within the Hira framework?

 

The programme for the workshops are being finalised. The format will include an introduction session presenting an overview of the Hira programme deliverables and breakout sessions focusing on topics such as interoperability, data and channels, and consumer and provider services. Your thoughts and feedback are critical to the programme and will inform the Hira approach and priorities.

Hira Programme Update February 2023

 

These monthly updates aim to keep everyone with an interest in the Hira Programme up-to-date on latest programme activities. This includes our consumers and communities, health professionals, the digital health industry, and others with an interest in digital health.

 

Thank you to the many groups and individuals who are so generous with their time, support and advice as we continue towards our goal of empowering people to see, manage and contribute to their health and wellbeing information.

 

Ngā mihi nui

Ray Delany

Hira Programme Director

                                                                                                                                                                                                             

Hira foundational to Te Pae Tata

 

Te Pae Tata | Interim New Zealand Health Plan has highlighted the critical importance of Hira in health system transformation. The need for data and digital is woven throughout Te Pae Tata, including in relation to interoperability and service improvements. Hira will be foundational to these, enabling the flow and consolidation of information.  

 

‘Placing whānau at the heart of the system to improve equity and outcomes’ is priority one in Te Pae Tata. Hira is strongly committed to this approach as can be seen in the work we do engaging and connecting with communities about their health information needs, and the barriers they face. This information is passed to other Hira workstreams, so that what is developed as part of Hira is what consumers, communities and health providers need.

 

What Hira will deliver

 

The Hira Programme is being delivered in three stages or tranches. The focus is currently on tranche one, release four, which runs to the end of March 2023.

 

In time, Hira will deliver:

 

  • A personal health record – an app/website allowing healthcare consumers to see their health information in one place and update some of it.
  • A platform allowing healthcare providers to access and update patient data held in different databases.
  • A digital ecosystem allowing vendors to access health information to build apps for healthcare consumers and providers.

 

Hira tranche one

 

Tranche one of the Hira Programme is being delivered over two-and-a-half years, to mid-2024. It will put in place many of the elements needed to lay the foundations for a digitally enabled health and disability system. This includes technology enablers such as digital identity and interoperability services.

 

When it is completed, whānau, communities and healthcare providers (with appropriate privacy, security and consents) will be able to access important health information, such as:

 

  • personal details
  • COVID-19 vaccinations
  • prescribed and dispensed medicines
  • health and wellbeing entitlements
  • summary primary care information
  • health service providers
  • diagnostic test results.

 

Hira tranche one has a number of overlapping releases. The first three releases took place from March 2022 to the end of August 2022 and built the foundations for following releases. Further releases are underway. Each release builds on the previous one, introducing additional technical capacity, access to new data sets, and adding to the functions that can be used by health service consumers and providers.

 

Current areas of focus

 

The Hira programme underwent a significant reset in 2022. One outcome was the decision to rescope our work programme. This rescoping work is nearly complete, and will be reflected in a roadmap of Hira tranche one work. We will be engaging widely on the roadmap, including holding a series of workshops for the digital health sector. The workshops, which will begin in the next couple of months, will be held in partnership with the Digital Health Association and our equity partners. They will be promoted widely to the sector. You can also register your interest by emailing contact@Hira.health.nz, with subject heading ‘Please notify me about the tranche one workshops’.

 

Hira Marketplace is live and growing

 

Hira Marketplace provides a single point of entry for vendors and healthcare providers to find what they need to enable the better flow of health information.

 

Aotearoa New Zealand has many data sources, application programming interfaces (APIs) and digital services, but until now there hasn’t been one place to house them all. Via Hira Marketplace, vendors and healthcare providers can find APIs to connect to health information from national data repositories and other trusted sources. Marketplace will also be the central point for information sources, improving the quality of data and digital information.

 

There are now seven APIs and three digital services on Hira Marketplace, and the number is growing. Vendors and healthcare providers are invited to suggest additions to Marketplace they believe would benefit the data and digital community.

 

The Te Whatu Ora Hira team is engaging with whānau and communities to ensure their needs are reflected in Marketplace. We are also working closely with healthcare providers and vendors and will continue to involve them as Marketplace is iterated and improved.

 

Monthly content releases from health terminology service

 

The New Zealand Health Terminology Service (NZHTS) is now doing monthly releases of new content. NZHTS is a one-stop source of the standard terminologies and code sets for Aotearoa’s health system. The free service is available to all New Zealand health entities and their industry partners. Standard terminologies and code sets ensure common meaning in health data, enabling interoperability across the system and improving patient safety through accurate information recording and communication. The service is listed on the Hira Marketplace.

 

NZHTS was launched at the December 2022 HiNZ conference, with a ‘Connectathon’ attended by 60 people with an interest in software development and standards. All participants were enrolled as NZHTS authenticated users, and another 30 health software developers have been enrolled since. Fifteen API keys (a code used to identify and authenticate an application or user) have also been issued to partnering organisations.

 

Releases to NZHTS so far include codes for reporting adverse reactions to medicines (MedDRA), ISO country codes, NHI and Health Provider Index (HPI) code sets, and FHIR NZ Base Code Sets.

 

Other releases planned include:

 

  • In February, NZ Pathology Observation Code Sets (NZPOCS) and the first two sections of the NZ International Patient Summary (NZIPS) code sets.
  • In March, the next iteration of NZIPS, as well as UCUM (Unified Code for Units of Measure).
  • In April, the major item will be over 70 SNOMED CT reference sets for Structured Pathology Reporting for Cancer – a project in partnership with Te Aho o Te Kahu.
  • Aotearoa Immunisation Register (AIR) code sets will be released in the next few months.

 

Requests to add new content to NZHTS are welcome. You are also invited to register for access whether you’re a software developer, database administrator, solution architect, data analyst or have some other role or interest. Please send enquiries to standards@health.govt.nz or you can find out more on the website.

 

Questions or comments

We welcome your feedback, input and questions about Hira – please email us on contact@hira.health.nz.

 

Please also let us know if you would like to be added to the list of subscribers who are alerted when these monthly updates are published.

Documents and resources

Hira business cases

The Hira programme business case outlines the justification and approach, timing and cost for establishing the Hira programme.

Read the detailed business case, Cabinet minute and Cabinet paper (PDF 6.1MB)

 

The Hira tranche one detailed business case covers the first tranche of the Hira Programme in detail.

Read the detailed business case, Cabinet minute and Cabinet paper

 

 

Workshops and webinars

Hira/Digital Health Association workshops April and May 2023

In April and May 2023, several workshops for digital health suppliers were held by Te Whatu Ora Hira Programme, in partnership with the Digital Health Association:

This document captures and themes the feedback from the workshop. Thanks to everyone who attended for your participation and strong engagement.

All feedback will be carefully considered as work on the Hira Programme continues.

Summary of feedback and themes 

 

 

On 10 December 2021 the Hira programme team held webinars to provide stakeholders with an in-depth briefing of the programme, its timelines and deliverables, and what it will mean for consumers, delivery partners, and the health and disability sector.

 

Downloads

 

Hira and Digital Health Association Q&A sessions

The Hira Programme and the Digital Health Association (DHA) hold regular online sessions to discuss the Hira Programme. Each month there is a focus on a particular topic, with discussions and questions and answers. Recordings of the sessions are available below.

 

These sessions are organised by DHA and are available to DHA members.

Please contact DHA at info@dha.org.nz to find out how to register.

 

Watch the latest session here: August DHA – Hira open Q&A session. This session focused on the New Zealand and Australian approaches to digital health investment.

 

Hira product delivery model

The Hira product delivery model sets out what tranche one will deliver, aligning to the Hira vision and overall outcome.

Hira product delivery model

Hira value delivery summary

The Hira value delivery summary shows the benefits to whānau and communities that will be delivered by Hira, and how the different components of the Hira Programme contribute. To achieve our goal of improved access to health information, we must first put in place the right foundations.

  • Data, API and digital channels business value will be delivered early where possible.
  • Change and adoption is critical to achieving Hira strategic outcomes and benefits.
  • A substantial proportion of delivery will be outsourced to external delivery partners. These areas have been highlighted in purple.

Hira value delivery summary (PDF, 1.2MB)

Pātiki and Waharua Kōpito patterns

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