Te Whatu Ora Counties Manukau Health is working with vulnerable patients who have heart failure to design this programme. There are about 10,000 hospital admissions related to heart failure in New Zealand each year. Māori and Pacific peoples are almost twice as likely to be affected.

Te Pae Hauora o Ruahine o Tararua is rolling out a programme to support the continued use of telehealth as an alternative to in-person consultations across the region. Aims include enabling people to have increased and equitable access to appropriate telehealth, and for telehealth technology to be available to all clinicians who require it.

Hauora a Toi Bay of Plenty is undertaking a project to provide access to an electronic shared care planning platform for consumers and providers in the region. The project will support the He Pou Oranga Tangata Whenua model of care by improving equitable access and timeliness of care.

Hauora a Toi Bay of Plenty is implementing an enterprise scheduling platform, to enable better management of outpatient appointments. The platform will build the foundation to move more easily to patient portals, kiosks and referral management. It aims to support the redesign of services so they are more equitable and consumer-centred.

Te Whatu Ora Waitematā has introduced an outpatient clinic scheduling and room-booking system that will improve patient and staff experience, and access to planned care. The system will replace the current paper-based approach.

This project was led by Counties Manukau’s Ko Awatea, focusing on the co-design of an in-home remote monitoring and treatment programme for Māori and Pacific heart failure patients.

While surveys of staff and patients found a preference for in-person interaction, people liked the access, time and cost-saving benefits of telehealth. The district is continuing to work with communities with a focus on cultural safety for Māori, internet connectively, digital literacy, and awareness of the telehealth service. The aim is to give patients a choice of telehealth or in-person visits

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.

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 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

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

• To register for the Christchurch workshop, please use this link.
• To register for the Auckland workshop, please use this link.

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.

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

• To register for the Christchurch workshop, please use this link.
• To register for the Auckland workshop, please use this link.

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.

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.

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

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 

• 07 June 2022– Health Information Model Workshop
• 07 April 2022 – Certification and Onboarding Workshop

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

• Webinar for Health IT industry and innovators PDF 2.5 MB
• Webinar for providers and consumers PDF 1.8 MB
• Hira frequently asked questions DOCX 573 KB

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.

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

Hira product delivery model

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)