National Systems Access - National Health Information Priority Action Zones - Health Information Strategy Advisory Committee

hisac2 Web Page
Printed 11/25/2009 05:10:41 AM Back Print

National Systems Access
This document is an initial HISAC view of the ‘National System Access’ Action Zone of the Health Information Strategy for New Zealand 2005 (HIS-NZ). Its purpose is to stimulate discussion and responses from health and disability sector practitioners, providers and funders, about the issues and opportunities associated with the improved use of existing and emerging information technologies and information management systems in the health and disability sector.

Back to Action Zones

Background
This Initial View is a HISAC informed ‘Straw Man’ and it does not claim to represent the final direction of the Action Zone. It is a starting point for the sector informed Preliminary Scope and Approach currently being prepared, by proactive engagement with the sector, for each Action Zone.

HISAC sees National System Access being delivered through a cohesive set of policies, processes and information technology initiatives that will enable improved access to National Systems. The successful delivery of National Systems Access is dependent on the successful delivery of the NHI, HPI and National Network Action Zones.

A view of the National System Access in the future

Vision: Ensure that access to National Systems for authorised users is efficient and secure.
Strategy: Develop and implement the governance, policy, technical frameworks and systems necessary to achieve the vision.

Features of National Systems Access
‘National Systems’ are defined here as the systems operated on a national basis providing standard sets of services to authorised health practitioners and organisations, for example access to the NHI.

‘National Collections’ are defined here as:

repositories of data collated from local and regional sources and held in one national location, or
‘on demand’ views from a range of local and regional sources.

HISAC envisages that the National System Access solution will include these features:

An agreed definition and list of National Systems.
Barriers to good outcomes in national systems access are identified then removed or significantly reduced. The right information is more easily located and is accessible by people and systems:
- with appropriate permissions based on role;
- when it is needed;
- presented in an understandable form; and
- with appropriate context provided, describing the meaning of the information, indicating the purpose for which it was gathered, and when it was gathered.
A comprehensive national systems access governance and policy framework is in place. It is anticipated that the development of that wider governance framework will be guided by HISAC’s National Collections Sub-committee, and that it will include the following:
- Principles. A set of principles which will guide the development and management of National Systems.
- Purpose. Policies to ensure that each National System has a clearly defined purpose, and that it continues to support that purpose over time.
- Processes. Appropriate processes for managing the establishment and on-going maintenance of National Systems.
- Performance. Guidelines for assessing the performance of a National System, i.e. how well it is meeting its purpose and is aligning with the appropriate principles and processes.
Processes are in place to ensure that stakeholders with valid needs are adequately identified, authorised and provided with appropriate access to National Systems.
Supporting architecture and information technology solutions are in place. User interfaces and inter-system interfaces are consistently designed and delivered.
Concerns about future compliance with the Privacy Act 1993 and the Health Information Privacy Code have been addressed through the appropriate management of personal information, and access to it.
Unnecessary duplication of systems and/or data input is reduced or wholly removed. Data quality is improved.
Related parts of other HIS-NZ Action Zones that will support National Systems Access are in place, for instance retrofitting of the NHI and HPI to existing National Collections.

Benefits from sector investment in National Systems Access
HISAC has identified the following expected benefits to stakeholders from National System Access.

Health practitioners will benefit as:

Relevant national information will be more accessible, e.g. online access to the NHI and National Minimum Data Set (NMDS) from general practice.
Information will be presented in a more user-friendly way.
The security and privacy of information will be better assured.
The quality of data in National Systems and National Collections will be improved over time.
Time taken to access information and log in to systems will be reduced.

Provider organisations will benefit as reduction in the duplication of data storage and data cleansing effort will reduce costs and increase data integrity. Improved access to information will also allow providers to more easily compare their own data to national data (e.g. average rates of prescription of pharmaceuticals in different situations). Health researchers will benefit as higher quality and more consistent information is more easily located and accessed.

Organisations responsible for policy development and funding the health and disability sector will benefit because:

information required to develop, support and evaluate proposals, programmes and performance will be more accessible and reliable; and
reduced duplication of data cleansing effort by sector organisations will reduce costs.

What happens today
National Systems support the work of the sector in delivering health outcomes and administering health programmes. A significant amount of data is collected about the activity and effectiveness of health services and the wellbeing of New Zealanders. Security of access to National Systems needs to be fully auditable and independently monitored.

Access issues exist because national systems have been developed over time, largely independently of each other, without reference to a common information architecture. As a consequence, access to existing National Systems is sometimes difficult, with variable governance arrangements and no longer supported by the most appropriate information technologies. A ‘one stop shop’ approach is required where users are authenticated once, and have access to relevant information that they are entitled to view.

Areas for improvement
HISAC has identified the following areas where information systems and processes could be strengthened.

The planning and delivery of clinical care is not as well-supported by appropriate, accurate, relevant and timely access to national-level information as it could be.
Work is being duplicated across the sector because of limited interoperability and user access.
Decision-makers are prevented from becoming as well-informed as they might be regarding what is needed to meet New Zealand’s health and disability sector goals, and how well these goals are being met by their programmes.
There is a lack of comprehensive, coherent and consistently applied access policies, and of an effectively implemented governance framework; either simply for system access, or for the governance of National Systems.
Supporting technology architectures and infrastructures may be inadequate or vary unnecessarily between different systems.
The Privacy Act 1993 and associated regulations are not always understood by the system owners or applied consistently, which can result in the creation of unnecessary barriers to access in cases where access would be appropriate and beneficial.

This diagram is a generic illustration of a National System. In reality National Systems have been designed and implemented in a variety of ways, depending on the needs and technologies at the time
Characteristics of a National System.

What happens next
Responsibility for implementing the Health Information Strategy for New Zealand lies with the whole health and disability sector under the leadership of HISAC. HISAC is working closely with sector representatives to prepare more detailed descriptions of current problems and stakeholders’ priorities for improvements. If you would like to discuss the National System Access, please contact HISAC through enquiries@hisac.govt.nz or write to:

The Action Zone Development Leader
HISAC Office
PO Box 5013
Wellington

Relevant documents
Initial View (PDF, 278 KB)
Preliminary Scope and Approach (PDF, 851 KB)
Road Map (PDF, 53 KB)

Page last updated: 22 May 2009