Welcome everyone. Thank you for inviting me to your conference today - I'm delighted to be here. I give a lot of speeches but I believe this is a particularly important conference because I believe it is pivotal to the Government's drive for increased productivity in the health sector.

I would like to begin by thanking the HINZ Chair Professor Jim Warren and David Parry of the Scientific Programme Committee for the invitation.

I would also like to give a special warm welcome to our friends from overseas, some of whom will be sharing the benefit of their international experience and expertise with us during the conference.

Opening

As you are all aware, we face some significant challenges in the health sector. In New Zealand, heart disease, cancer, diabetes and tobacco-related disorders account for 80 percent of early deaths. Chronic conditions have a disproportionate effect on people on low incomes, and on Maori and Pacific peoples.

Health spending in New Zealand has increased much faster than our Gross Domestic Product, but to date, the gains have been patchy. Health system performance has not kept pace with increases in funding in areas such as elective services, emergency departments, waiting times and the workforce.

This government is committed to ensuring that New Zealanders get better, faster and more convenient health services and information technology has a key part to play in enabling us to achieve this.

The last decade has witnessed a global health information explosion. Doctors and other health professionals are able to exchange ideas and consult with colleagues all over the world. And the Internet is giving everybody the opportunity to find out about the latest developments in health. Whether we are looking at the benefits of increasing health information or the risks - information technology is changing the context in which care is delivered.

 "Person-Centred Healthcare - eHealth as an Enabler" - this is a timely theme for the conference.

There is a real demand for new models of care that see the patient rather than the institution at the centre of service delivery. The challenge is to promote a seamless patient journey across the community, primary, and hospital sectors. We need to make greater use of primary and community care and shift the focus of care ‘closer to home' to get the best value from our health services.

Planning of services has to involve those who are actually delivering care. We need stronger clinical and management partnerships to ensure that doctors, nurses, and other health professionals can play a key role in IT decision-making, and help sharpen our focus on patient safety and quality of care.

Patients see many different health professionals in their interactions with the health sector. They have so many notes, updates and documents in their medical records, that it's a challenge for any one person to get a handle on that patient's overall health status. Vital information gets missed and errors get made. With the technology we have today, I believe we can do more to improve the systems and processes to support the people delivering our health services.

It's not just about the technology. Health professionals need support from those who understand technology if a person-centred health service model is to be achieved.

Ministerial Review Group

As I am sure you are aware, the Government set up a Ministerial Review Group earlier this year to make recommendations on how New Zealand might improve the overall quality and performance of the public health system.

The Group's recommendations are currently being considered by Cabinet and Minister Ryall is likely to be announcing the outcome of this review within the next few weeks.

Among this Group's 170 recommendations is a strong theme for improving quality - to both improve outcomes of patients and to reduce costs so that savings made can be put back into more health services.

The Report recognises that to improve frontline services we need more input from frontline staff, and there are recommendations to strengthen clinical leadership and clinical networks.

The report proposes consolidating back office functions across the 21 District Health Boards to harness the power of bulk purchasing. It also proposes reducing the number of committees that advise the Ministry of Health from 157 to 54.

Any savings in health will be reinvested in health - we are not cutting health spending. In fact DHBs have more money to spend this year than ever before.

Financial Situation

As we plan for the future of healthcare in New Zealand, we must acknowledge that all publicly funded services have to manage the growing demand for healthcare against the backdrop of a resource constrained environment. This is not news to any of us here today, and you will be well aware of what this entails.

While the challenges may appear daunting, they stimulate new, innovative and more effective ways of working.

There's still room to reduce waste in the public health system - we don't want to see 21 DHBs doing things 21 times. Reducing this waste doesn't necessarily mean wholesale structural changes to our existing system; but it does mean finding ways to improve the system, and ways to do things better.

Taxpayers expect those of us who work in a publicly financed system to strive constantly to do better with the resources we have. Techniques and approaches that incorporate technology to drive out waste and increase efficiency should be a focus. This means that IT systems should add value and serve the needs of our clients, patients, consumers and customers.

Implementation of Better, Sooner, More Convenient Primary Care

Delivering good primary care plays a key role in achieving a more efficient health system. We know from what New Zealanders have been telling us that hospital services are a priority, but while we deal with those we will also be advancing primary health care and supporting it to fulfil its potential.

Primary care offers the best way to deliver timely healthcare closer to home for New Zealanders.  International research demonstrates that those health systems with strong and vibrant primary-care services have much better health outcomes for a lower cost than those that focus on specialist or tertiary care.

In order to improve New Zealand's primary care services, the Government is focusing on a range of things; putting patients first, offering care closer to home, and providing integrated care.

On 2 September 2009 the Ministry of Health issued a request for Expressions of Interest from primary health care providers to select a first wave of providers to be funded to implement the Better, Sooner, More Convenient policy, which includes establishing Integrated Family Healthcare Centres.

It is the Government's intention that improvements will begin to be implemented in this current financial year, with initiatives reaching up to 30 percent of all New Zealanders over the next three years.

Let's be clear. None of this will happen without strong clinical leadership and the combined IT muscle of the people in this room. We will need a fit for purpose payments and information environment that meets the needs at a national, regional, PHO, and right out to, practice-level. The Ministry has been asked to lead a programme of work to define these requirements.

Patients too need a better understanding of what this new model of care will mean to them and their health information. For too long there have been too many myths about health information, what is held and who can see it. The Ministry is currently working with the Health Information Strategy Advisory Committee Consumer Forum to scope out a "Safe Sharing of Information" programme to address this.

Necessity is driving the changes and IT will enable it. Broadband will play a role in this.

Broadband Investment Initiative

The Government's vision is for all New Zealanders to have access to quality and affordable broadband - or ultra-fast broadband - with the initial goal of making fibre available to 75 percent of New Zealanders, with an initial focus on business, education, and importantly, health users. We've set aside up to $1.5 billion for this and we expect that to be at least matched by private sector investment.

This investment includes a Rural Broadband Initiative that will provide the ability to connect hospitals and health provider sites outside of the 75 percent footprint. In rural areas, better broadband access will help remove distance as a barrier to receiving quality healthcare. As part of the Broadband Initiative, hospitals and significant health sites will be a priority for connection to fibre within the first six years of the initiative. Where we connect a rural school we will take the opportunity to ensure that the fibre is available to any significant health site nearby.

I am advised that faster broadband can support applications such as high definition videoconferencing into regional New Zealand to allow remote diagnosis from specialists in other parts of the country, and the ability for health providers to transfer data such as high resolution scans in real time.

These applications could help address the workforce shortages in these areas, and reduce the inequalities of access to healthcare currently experienced by people living in non-urban areas.  This in turn should lead to better health outcomes, particularly in rural areas.

While broadband is an important enabler for new healthcare delivery models, having standards for data and systems to allow interoperability and the secure transfer of information is a significant challenge, one which the Ministry of Health is addressing through working closely with the sector through its Connected Health Programme.

Recent Successes

I've talked about plans for the future, but I would also like to acknowledge some achievements of the past year.

GP2GP Steering Group issued draft system requirements for sector feedback

It's good to see the progress being made with the GP2GP project. In mid-August, the project's steering committee asked clinical and vendor stakeholders to feedback on draft user requirements for the system, and I'm delighted to see this project being presented here on the programme today.

Currently, around 375,000 patient records are transferred between practices each year, by fax or standard mail. This is obviously inefficient and can lead to vital pieces of patient history being buried in notes or being re-entered incorrectly.  

Online Pharmacy Claiming now rolling out nationwide

Pharmacists too are benefiting from enhanced IT. Online claiming enables pharmacists to submit their claims to the Ministry through a secure electronic gateway embedded in pharmacy management software. This is quicker and more convenient than sending claims on floppy discs in the mail.

The Ministry has announced that it will be rolling out the online pharmacy claiming system nationwide, starting with DHBs. This roll-out follows a pilot run from late 2008 in 210 Auckland Metro pharmacies.

Project for the Integration of Mental Health Data (PRIMHD; pronounced ‘Primed')

The new mental health national collection Project for the Integration of Mental Health Data or Primed also achieved a major milestone in August. The web-enabled system went live, allowing smaller NGOs to report information direct to the national collection via the internet.

Now even the smallest of mental health providers is able to contribute information to build a national picture of mental health service use and outcomes. Primed opens another dimension towards achieving the vision of improving mental health outcomes for consumers.

Health Domain .health.nz launched 2 September

In September, the Minister of Health announced that the Ministry would be starting to roll-out the second-level health domain name .health.nz to eligible organisations.

The health domain will provide added confidence to the public and health sector that health websites they visit, and emails they receive, are from genuine health professionals.

H1N1 response

It has been a year of change for the health sector, with the added challenge of the H1N1 virus putting more pressure on the health system. As a health sector, you should proud of your contribution to the H1N1 response. Everyone rallied together to get the systems and processes in place to minimise the threat, and I know that IT played its part in this response.

Closing

Today, I have outlined some of the challenges facing us and mentioned just a few achievements of the past year.

The technology we have, and the people we need are here too - in this room.  While technology has provided us with a range of powerful tools, the challenge for all of us is to enable those delivering health care to employ these tools effectively. New Zealanders are renowned for their innovative approach and I believe we have a great opportunity to use technology in smart ways for the benefit of health providers, consumers, families and whänau.

Thank you to Health Informatics NZ for the invitation to your Conference. It looks like you have a great programme. You do a great job in bringing all these people together. Have a good conference.