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Half of the critical IT hardware in hospitals is past its use-by date, the government has been warned.
Significant near-term effort and investment in hospital data and digital technology were needed just to "keep the lights on", Health NZ - Te Whatu Ora told Health Minister Shane Reti, in a briefing released to RNZ under the Official Information Act.
It also advocated for freeing up private investment in digital health as part of the solution, noting it had "increased dramatically over the last 5 years, particularly in the USA".
"We need to similarly unleash innovation in NZ," Te Whatu Ora said.
"Embrace global standards + reduce local barriers to innovation."
The briefing showed a five-year project of digital modernisation in the public health system was due to begin, on top of a new operating model for data and digital services introduced in November 2023.
But it was starting from way behind: "We've inherited significant tech debt which constrains performance - a new national approach was needed, but it will take time, effort and investment to rise above the legacy."
A page from the Health NZ Minister briefing to the Minister of Health showing tech problems. Photo: Supplied/ Health NZ
The legacy systems were "fragile and fragmented", including:
- more than 6000 apps
- 1000 servers, almost half of which were so old they were "out-of-support"
- a quarter of databases out-of-support and half on "extended" support
- 1000 devices over a decade old.
The system has to cope with the equivalent of more than 5000 billion pages of data.
As a result, vital health data had been "locked away in operational silos" of 28 different data warehouses and exposed to ad hoc access and lack of security standards, without the ability to track if information was being used the wrong way, documents previously released to RNZ showed.
Read more:
- Stocktake found health IT systems vulnerable to significant cyber attacks
- Hospital stocktake shows $14B in upgrades required, and outdated IT systems
"Technology is arguably the biggest lever available for improving care given current system capacity constraints," the newly released briefing to Reti said.
"Smart use of technology can free up capacity, drive savings and enable clinicians to be more productive and effective."
It labelled the national public health IT system (set up to deal with notifiable diseases, pandemics and the like) as an exception that was "truly world class" - though work to build that system had been running months behind.
It described 11 international examples that New Zealand could copy, such as a "NASA-style" control centre in Canada that boosted bed capacity, and "hospitals without beds" for 600,000 patients who got remote monitoring 24/7, cutting inpatient numbers in half, in the United States.
It also noted how work by the Māori Health Authority Te Aka Whai Ora - which will be defunct as of 30 June - had helped in the complex area of Māori data sovereignty.
The briefing comes four years after an inaugural national assessment of health infrastructure said $2.3 billion was needed to upgrade hospital IT by 2030.
RNZ asked Te Whatu Ora for details of any improvements made since, and for a copy of its new digital roadmap.
Health Minister responds
Minister of Health Shane Reti said the broader issues had been building over two decades and working through them would require careful planning.
He had been assured that work on priority projects was carrying on, such as on cybersecurity, payroll and rostering, and the Auckland hospital patient administration system Tū Pono Āroha.
In a statement, Reti said he would consider new investment later this year once Health NZ delivers a new 10-year digital plan setting out the scale of what is needed.
"This will mean the government can make informed decisions about putting resource where it will have the greatest impact."
