This document discusses the role of general practices in New Zealand and opportunities for health informatics. It outlines that general practices are the primary care provider responsible for longitudinal patient health records. It also describes the general practice information framework including standardized systems, backups, support services and high levels of electronic health record adoption. Finally, it discusses priorities around enabling patient-centered care, organized general practice through population health tools, and demonstrating leadership in multidisciplinary healthcare through information sharing.

1. Health Informatics New Zealand - www.hinz.org.nz
Organisational Strategy
Direction and Challenges
General Practice Position
First level care provider
Principal referrer to other services
Only repository of longitudinal health information
Up to date demographic and clinical information for all of
the enrolled population (eg. Pre-school dental)
Only “enrolled” provider (therefore ongoing accountability)
Central to the provision of primary/community health care
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2. Health Informatics New Zealand - www.hinz.org.nz
General Practice Information Framework
Provided by RGPG
– Standard practice server and OS, consolidation from 5 to 2 PMS
– HealthLink and Health Intranet connection
– Radio VPN (includes a/hrs clinic, hospital and several Pharmacies)
– Overnight backup
– High speed internet access and individual e-mail for all
– Level 1 Helpdesk for all issues (remote support over VPN)
– Level 2 Helpdesk PMS and IT Engineering services
– Practice Technology Facilitator (PMS)
– Quality Manager (clinical systems/processes, remote clinical audit)
– Practice Liaison (business systems/processes)
– PHO Services (Capitation, Population Health etc)
– Training programmes (group, individual)
Clinical Information Capability
NHI, Ethnicity, Deprivation recording (over 96%)
Electronic prescribing/lab investigation ordering (100%)
Electronic results (100%)
Electronic Referral and RSD (100%)
Smoking status recording (86%)
Standardised READ disease coding (100%)
Consultation coding (85%)
Prescribing link to diagnosis (50%)
Systematic approach to clinical information collection
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3. Health Informatics New Zealand - www.hinz.org.nz
Organisational Priorities
An environment which enables general practice to focus
on the person, their family/whanau and the health the
community
Collective responsibility for the health and well-being of
our community through Organised General Practice
Demonstrating leadership in a multidisciplinary healthcare
environment
Technology and IM critical enabler
Environment
An environment which enables general practice to focus
on the person, their family/whanau and the health the
community
– Centralised clinical and support service referral (including
case management)
– Development of clinical management and referral templates
– Complete clinical and social overview in PMS
– Facilitate electronic information sharing wherever possible
– Centralisation/standardisation of business and clinical
support activities
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4. Health Informatics New Zealand - www.hinz.org.nz
Organised General Practice
Collective responsibility for the health and well-being of
our community through Organised General Practice
– Population health = sum of individual health
– Implement population health management tools
Managed screening programmes
Opportunistic tools (eg. alerts)
Clinical management templates
EDS
– Data standards to enable population health data collation
– Information sharing (horizontal and vertical care integration)
Leadership in Multidisciplinary Care
Demonstrating leadership in a multidisciplinary healthcare
environment
– Building relationships and developing understanding
– Sharing information / sharing care
– Building on the general practice information repository
– Providing support to other primary care providers
– Including other providers on RGPG VPN
– e-Pharmacy pilot (applies to e-Lab as well)
Close the gap between prescribing and dispensing
Extend clinical partnership (med mgmt and adherence)
– Rest Home Clinical Information pilot
Provide clinical view to Rest Home and Pharmacy
Enhance clinical safety
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5. Health Informatics New Zealand - www.hinz.org.nz
Vision
Single, centrally hosted community database of all enrolled patient
information
Profile ASP interface for general practice
HCC interface for other primary/community providers
– After hours ED
– Pharmacy Community Mental Health
– Laboratory Out patients
– Radiology Hospital
– Physiotherapy Rest Homes
– Specialists Enrolled patients
InSync interface for PHO and Population Health management
Accession interface for enrolled patients (self management)
Access to information determined by explicit referral process and/or
type of provider
Challenges
General Practice sovereignty of patient
information
MoH/DHB paternalism
Cost of supporting technology
Confidentiality/security of patient information
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6. Health Informatics New Zealand - www.hinz.org.nz
Opportunities
Maximising our investment
Enhancing clinical management
Enabling multidisciplinary care with
information sharing
Simplifying the patient journey
Empowering patients around self care
More effective use of resources
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