Reflections on HiNZ 2025 Digital Health Week.

Ray Delany
Dec 14
8 min read

Day 1

Digital Health Week, hosted by Health Informatics New Zealand (HINZ) at Te Pae in Christchurch, opened with a set of keynotes that offered both a clear-eyed assessment of the current state of New Zealand’s health technology and an outline of a long-term plan to improve it.

The release of what was described as the country’s first national digital health plan created a more optimistic and energised atmosphere than in previous years. Even so, the Health and Disability Commissioner (HDC) reminded attendees that poor systems have real consequences for patients and their whānau.

Candid Assessment

Minister of Health Hon. Simeon Brown didn’t mince words as he set the tone, outlining the scale of the challenge facing Health New Zealand. He noted that the system is under strain and held back by outdated and disconnected technologies (not a startling revelation to this audience).

Minister Brown presented figures to illustrate the extent of the problem:

65% of hospitals still use paper-based notes.
85% of digital systems cannot share information reliably, meaning GPs often lack access to hospital records and essential details, such as allergies, are not consistently visible as patients move through the system.
The sector is operating with around 6,000 data and digital systems, or roughly one system for every 15 staff members. This fragmentation reflects years of underinvestment and short-term fixes.

Health and Disability Commissioner Morag McDowell reinforced this picture with case examples drawn from the thousands of complaints her office receives each year. They demonstrate how digital gaps affect patient safety and the continuity of care.

Examples included:

A patient experiencing anaphylaxis after receiving antibiotics because allergy information was captured inconsistently across systems.
A lost paper referral for a patient with a suspected heart infection, leading to delays and a breach of the right to continuity of care.
An ultrasound referral that disappeared because the systems involved were not connected, requiring manual re-entry that resulted in error.

Important reminders that digital failures are not simply technical issues; they can lead to avoidable and sometimes serious harm.

The Solution: A 10-Year Health Digital Investment Plan

The central announcement was the launch of what was described as New Zealand’s first Health Digital Investment Plan (HDIP). This is a 10-year roadmap intended to guide investment decisions and modernise core health technology.

Darren Douglass, Acting CIO at Health New Zealand, outlined the plan’s staged approach:

Stabilising critical systems – improving connectivity, devices, logins, and cyber security.
Modernising platforms – including the shift toward a single electronic health record (EHR).
Supporting new models of care – using technologies such as AI and precision health.

Planned improvements include:

Connected health records to ensure information follows the patient between providers.
A national radiology system with improved access to imaging and integration of AI-based diagnostic tools.
Remote monitoring that allows clinicians to track patients at home.
Continued development of established services such as online GP care.

The plan builds on Health New Zealand’s existing Accelerator programme, which is digitising inpatient notes, observations, and clinical workflows.

Strengthening Delivery Capability

Both the Minister and Darren Douglass acknowledged that past digital strategies have struggled to move from intent to execution. To address this, the HDIP is supported by a new Centre for Digital Modernisation of Health, described as a different way of organising delivery.

The centre is intended to:

Act as the core delivery function for the HDIP
Bring together Health New Zealand teams with external partners
Draw on expertise in areas such as AI, engineering, and service design
Build internal capability through a new Digital Academy

The intent is to break large, complex programmes into manageable steps and reduce the delivery risks that have hindered previous initiatives. Procurement activity related to remote monitoring, the new EHR, radiology, and cloud services amongst others is expected to follow.

Keeping Patients at the Centre

While the HDIP signals progress, Health & Disability Commissioner Morag McDowell emphasised that digital change must remain grounded in the needs and rights of consumers.

She highlighted several areas of concern:

Accessibility: Ensuring digital services do not further disadvantage communities with limited access to technology or those living with disability, as well as Māori and older people.
Human connection: Recognising that digital channels may change the nature of clinical interactions.
Accountability: Maintaining transparency, safeguards, and clarity of responsibility when using tools such as AI.

The Code of Rights continues to apply in full. Providers must:

Obtain informed consent when using digital tools, explaining benefits, limitations, and risks.
Ensure care is coordinated, particularly when using telehealth or remote prescribing.
Retain clinical accountability; digital tools do not replace professional judgement.

The HDC’s comments provided an important balance to the technical details, underscoring that the purpose of digital investment is to support safe and equitable care, not simply to modernise systems.

The publication of the HDIP marks a significant step for New Zealand’s health sector. The government and Health New Zealand have acknowledged the fragmentation and instability of current systems and set out a long-term approach to address them. But as the HDC made clear, success will depend on disciplined delivery and a continued commitment to equity, transparency, and patient rights. Moving from thousands of disconnected systems to a more unified, patient-centred approach is complex and will require sustained attention from clinical, technical, and operational teams alike.

Clearing the "Fog" and Making Data Truly Work

Scott Bradley from Philips put a name to the problem holding back health innovation: The FOG (Finance, Ownership, and Governance). His point was simple but essential: it’s these structural barriers, not the lack of shiny technology, that most often slow the system down.

He grounded this in global realities:

Radiology scan volumes are growing 7% per year.
Workforces are shrinking, with NZ needing to double clinical staff by 2032.
77% of clinicians lose time because patient data isn’t accessible.
A third of clinicians lose up to four workdays a month to inefficiency.

Bradley showcased vendor-neutral solutions that ingest data from 1,200+ point-of-care devices, regardless of manufacturer, and route it cleanly into EMRs.

He also highlighted “hospital in the home” models that are proving their worth globally. From WA Health’s Hive Command Centre (46 days fewer on average length of stay and $50m saved in travel) to Emory’s critical care surveillance model used as both a safety net and a staff-retention tool—these aren’t pilots anymore. They’re scalable solutions.

Some Real Lessons from Digital Deployment

Dr Lloyd McCann delivered one of the most grounded talks of the day. His message: large-scale digital implementations are never easy, and success rarely depends on the “sexiest” tech.

Drawing on personal experiences growing up in Apartheid South Africa, he translated three life lessons into practical guidance for deploying Tamaki Health’s cloud HRIS - a project he admitted felt “boring” next to AI.

His three fundamentals:

1: Be More Commercial

Digital health is built on contracts. If you don’t have a solid commercial underpinning from day one, things unravel fast. McCann likened this to trying to sell Wilson Blocks as a kid without understanding credit. Tamaki Health partnered with Oracle and Deloitte early to ensure the right commercial constructs were in place.

2: Use a Third Party as a Circuit Breaker

Implementation partners matter. He talked about trying to convince teachers he’d already eaten breakfast as a child which had no effect until his mother got involved. The point being that a neutral third party is often the only one who can push big vendors hard enough to deliver something truly fit for purpose. (No argument from anyone at CIO Studio.)

3: Without Struggle, Hope Cannot Exist

Innovation journeys are full of friction. While not comparable to systemic repression, the principle holds: struggle often precedes meaningful progress. For Tamaki, that included gaining a richer understanding of the workforce and their development needs through the HRIS rollout.

Aged Residential Care: The Invisibile Giant

Tracey Martin from the Aged Care Association offered a sobering view of the sector that will dominate the next 50 years of NZ’s health system, yet sits awkwardly outside primary, acute, community, and secondary care.

Key insights:

39,000 New Zealanders live in residential care. Most providers are small owner-operators, charities, or not-for-profits serving older people who rely solely on superannuation.
Technology is often pointed at the wrong problem—counting things for regulation rather than improving quality of life for residents whose average stay is only 18 months.
Human connection matters most. Martin warned against replacing care with robotics and instead urged us to design solutions that free humans to be more human.
Regulation is actively blocking innovation. A Waikato virtual RN model that dramatically reduced hospital transfers (below 1%) and improved safety was shut down because it didn’t fit the ARC contract rules. Her message: if we provide healthcare to people in the community, we must also provide it to those who live in care homes.

Generative AI: Speed, Confidence, and the Helpful Junior

Dr Emeline Ramos from InterSystems brought global insights from the real-world deployment of Generative AI inside the EHR at EMC Healthcare in Jakarta.

The findings were practical and grounded:

Clinicians use AI primarily for retrieval, not interpretation. About 80% of prompts were simply: “Show me the fundamentals—latest labs, imaging, meds, vitals.”
It’s about confidence, not substitution. Only ~1.6% of prompts sought recommendations. Doctors want clarity, not a digital co-pilot making clinical calls.
AI is already being treated like a junior colleague. Around 10% of prompts began or ended with “Hello,” “please,” or “thank you”. There’s a subtle humanisation of the tool happening.

Her conclusion: the future of AI in medicine will be shaped by how effectively it helps clinicians work faster and safer, and how well vendors listen to the people using it every day.

Final thought from Day 1

There were undoubtedly many other presentations of equal calibre that I didn’t get to. But from what I saw, the direction of travel is clear: we’re getting better at combining digital tools with commercial realism and human-centred design - and that’s where real system-level gains emerge.

Day 2

Day Two was about big themes, clear signals, and plenty for those of us in the digital health space to act on.

Mandate for Change

Dr Lester Levy, Chair of Health New Zealand, opened with his customary quiet bluntness: we’re carrying a “massive” technical and data deficit. His point wasn’t just about systems, it was about the “software of the organisation” as he put it: leadership, culture, and how we operate.

His big strategic signals:

A devolved operating model by the end of June (I guess 2026?) nationally consistent, regionally coordinated, locally delivered.
Clinical leadership fully embedded at every level, not just consulted at the end.
A shift from a mindset of scarcity to one of abundance, enabled by digital modernisation and new models of care.
Access remains the defining issue, and productivity will only come from working differently, not harder, AI and smart systems included (an oldie but still good)

The Hon. Matt Doocey reinforced this theme zeroing in on his mental health portfolio. The shift from a justice-system-led response to a genuine mental health response is long overdue. His announcement on funding AI navigation - a true “digital front door” - goes straight to addressing unmet need, especially for the quarter of New Zealanders who simply don’t know where to go for help.

Using data to drive New Zealand’s first mental health and addiction targets is another step forward. Being able to understand variance at the level of “Northland Māori rural young person” is exactly the level of granularity required if we want to finally end the postcode lottery.

Cross-Government Lens

Myles Ward from DIA brought the whole-of-government perspective and didn’t sugarcoat the challenge either. Transformation, especially in a “loosely coupled ecosystem” like health, is inherently hard. But the direction is clear: reuse over duplication, integration over fragmentation, and service design anchored in people, not processes.

He made an important point about pace: digital change has to match the pace of trust, policy, and legislation. And there were some encouraging examples: The AI scribe rolling out to thousands of ED clinicians is a good indicator that AI in government isn’t just PowerPoint anymore.

Centre for Digital Modernisation

The day finished with a Q&A on the newly established Centre for Digital Modernisation which is positioned as the engine room for the Health Digital Investment Plan (HDIP). It has the remit and the focus to deliver what will likely be New Zealand’s largest technology transformation program.

Priority areas for upcoming market engagement include radiology, cancer, remote patient monitoring, and cloud platforms. Health NZ made it clear that delivery isn’t something they’re doing to the market - it needs to be done with it. Existing all-of-government panels will be used where they’re fit for purpose, but health-specific procurements (like the upcoming open engagement for clinical core systems) will be stood up when needed.

The End of the Beginning?

If Day 1 was about framing the opportunity, Day 2 was about the work ahead. The signals are clear. The sector’s moving, and the system is finally starting to build the digital foundations needed for a more abundant, accessible, people-centred health future.