Originally posted eHealthNews

‍Standards establish a minimum benchmark of expectations that are central to the goal of health consumers accessing, controlling and monitoring their own health-related data.

The recent article I wrote on the importance of health IT standards resulted in a lot of positive feedback along with a small number of negative responses.

The latter seemed to relate to a view that standards should be treated just the same as completely free-market principles. In other words, all that is required is for general guidelines to be in place and to then allow the purchaser and provider to establish the set of standards required for specific instances of their digital solution.

This assumes that the purchaser operates in an autonomous capacity and the provider can vary their standards based on a business model that enables customisation for every instance, and presumably can apply different funding mechanisms for various purchasers for essentially the same thing.

Clearly, New Zealand’s health sector cannot sustain this type of approach and standards have to be developed and applied in a consistent manner that also encourages different business models to be introduced. Standards are a means to establish consistency, set levels of expectations and provide the ability for various digital systems to interoperate, exchange data and support clinical decision-making, while at the same time ensuring they are safe, secure and reliable.

Fundamentally, the future holds no place for a siloed approach to the purchase, provision, implementation and maintenance of fit-for-purpose digital health solutions. Standards are not the only way to ensure key digital enablers are doing what they should, but they’re extremely important for establishing a minimum benchmark of expectations that can be relied on.

Fortunately, the feedback that I received demonstrates that we’re very fortunate to have a majority of enlightened people in the sector who understand the performance benefits that standards provide, along with the ability to compete in a market that views standards as important enough to support through funding models that reward the required commitment and investment.

Challenges and opportunities of a maturity phase

When it comes to health IT standards, the sector is moving through a maturity phase that will cause a degree of discomfort, as well as numerous opportunities, for NZHIT’s members.

From my past experience in healthcare delivery, the most important thing that anyone can do during this phase is to become engaged in the process, make a contribution to the setting of standards and construct a business model that takes these into account.

Understanding the opportunities that a set of consistent standards provides can become a competitive advantage during and following this phase.

On the purchaser side, there will also be a period of adjustment as the commitment and investment by providers in achieving the required standards has to be recognised and rewarded.

A ‘cheap as chips’ approach is not consistent with the future state of health that intergenerational wellbeing expects of us.

Establishing a minimum set of digital health requirements when it comes to standards, data governance, security, privacy and integration is essential for New Zealand’s health and disability sector. It is not sustainable to expect these to be delivered via historical funding models that continue to support the status quo.

Providers must take advantage of standards and digital advances to create efficiencies in their business modelling so their pricing structures are attractive and competitive. A cost-plus approach without changing traditional business structures sends the wrong signals to the market.

At the same time, the market has to be fair and openly competitive so innovation across the board can flourish and efficiencies are encouraged. For example, a topic for another day is the burden and barriers that the sector places on itself and others with the likes of lengthy and costly procurement processes. An inefficient health system cannot expect others to change without doing so itself.

Standards also expect that the full life cycle of a digital solution is taken into account. The so-called ‘sweating the assets’ approach cannot apply to software – especially where people’s health and wellbeing are at risk.

Effective change management during the implementation stage, right through to having software at its latest version and kept up to date, is essential. Just as a surgeon would not carry out an operation with a rusty scalpel neither should any healthcare provider be using outdated, and risky, digital tools.

The health data holy grail

The holy grail appears to be enabling consumers of health services to be able to access, control and monitor their own health-related data. There is no doubt that considerable gains can be achieved when people feel more in control and take greater responsibility for their health and wellbeing.

This describes a digital-first approach, as there is no other way that this future state can be attained. Hence, it is understandable that standards must play their part to ensure this is possible and, most importantly, that a trusted environment exists to encourage full engagement.

Therefore, I encourage us all to become engaged on this standards journey – partner up, collaborate and then hang on for an exciting ride!

Scott Arrol is the CEO of New Zealand Health NZHIT.

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