eHealthNews.nz editor Rebecca McBeth

Four regional agreements for DHBs that use Titanium software and a new Oral Health Data Standard have been developed as part of progress towards a nationally consistent Electronic Oral Health Record.

Titanium is a clinical system used by publicly funded oral health providers and the University of Otago Faculty of Dentistry in New Zealand.  It contains critical information about the status of patients and treatments provided to nearly all children up to the age of 12, and some adults.

Sixteen DHBs are using Titanium Solutions, but each have their own instance and customisation of the software, making it challenging to get nationally consistent information from the system.

These 16 licences for the software have been incorporated into four regional support and service agreements covering the Southern, Central, Midland and Northern regions of New Zealand.

Professional services organisation TAS is leading the project on behalf of the DHBs and the Ministry of Health. Bryan Pay, EOHR programme manager, says the implementation plan was approved by DHB chief executives in May 2019, and the new regional agreements were agreed with Titanium in May this year.

“This is a major achievement for the programme,” he says.

Regional Oral Health Information System (OHIS) User Groups have met and a national governance structure based around a National OHIS User Group is being set up, which will be the key group for managing the relationship with the vendor and the national strategy for upgrading the software.

The programme worked with a design group of clinical and operational subject matter experts to develop the national code-set.  This was published through the Health Information Standards Organisation in March of this year, and called the Oral Health Data Standard.

A national data service or warehouse has also been designed and, if implementation is approved, will allow a standard and consistent picture of oral health to be developed across the country.

Chair of the EOHR programme board and chief medical and dental officer at Hawke’s Bay DHB, Robin Whyman, says the regional agreements enable greater uniformity, making it easier for clinicians who move around a region to work.

When combined with the national data set, this helps to create a more regionally and nationally consistent system.

“The strength is really coming from the governance groups at the moment. The data standard enables us to have commonly agreed standards for the inputting of data and as we develop the national data service, we will then have the ability to extract nationally consistent information and that's where a big gain is going to come,” he explains.

The national data service will allow DHBs to understand their oral health status locally and compare that nationally. He says it will promote greater understanding of equity issues and value-based healthcare, particularly through the ability to measure the impact of quality improvement interventions.

“As a clinical director of a service you want to be able to look at interventions that you're putting into place and accurately measure how effective those are,” says Whyman.

He says the Electronic Oral Health Record Programme has followed an iterative approach to date and focused on quality improvement.

The programme may be extended at the end of the year to enable implementation of a single instance of Titanium across the country.

“As we move into a Health New Zealand environment, then we need to see how that evolves, but our expectation is that it will open up possibilities,” Whyman says.

‍