One step forward, one step back? Restructuring, evolving policy, and information management and technology in the New Zealand health sector

In 2001, the New Zealand government launched an ambitious health care information management and technology strategy that seeks to integrate the health sector, facilitate electronic health records and information portability and give patients greater information access. This article looks at the prospects for the strategy, against a background of extensive public health system restructuring in the 1990s. It notes that through this period, health purchasers and providers developed information systems in isolation from one another and with minimal central oversight. The result is a highly complex and firmly established architecture and an array of problems that need rectifying. Combined with present decentralised health structures, government capacity to influence activities is limited. The article concludes by reviewing current developments noting that advancement on the government's goals is likely to be incremental, across a range of areas, sometimes driven by providers and sometimes by central agencies.