Orion Health is calling for New Zealand to develop a national shared care record within 12 to 18 months, with CEO Brad Porter saying connecting information already held across the health system should be treated as an incremental program rather than a decade-long transformation.
The call is one of the key recommendations in Orion Health’s New Zealand Election Manifesto, which sets out a three-phase roadmap for developing a more connected health system as demand increases and the population ages.
The manifesto calls for a single national approach to digital health, mandatory interoperability across public health systems, reduced duplication through shared procurement, a long-term digital workforce plan and regular public reporting on progress and outcomes.
It also proposes a national digital front door, greater use of data in clinical and operational decision-making and modernisation of underlying infrastructure.
Mr Porter told Pulse+IT that New Zealand had invested significantly in digital health over the past 20 years but had often done so through a fragmented model.
“We’ve got somewhere north of four to six thousand clinical applications all doing their own good bit of work but in isolation,” he said.
“Fragmentation is one of our core problems – functional, structural problems – that we’ve got in New Zealand. We’re operated as one national system, but was it ever designed that way? Not really from an infrastructure point of view.”
He said clinicians were often left carrying the burden of that fragmentation by having to reconcile information held across different systems.
“Patients just expect that the clinician knows they went to the GP yesterday or visited the emergency department, but clinicians are blind to that information and that’s one of the biggest problems that we’re hoping to help solve.”
Connect what already exists
Mr Porter said the answer was not necessarily another attempt to replace existing systems with a single national platform.
“I think we’ve tried to fix everything at once. We see it in healthcare systems all around the world – we try and fix everything in one standard national solution. What we need to start doing is just connecting up what already exists.
“We don’t have a data problem, we capture plenty of data, it’s just disconnected.”
The manifesto proposes a minimum viable national shared care record initially focused on high-value information including care plans, medicines and allergies, patient identity and discharge summaries.
Mr Porter said Orion’s proposed 12 to 18-month timeframe was realistic based on shared care record projects internationally, with value potentially able to be delivered to clinicians within six months once a health system committed to the work.
“It should be treated as an incremental program, not a decade-long transformation. Getting the data that already exists across multiple different source systems into a single record can be done relatively quickly and efficiently using modern technology and it doesn’t need to take a long time to start delivering value,” he said, noting “you’ve got to start with a well-defined use case and the value that creates.”
Interoperability at heart of procurement
The manifesto also addresses health technology procurement, noting that existing practices have contributed to fragmentation by prioritising individual systems rather than connected solutions that can scale nationally.
Mr Porter said interoperability should become a core consideration when health technology was purchased.
“The fundamental question we should consider with procurement is – ‘does this new procurement create more fragmentation or does it solve interoperability challenges?’
“We should try to build capabilities once and reuse them across multiple different settings – but in saying that, healthcare is highly localised – it’s complex and a solution in the far north might be different to central Wellington and so we’ve got to recognise that as well.
“Interoperability at its core should be the mandate for procurement and one of the core evaluation criteria in procurement channels.”
Mr Porter said this did not mean favouring New Zealand companies over international vendors, noting Orion itself generated about 80 per cent of its business overseas.
However, he said having a local presence and understanding of the New Zealand market could be important to successful adoption.
HDIP ‘right direction’
While the Health Digital Investment Plan is not mentioned in the manifesto, Mr Porter said its development was a “massive step” and Orion broadly supported its direction.
“I think that’s a massive benefit of a framework of things that we need to achieve over the next decade as an ecosystem – that’s vendors, that’s the public health system – to achieve,” he said.
“I think what they’ve identified there across their top ten priorities is fairly common sense and in a good place to start. So I think there’s no disagreement that that’s the right direction.”
He said the question now was how quickly the strategy translated into investment and improvements clinicians and patients could see.
“The patient should be able to turn up anywhere in New Zealand and the clinician should be able to see the relevant information about their care.
“I don’t think anyone will disagree with that statement – and the plans align to that – but it’s how quickly can we actually get that in the hands of the patient and hands of the clinician.”
Mr Porter also called for cross-party support for long-term digital health investment, saying infrastructure decisions could not continually change with the three-year political cycle.
‘Tens of millions’
The manifesto does not put a price on its proposed roadmap, but Mr Porter told Pulse+IT the initial changes would require investment in the tens rather than hundreds of millions of dollars.
He stressed the manifesto was “not a shopping list for tech vendors,” but reflected where Orion believed digital investment could deliver the greatest return for the health system.
Asked for the three things he would want the incoming health minister to do in the first six to 12 months, Mr Porter’s first priority was clear – “Connect the record. Make the clinician fully informed.”
The second priority was measuring digital health investment through outcomes, rather than the technology deployed – including fewer duplicate tests, reduced clinician administration and faster decision-making.
“The third thing: set the strategy, set the funding and execute,” Mr Porter said.
“Too often we get caught in hypothetical discussions and, ‘Oh, this might work but it probably won’t work.’ Set a vision, set aside a budget and just get on with it.”
He said getting the digital foundations in place would eventually allow New Zealand to move towards greater use of prevention, care closer to home and AI.
“We’ve got all these new technologies, we’ve got the promise of AI which is immense. But we’ve got to get the foundations. AI is only truly valuable if we have that data foundation in place.”
The New Zealand election will take place on Saturday, 7 November 2026.
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