A new stocktake of the country's hospital facilities shows many IT systems are so old they will run out of technical support this year.
The stocktake released today also shows hospital buildings, pipes and back-ups such as boilers need $14 billion in upgrades by 2030, including major redesigns and expansion of often cramped and unworkable critical-care spaces such as emergency departments.
Another $2.3b is needed for IT systems and devices it describes as "ageing", "limited", "slow" and "not fit for purpose".
Multiple system failures detailed in the report included a three-day outage of communications on the secure national network, an eight-hour outage of internet access, and a fire in a data centre due to overheated cables.
The stocktake did not go into details about these, although it said the five district health board (DHB) data centres assessed were mostly in "poor" condition.
At present, 90 percent of all hospital IT spending was going on patching up outdated systems, when it should be only 75 percent.
Adoption of national standards was slow, so DHBs struggled to share information.
Ten of the 20 DHBs had "poor" financial management systems, and four had "poor or very poor" patient administration systems, the assessors found.
Another four had "very poor" pharmacy management systems, and one, Bay of Plenty, had a "very poor" clinical portal.
Portals let health professionals share patients' information.
An IT problem to do with a portal contributed to the death of a patient at Hawke's Bay District Health Board, the health system watchdog reported this week.
The stocktake said 60 percent of core DHB IT systems had no disaster recovery arrangement.
Security was poor as users logged on to multiple systems, and their access was not removed when they moved on, it said.
IT infrastructure, networks and security were "outdated and not adequate to support the introduction of new systems and to manage the increased cyber security issues".
Half of the Northern Region's network infrastructure would be without any technical support from this year on.
Its Windows 7 operating system lost such support in January.
To cope with IT woes, doctors and nurses across the DHBs adopted makeshift practices on smartphones or reverted to pen and paper "particularly at the bedside and treatment bay".
"DHBs may have up to 6000 devices," it said.
"It is common for these to be used beyond their expected life."
In the Northern Region alone, which has three of the country's largest DHBs and more than a third of the population, there were 70 outdated phone systems; it had 240 apps on outdated integration systems, half of which accessed core systems.