The Director-General of Health is urging district health boards to "reprioritise" spending to upgrade hospitals' IT systems in the wake of Covid-19.
Dr Ashley Bloomfield said "very serious consideration" should be given to digital and data projects in the coming year to allow more staff to work from home, more remote patient consults and better data sharing, he wrote in a 24 July letter to all district health boards (DHBs).
"We urge DHBs to consider where resources should be reprioritised and projects deferred in order to support priority data and digital investments."
A month earlier, nearly 400 clinicians wrote to Dr Bloomfield demanding progress be made on updating the country's "ageing" hospital IT systems.
Dr Bloomfield said he recognised the "frustration" of clinicians in that open letter, and the Ministry of Health (MOH) was working towards "some targeted data and digital funding".
However, DHBs would also have to find ways to pay for upgrading their IT systems from existing budgets.
"As a sector we are in challenging times, perhaps the most challenging since the 2008 global financial crisis.
"We expect DHBs to coordinate regionally, prioritise the alignment of portfolio strategies, and explore options for co-investment where appropriate," Dr Bloomfield said.
Hawke's Bay DHB noted it would have to spend an extra $1.47 million on improving its IT systems following Bloomfield's directive, noting a "lack of historical investment" had resulted in "critical health services" being supported by infrastructure that did not meet growth requirements and was vulnerable to security risks.
'There's a very big digital and data inequity issue here' - senior doctor
Chair of the Telehealth Leadership Group and senior doctor at Waikato DHB Dr Ruth Large told Morning Report there has been a long-term under-investment of technology in the health sector.
"Health is a very complex environment and I think we haven't really had the opportunity to think about the advantages that digital tech could make," she said.
She said it's important that DHBs recognise it is not just about GP visits being done via video conferencing.
"It's the pieces underneath that that are important, so it's protecting privacy, security, those sort of things, but even more than that it's enabling us to be able to look at information together so that when I'm talking with a patient I know that the patient I'm talking to is the patient whose health record I'm also looking at."
Dr Large said there are also inequity problems for DHBs and their patients.
"We saw that our general practices had a lot difficulty getting really high speed internet in order to make these connections.
"I think there's a very big digital and data inequity issue here... we know that probably 20 percent of our patients will have difficulty with this technology and that's not even just the devices it's also the digital literacy - understanding how things work."
She says the DHB decision makers will have to think carefully about where they spend their money in the future if they are forced to reprioritise spending towards technology upgrades.
"If I break it down really simply I think about healthcare workforce, you know the bricks and mortar, and then healthcare tools. What we have seen traditionally is a big emphasis on medicines, development, lots of really fancy new tech to do new procedures, but perhaps what we haven't done is make our workforce more efficient with digital tools. So I think that there is a capacity issue there."
The MOH did not respond to requests for more information about what funding was available for district health board to upgrade their IT systems.