HINZ 2011 kicked off this morning in Auckland New Zealand with a talk by David Blumenthal, the former National Coordinator for Health IT for the department of Health and Human Services in the US.

Dr Blumenthal talked about the concept of "Meaningful Use" which focuses more on health outcomes rather than implementation. He talked about how the role of the central government was to act as a coordinator and champion that enabled a bottom up approach to improving IT implementation. His department did this through a governence mechanism that spanned a number of areas including improving privacy regulations, funding Health Interoperability Exchanges (through the various states), creating incentive payments for health providers, creating interoperability standards and training the health informatics workforce.

The key early objectvies, which were helped by incentive payments, were getting doctors using IT systems instead of paper records. He said there is a need to operate before you can interoperate! Over the course of the programme to date, they have more than doubled the number of physisicans using IT systems (albeit from a low starting point of only 17%) Another key success of the progrogram has been the psychological shift of providers equating use of IT with higher quality and he feels that it is becoming accepted that healthcare providers will all end up using electronic health records (something that wasn't obvious just a few years ago).

In answer to some questions from the NZ-based audience, Dr Blumenthal highlighted the importance of financial incentives to kick-start the process. He also said that NZ would have different challenges and the focus may need to be more centralised with greater government involvement. This is because the smaller NZ market may not support the level of innovation that is possible with the bottom-up approach he advocates for the US system.