this post was submitted on 10 Feb 2025
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I can tell from first hand experience that the NZ health digital systems are atrocious. The reason is not incompetency (although that does play a large part) it's corruption. It's the way contracts are handed out for building and maintaining these systems.
Just jumping in to add, lots of people think this is a Public Sector problem with IT procurement. But coming up to 20 year experience in IT for corps, its pretty much the same thing.
Lots of moaning about bespoke, or multiple systems interacting together, so instead lets buy an "off-the-shelf" solution because we did an 80/20 and we won't need to customise anything.
Oh whoops, turns out the 20 was the critical stuff and we now need some convoluted "fix" by our hugely expensive consultants' favoured implementation shop (oh weird, they share the same parent company?!) that gets 3/4 of the way through before budget is pulled and some stuff just never works. If you're lucky its left in the old system, sometimes you just lose features.
Ah yes...the old "management has chosen SAP"
There are roughly five million people in NZ. If each person had ten interactions with the health system every year that's only fifty million records per year in a database. I have built systems that process fifty million records per year on an off the shelf postgres database using a slow interpreted language.
There is no excuse for NZ to not have a centralized medical records system. There is no excuse for a centralized medical/hospital management system. This should have been done years ago. Right now there are open source medical systems being used by countries which are bigger than NZ with more complex health and social challenges. NZ could take one of those systems, hire ten engineers to tweak and customize it and deploy them on a half a rack without too much trouble.
Hell give me a couple of hundred thousand dollar contract and I will put it together and hire all the engineers for you.