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Terms of Reference for the IT Health Board

Background

1. On 19 October 2009 Cabinet decided (Cab Min (09) 37/13-15 refers) to establish the National Health Board (NHB) as a Ministerial Committee under section 11 of the New Zealand Public Health and Disability Act 2000 (NZPHDA) and to replace the Health Information Strategy Advisory Committee with the National Health Information Technology Board (informally known as the IT Health Board)f.

2. The National Health IT Board is established as a sub-committee of, and reports to, the NHB.  The National Health IT Board is not established under section 11 of the NZPHDA.  The role of the National Health IT Board is to provide strategic leadership on information systems across the health and disability sector, and to ensure that the IT strategy is reflected in capital allocation processes and capacity-planning decisions.  

3. These Terms of Reference set out the objectives and other administrative details for the National Health IT Board.

Relationship between the Ministry of Health, the National Health Board and the National Health IT Board

4. The National Health IT Board will provide independent, strategic advice to the Minister of Health, National Health Board and Ministry of Health.  The National Health IT Board is to provide:

4.1. Strategic leadership on information systems across the health and disability sector, and

4.2. Advice on a national IT work plan, which is reflected in capital allocation processes and capacity-planning decisions.  

5. The National Health IT Board will have a role in providing advice to the National Health Board and the Minister of Health as appropriate, about whether the Ministerial Review Group (MRG), (July 2009) IT recommendations should be agreed and advising on the implementation of any decisions that are taken.  The Ministry of Health, through the National Health Board Business Unit, remains the primary advisor to the Minister of Health in relation to the policy implications of the MRG IT recommendations.

6. The National Health IT Board is accountable to the NHB for the quality and timeliness of its advice and reports.  The Ministry of Health is accountable to the Minister of Health for providing support to the National Health IT Board.

7. Any dispute between the National Health IT Board and the Ministry of Health in terms of support, will be resolved by discussions between the Director General of Health and the Chair of the National Health Board and, if necessary, by final decision of the Minister of Health.

Objectives and key tasks

8. The role of National Health Information Technology Board is to provide advice to the NHB and the Minister of Health in matters regarding the health and disability sector information systems and IT environment.

9. The objective of National Health Information Technology Board advice is to improve health outcomes for all New Zealanders within the available health resources.  Critical success factors include:

  • achieving clinical engagement and obtaining the confidence of the New Zealand health sector
  • providing robust advice to support decisions about the Ministerial Review Group IT Recommendations
  • ensuring the work conducted supports the long term view of service planning and is well integrated into decision making around workforce and health sector capital investment programmes
  • deliverables are consistent with, and contribute to, Government priorities
  • the IT work plan will be consistent with the service direction advised by the NHB and the Ministry of Health.

10. The following activities, to be undertaken as the Objectives for National Health Information Technology Board, are split into two categories.

  • advice on the Ministerial Review Group Recommendations.
  • matters regarding the development and achievement of an IT work plan.

Advice on the Ministerial Review Group recommendations

11. National Health IT Board was to carry out, by 15 December 2009, a review of:

  • the HMSC initiative and to provide advice on recommendation (g), Annex 3, Section 3 of the Ministerial Review Group report
  • the operation and services provided by NZHIS and Sector Services and recommendations on the actions needed to facilitate the transfer of these services from the Ministry of Health to a separate shared services organisation
  • how health and other government agencies certify and accredit software applications and recommend a cost effective, efficient approach for certification and accreditation of software for the health sector.

12. The National Health IT Board will have a role in providing advice to the NHB and the Minister of Health, about whether the Ministerial Review Group (July 2009) IT recommendations should be agreed and advising on the implementation of any decisions that are taken.  The related Ministerial Review Group recommendations are:

  • an interim governance group be set up for both National Service Development Programme and Key Directions (KD) to reprioritise and reduce the number of NSDP and KD projects with a focus on:

a) addressing the risks in the payments system, and
b) supporting the implementation of the distributed approach to a safe sharing and transfer of patient electronic information amongst providers

  • the Refresh HISNZ project of KD should cease and the Safe Sharing of Health Information Community Dialogue and Education project of KD should be slimmed down and utilise the existing HISAC consumer forum.
  • all primary care related IT projects such as GP to GP Notes Transfer, PHO Performance Programme, Qi4GP, electronic referrals, electronic discharges, electronic medication, and electronic laboratory should be integrated and rationalised under a new primary care information system initiative.
  • the Grants Scheme project of KD is reviewed to support projects related to the primary care information system initiatives.
  • the PHO Performance Programme is scaled back and savings be redirected to support the development of Qi4GP as part of a broader primary care information system initiative.
  • that the interoperable and connected distributed approach rather than the single sector-wide enterprise system be confirmed as the preferred approach for the development of a safe sharing and transfer of patient electronic health information for the New Zealand health sector.
  • the HMSC initiatives by seven DHBs revise their scope to concentrate on replacing the PAS for hospitals.  This revised scope be implemented using a distributed approach for the development of a safe sharing and transfer of patient information for the New Zealand health sector.
  • National Health IT Board will work closely with the HSMC initiative and the proposed primary care information system initiative to advance:
    • the implementation of a safe, shared and transferable patient electronic health record for New Zealand health sector, using a distributed approach based on interoperability standards set by the HISO, and
    • the implementation of a consumer portal.

Matters regarding the development and achievement of an information work plan

13. The National Health IT Board is to:

  • in conjunction with the lead agency, the Ministry of Health, and other agencies:
    • provide advice to support the development of an IT work plan and facilitate key strategy activities.
    • review, assess and comment on progress against the IT work plan approved by the Minister of Health.
    • to identify and as requested, to assist in the removal of barriers to the implementation of the IT work plan.
  • review all business cases for IT investment over $500,000 by the Ministry of Health, DHBs (and subsidiaries of the Ministry of Health and DHBs), and after such review give a recommendation for approval of any projects to the Minister of Health (for projects over $3m) and to the Director-General of Health (for projects between $500,000 and $3m).  This review is in addition to the wider Ministry of Health and government capital and policy approval arrangements.
  • undertake such research as is considered necessary to better inform advice provided to the Minister of Health on the implementation of an IT work plan.
  • review, support and endorse health information standards.  Advice may be sought or given as to any additional standards considered necessary to the further development of the health and disability system.
  • seek applications from across the health and disability sector for grants, awarded from a primary health IT grants fund, which will be administered on behalf of the National Health IT Board by the National Health Board Business Unit.

Key tasks of the National Health IT Board

14. Key tasks include:

  • producing an annual plan for approval by the National Health Board, incorporating a requirement to report to the NHB six-monthly against that plan
  • providing quarterly reports to the National Health Board on implementing the Ministerial Review Group recommendations. 
  • developing a communications plan and clinical engagement strategy.

Membership

15. The National Health IT Board will comprise up to eight members including the Chair.  Members shall be appointed for up to 36 months and can be re-appointed for one further term of up to 36 months.    

16. The Minister of Health may remove a member of the National Health IT Board by notice in writing stating the date from which the decision is effective.  The Minister of Health shall have the discretion to consult with the Chair before removing a member of the National Health IT Board.  The National Health IT Board Chair may be removed by the Minister of Health issuing a notice in writing stating the date from which the decision is effective.

17. Any member of National Health IT Board may tender their resignation at any time by way of letter addressed to the National Health IT Board Chair.

18. The advisory group, Health Information Standards Organisation (2010) will be accountable to the National Health IT Board.

19. The National Health IT Board may appoint any expert advisors to assist it in making deliberations.  These expert advisors are not National Health IT Board members and have no voting rights.

Appointment process

20. The Minister of Health will appoint the Chair and members of the National Health IT Board. 

21. Nominees will need to have the requisite skills to assist the work of  the National Health IT Board and should have held or are currently holding, a position of influence within the health and disability sector, have demonstrable leadership, oversight and governance skills and the ability to work collaboratively towards overall sector solutions.  Nominees should be able to demonstrate confidence that the sector or organisation they represent will support and participate in the agreed solution.

22. The membership and Chair of the National Health IT Board will be reviewed annually.

Duties

23. Through their letters of appointment, National Health IT Board members of will be advised of the term of their appointment and will be given a copy of these Terms of Reference.

24. National Health IT Board Members are expected to act in good faith, with reasonable care, and with honesty and integrity when exercising their powers or performing their duties on behalf of the National Health IT Board.

Liability

25. A member of the National Health IT Board is not liable:

  • for any legal liability as a result of any act or omission of the Ministry of Health.
  • to the Ministry of Health or the Crown for any act or omission done or omitted in their capacity as a member of the National Health IT Board if they have acted in good faith, and with reasonable care, in pursuance of the role specified for the Board in this Terms of Reference document.

Disclosure of interest

26. Any National Health IT Board member, who has an interest in a transaction, which is not limited to advising on contracts but includes exercising all tasks under these Terms of Reference, must, as soon as practicable after the relevant facts have come to the member's knowledge, disclose the nature of the interest to National Health IT Board.  For the purposes of this clause, section 6(2) of NZPHDA will apply.

27. Disclosure under this section must be recorded in the minutes of the next meeting of the National Health IT Board and entered in the separate Conflicts of Interest register.

28. A member of the National Health IT Board who makes a disclosure under this obligation, after that disclosure must not:

  • subject to clause 29, take part in any deliberation, discussion or decision of the National Health IT Board  relating to the transaction
  • be included in the quorum required for any such deliberation or decision.

29. A member of the National Health IT Board who makes a disclosure under clause 26 may take part in any deliberation or discussion (but not any decision) of the National Health It Board relating to that transaction provided:

  • a majority of National Health IT Board members and the Chair wish the member to do so, and
  • wherever and in whatever form such permission is given, this action must be reported immediately to the National Health Board Chair.

30. In such a case, the National Health IT Board must record in its minutes:

  • the permission and the majority's reason for giving it
  • what the member said in any deliberation or discussion relating to the transaction concerned.

31. Every member of the National Health IT Board must ensure that:

  • the statement completed by the member is incorporated in the Conflicts of Interests register, and
  • any relevant change in the member's circumstances affecting a matter disclosed in that statement is also entered in the Conflicts of Interests register as soon as possible after the change occurs.

32. Failure to comply with these requirements however, does not affect the validity of any action taken, or arrangement, or agreement, or contract made by the Ministry of Health subsequent to resolutions made by NHITB.

Fees and expenses

33. Fees are determined under the fees framework set out in Cabinet Office Circular CO(09)5.  Under this framework, National Health Information Technology Board has been classified as a Group 4: level 2 body which covers "All other Committees and other bodies". 

Frequency of meetings

34. The National Health IT Board will meet a minimum of eight times each year.

Work programme

35. The National Health Board and the National Health IT Board will, with input from the Director-General of Health, agree on an annual work programme for the National Health IT Board.

Reporting     

36. The National Health IT Board shall report on such other matters as the National Health Board specifies by notice to the National Health IT Board, these reports to include the committee's rationale for its advice and any relevant evidence and/or documentation.

37. The National Health IT Board shall provide a brief performance report to the National Health Board, with a copy to the Director-General of Health, within two months of the end of the financial year, detailing the work undertaken by the National Health IT Board for the past year.

38. The National Health IT Board will present an annual business plan to the National Health Board including proposed expenditure.  The National Health IT Board will report six-monthly on progress against the business plan.  The business plan and reports back will undergo agreed quality assurance process.

39. The National Health IT Board will document its work, recording the proceedings of all meetings in writing.  Such records will be available to all National Health IT Board members and, in respect of each National Health IT Board meeting, will comprise agenda, papers andff minutes of meetings that will include statements regarding any conflicts of interest, any decisions taken and recommendations made.  Separate Registers will be maintained covering Conflicts of Interest, Activities, Risks and Issues and Attendance.  Reference to these will be included as appropriate in the documentation for each National Health IT Board meeting.

Resourcing

40. The work of the National Health IT Board will be supported and resourced by the Ministry of Health within the Vote: Health baselines.

41. Secretariat support for the National Health IT Board will be provided by the Ministry of Health. 

42. The commissioning of work by external advisors as part of the work by the National Health IT Board will be agreed with the Ministry and contracted through its contracting processes.

43. The National Health IT Board has no power to:

  • direct the work of health and disability sector organisations
  • employ staff, enter into contracts, make loans or commit expenditure.