Electronic Oral Health Record (EOHR) Programme

The EOHR Programme will work with DHBs to move towards a nationally consistent platform of information, processes and technology. This will help to better meet the needs of consumers and clinicians of DHB provided oral health services, and support New Zealanders to live well, stay well, and get well.

Through improved capture and quality of oral health information, improved patient and clinician access to this information, and more fully informed service development and planning, the EOHR Programme will support DHBs to deliver better health services for New Zealanders. Oral health information will form part of the comprehensive electronic health record for each patient, and be integrated with key national and DHB applications to support efficient service delivery and integrated patient care.

For DHB provided oral health services, the EOHR Programme relates to the care of children seen by the Community Oral Health Service. It also includes oral health services delivered to children or adults by hospital dental services and some other key service providers such as Māori health providers.

EOHR Programme vision and objectives

The vision of the EOHR Programme is to enable oral health services to support all New Zealanders to live well, stay well and get well. 

This will be delivered via three programme objectives, which are to ensure that:

1. Oral health information and processes are consistent, integrated and high quality
2. Oral health information systems are robust, nationally consistent and connected
3. Oral health service delivery and consumer needs are highly supported.

EOHR Programme plan

The high-level EOHR Programme plan will achieve the vision and objectives through the delivery of five programme tranches:

1. Establish an EOHR framework for change and requirements for a nationally consistent platform
2. Design a nationally integrated Future Operating Model (FOM) enabling the EOHR
3. Establish a nationally consistent Oral Health IT solution (OHIS)
4. Roll-out and embed the national EOHR platform, FOM and OHIS
5. Implement ongoing national governance and management of the EOHR platform FOM & OHIS.

EOHR Programme leadership

To provide strategic direction and stakeholder engagement, the Ministry has established the EOHR Programme Board (the Board). The Board is being chaired by Dr Robin Whyman, Chief Medical and Dental Officer, Hawkes Bay DHB. The other Board members appointed by the Ministry include:

• Geoff King (Chief Information Officer, Waikato DHB)
• Brigadier Andrew Gray (Director of Health, NZ Defence Force)
• Dr Martin Lee (Clinical Director Community Oral Health, Canterbury DHB)
• Lexie O’Shea (Chief Operating Officer, Nelson & Marlborough DHB).
• Neil Gyde (Manager, Data and Digital, Ministry of Health).

Oral health sector support and input

To ensure success, the EOHR Programme at the Ministry worked closely with all DHBs and other stakeholders, to understand their current situation and requirements to co-design the approach for achieving a national EOHR. In November 2018, the Ministry contracted Central TAS to lead the implementation phase which means the EOHR programme team now sits with Central TAS.

The EOHR Programme Board has established an EOHR Design Group to support it and collaborate with the EOHR Programme Team to co-design and deliver a nationally consistent EOHR. The Design Group is the key oral health sector stakeholder working group with members from across the public oral health sector, DHB operations and technology.

Approach and progress

• The focus for phase one of the EOHR programme was towork with each DHB and region to understand their current state processes, data and technology which support their oral health services. This has validated a number of opportunities and variations across DHBs to inform the requirements for the future state.
• In conjunction with this work, the EOHR Programme Team worked with the EOHR Design Group to develop a Future Operating Model (FOM). The FOM focuses on developing national frameworks, standards and processes to support DHBs to incrementally align their systems, data and processes.  This will support the development of a comprehensive and reliable view of oral health information and identify opportunities for improvements to health outcomes and service delivery at local, regional and national levels.
• An open Request for Proposal (RFP) was released at the end of November 2016 for providers of oral health clinical software solutions. To ensure a high-quality outcome from the RFP, the programme team worked with the EOHR Design Group to define the future state business, data and technical requirements. Responses to the RFP closed on the 22 December 2016.
• An RFP evaluation panel short-listed proposals from two vendors. A detailed solution refinement process and an independent technical assessment was then completed.
• The RFP process confirmed that while the preferred proposal could meet our requirements, the risks associated with the solution complexity, hosting and outdated technology were too high. The EOHR Programme Board recommended not to award a contract as an outcome to the RFP.
• In light of the outcome of the RFP process, the Ministry agreed to work with DHBs and the current provider, Titanium Solutions Ltd, to make improvements where possible that incrementally move towards a nationally consistent and integrated EOHR.
• In November 2018, the DHB Chief Executives approved the decision to contract Central TAS to progress phase 2 of the EOHR- implementation.
• In May 2019, the DHB Chief Executives approved the implementation plan developed by Central TAS together with DHBs and for the project to proceed to the implementation phase.
• The implementation phase will include 4 main workstreams to:
  • develop a standard service code set for DHB oral health services
  • develop an approach to vendor management, through the development of regional licensing agreements with the current provider, Titanium.
  • Identify a solution to share, access and analyse oral health information at local, regional and national levels
  • Provide “required support from the centre” (eg. Nationally led change management support).