16 August 2023
Renoh Chalakkal
[FYI request #23292 email]
Tēnā koe Renoh,
Official information request HNZ00023961
Thank you for your email on 28 June 2023, asking for the following which has been
considered under the Of icial Information Act 1982 (the Act).
1. How many DHBs/specialists in ophthalmology used a teleophthalmology (telemedicine
specific to ophthalmology) mode of consult during and after the covid-19 pandemic?
2. What were the major telemedicine portals used by the DHBs in New Zealand for virtual
consults in the ophthalmology specialty, and who is responsible for procurement/management
of these portals?
3. Are there any established teleophthalmology pathways followed by the specialists practicing
under Te Whatu Ora hospitals/DHBs/clinics?
4. Do Health NZ/DHBs/Hospitals keep track of the number of virtual consultations done pre-
/post-Covid using telemedicine for ophthalmology referrals? If so, what are the numbers/stats
for these, and who is responsible for managing this data?
5. How many DHBs/hospitals under Health NZ have an established pathway for conducting
remote virtual telemedicine consultations in ophthalmology specialization? Can we have the
names/details of these DHBs/hospitals?
6. How many DHBs/hospitals under Health NZ currently accept tele-referrals from
GPs/optometrists for:
a. Urgent referrals
b.Semi-urgent referrals
b. Routine referrals
Can we have the numbers/names/details of these DHBs/hospitals?
7. Are there any studies conducted by Health NZ researchers/experts to understand the
workflows and practices of staff working and patients enrolled in GP/optometry practices with
already established teleophthalmology pathways?
8. Are there any studies conducted by Health NZ to understand technical, logistical, and human
factors affecting the implementation of telemedicine followed in ophthalmology in the NZ health
setting?
9. Have the telemedicine practice addressed the equity and accessibility issue of specialist
ophthalmology referrals in New Zealand? Any data pertaining to this would be appreciated.
10. Are there any set regulations followed by Health NZ to review/regulate the telemedicine
consultations/practice followed by various clinics/hospitals under Health NZ? Especially for the
ophthalmology specialty.
11. How many GP practices/private optometrist practices are currently eligible to refer patients
to eye specialists practicing in Health NZ hospitals? Can we have the names/details of these
DHBs/hospitals?
12. What are the cybersecurity clearances/certifications/tests needed for a telemedicine
platform to be able to be successfully integrated into a Health NZ referral/treatment portal?
Please see below a response to your request.
4. Do Health NZ/DHBs/Hospitals keep track of the number of virtual consultations done pre-
/post-Covid using telemedicine for ophthalmology referrals? If so, what are the numbers/stats
for these, and who is responsible for managing this data?
While not referrals specifically, we can identify the number of outpatient attendances done virtually
in the Ophthalmology specialty. Outpatient data is reported to National Non-admit ed Patient
Collection (NNPAC), and the mode of delivery code allows us to identify those done by telephone
or video.
Ophthalmology telehealth appointments by financial year
The total number of records from NNPAC with an inter district flow (IDF) unit of measure of
“Event”, and the number that were telehealth (Mode of delivery = telephone or video) were:
2018/19 = 950
2019/20 = 5,750
2020/21 = 6,681
2021/22 = 10,240
This data relates to outpatient events reported to NNPAC with an Ophthalmology specialty
code (S40).
12. What are the cybersecurity clearances/certifications/tests needed for a telemedicine
platform to be able to be successfully integrated into a Health NZ referral/treatment portal?
The implementation of security controls varies depending on the sensitivity of the data. However,
when dealing with personally identifiable information (PI ) or protected health information (PHI), all
systems and services handling such sensitive information must undergo a cyber certification and
accreditation process before receiving approval to operate. The assessment of security risks aligns
with both the Health Information Security Framework (HISF) and the New Zealand Information
Security Manual (NZISM), which are standard government frameworks. Among the controls
typically evaluated are encryption at rest and in transit, multifactor authentication (MFA), general
access management, data sovereignty, and backup, to name a few. It is advisable to implement
controls described in these frameworks based on the sensitivity of the information, as this wil
determine whether they are categorized as "Must have" or "Should have" controls.
In order to provide responses for the remaining questions, Te Whatu Ora would need to divert
personnel from their other core duties and allocate extra time to complete this task. The diversion of
these resources would impact Te Whatu Ora’s ability to carry out our other core functions. As such,
your request is refused under section 18(f) of the Act, as it requires substantial collation.
I have considered whether fixing a charge for the supply of the information or extending the
timeframe for response would enable Te Whatu Ora to respond. I do not consider that either option
would remove the impact that supplying the information would have on our other operations.
How to get in touch
If you have any questions, you can contact us at
[Health New Zealand request email].
If you are not happy with this response, you have the right to make a complaint to the
Ombudsman. Information about how to do this is available at
www.ombudsman.parliament.nz or
by phoning 0800 802 602.
As this information may be of interest to other members of the public, Te Whatu Ora may
proactively release a copy of this response on our website. Al requester data, including your name
and contact details, wil be removed prior to release.
Nāku iti noa, nā
Michael Cleary
Acting OIA Manager
Government Services
TeWhatuOra.govt.nz
Te Whatu Ora, PO Box 793,
Wel ington 6140, New Zealand
