Dear Health New Zealand,

I am making a request under the Official Information Act 1982 regarding IT infrastructure investment and operational efficiency within Health Alliance NZ and Te Whatu Ora, covering Auckland, Northland, Middlemore, and Waitematā.

I am particularly interested in how investment in IT infrastructure and IT staffing levels affects operational costs, workforce efficiency, and patient outcomes. The key themes I would like information on include:

A. Whether more or fewer IT staff reduce long-term operational costs for Te Whatu Ora, considering the wider implications of underinvestment in IT support.
B.The extent to which IT spending leads to cost savings through reduced downtime, improved efficiency for frontline healthcare staff, and fewer missed patient appointments.
C. How IT infrastructure affects human capital—specifically doctor, nurse, and administrative workload, as well as the impact on staff retention and burnout.

If existing reports contain relevant insights, I am happy to receive copies of those instead of raw data. I also welcome any internal business cases or cost-benefit analyses that evaluate

1. IT Investment vs. Long-Term Cost Savings for Te Whatu Ora
1.1 Total IT Spending and Financial Impact
1.1.1 Annual IT Expenditure and Cost Breakdown
I request the total annual IT expenditure over the past three financial years (2021–2024), including a breakdown into:
1.1.1.1 Hardware (servers, processors, networking equipment).
1.1.1.2 Software (electronic health records, decision support systems).
1.1.1.3 IT staffing (technical support, system administrators, cybersecurity specialists).
1.1.1.4 Maintenance, upgrades, and cloud computing.
1.1.2 IT Investment and Cost Reduction Modelling
I request any internal reports or modelling conducted by Te Whatu Ora that examine whether:
1.1.2.1 Higher IT investment has resulted in lower administrative costs for hospitals and clinics.
1.1.2.2 IT-driven automation and digital transformation have reduced manual administrative workloads.
1.1.2.3 Te Whatu Ora has used cost-benefit analysis to determine whether spending more on IT leads to greater operational savings across multiple departments.

2. IT Staffing Levels and Operational Cost Efficiency
2.1 Impact of IT Staffing on Overall Healthcare Costs
2.1.1 IT Staffing Levels and Cost Efficiency
I request information on:
2.1.1.1 The current IT workforce size at Health Alliance NZ.
2.1.1.2 Any evaluations or business cases assessing whether increasing or decreasing IT staffing levels affects operational costs (e.g., whether a larger IT workforce improves efficiency and reduces long-term spending on IT-related disruptions).
2.1.2 Financial Implications of IT Underinvestment
If available, I request any internal assessments of how IT underinvestment (staffing, system performance, or infrastructure upgrades) has:
2.1.2.1 Increased system downtime and lost productivity for clinical and administrative staff.
2.1.2.2 Led to higher costs from reactive IT issue management instead of proactive system improvements.
2.1.2.3 Affected patient care efficiency and clinical workflow, particularly in hospitals with high patient throughput.

3. IT Performance and its Effect on Workforce Productivity
3.1 System Load Times and Staff Productivity
3.1.1 Average Log-in and System Load Times
I request data on average log-in times and system load speeds for clinical applications (electronic health records, prescribing platforms, patient management systems) used by:
3.1.1.1 Doctors in hospital and primary care settings.
3.1.1.2 Nurses in inpatient and outpatient settings.
3.1.1.3 Administrative staff handling patient records and bookings.
If any internal evaluations have measured the effect of slow IT performance on workforce productivity, I would appreciate access to those findings.
3.1.2 IT Downtime and Impact on Patient Services
I request data on IT system downtime per year (total hours of outages) and any:
3.1.2.1 Internal evaluations on the financial or operational impact of downtime (e.g., delays in patient care, increased administrative backlog).
3.1.2.2 Reports showing whether IT infrastructure upgrades have improved system uptime and overall hospital workflow.

4. IT-Driven Patient Engagement and Missed Appointments
4.1 Automated Appointment Reminders and Financial Impact
4.1.1 Effectiveness of IT-Enabled Reminders
I request:
4.1.1.1 The annual cost of automated patient reminders (SMS, email, phone calls).
4.1.1.2 Any internal reports or evaluations on whether IT-driven reminders reduce patient no-shows and improve scheduling efficiency.
If a cost-benefit analysis exists comparing the financial loss from missed appointments vs. the cost of IT-enabled reminder systems, I would appreciate access to it.

5. Future IT Strategy and Workforce Planning
5.1 Strategic IT Investments and Cost Optimisation
5.1.1 Future IT Roadmap and Workforce Impact
I request any strategic IT planning documents or business cases covering the next five years (2024–2029) that outline:
5.1.1.1 Major planned IT investments for hospitals and general practice settings.
5.1.1.2 Whether these investments are projected to reduce hospital workload, improve doctor/nurse efficiency, and lower administrative costs.
5.1.1.3 Any financial modelling comparing different levels of IT investment and their impact on Te Whatu Ora’s long-term budget.

6. Request for Existing Reports and Analysis
6.1 If any of the requested information has already been compiled into internal reports, cost-benefit analyses, or strategic documents, I would appreciate receiving copies or links to those documents.

7. Scope Management and Prioritisation
7.1 If this request is too broad, I am happy for Health Alliance NZ and Te Whatu Ora to prioritise responding to the most critical sections first, particularly those covering:
7.1.1 (1.1.1; 3.1.2.2; 3.1.2.1; 3.1.2; 2.1.2.2; 2.1.2.1; 2.1.2; 2.1.1.2; 2.1.1; 2.1.2.3; 1.1.1.3; 1.1.2.2; 1.1.2.1; 1.1.2; 1.1.2.3; 4.1.1.2; 4.1.1.1; 4.1.1; 1.1.1.1; 1.1.1.2; 2.1.1.1; 3.1.1.2; 3.1.1.1; 3.1.1; 1.1.1.4; 3.1.1.3; 5.1.1.3; 5.1.1; 5.1.1.1; 5.1.1.2; 6)
7.2 Please prioritise completing as much of this request as possible in order as per 7.1.1. If some aspects cannot be fulfilled within this request, kindly provide an explanation. I may submit a independent request for the remaining information as needed.

Yours faithfully,

Richard Shelton