Sample Health Care Essay Paper on Information Management

Executive Summary
The report has identified key health information service management with respect to Waitemata
birth cases that took place in New Zealand for a long time. The purpose of this investigation was
to draw attention to the major causes that happened to such a growing rate of Preterm birth,
which was due to various reasons like smoking, alcoholism, changes in the dietary pattern as
well as household deprivation as well found in women.
On the other hand, it was also analyzed about the themes that were actually outlined in the
Health Information Strategy under the New Zealand government as well. This was considered in
terms of the mentioned themes of recognizing its connection along with decision support tools as
well as consumer involvement and its benefit from being accessed. Hence, through its analysis, it
was further focused on its new strategic framework that had mainly emphasized on the
distribution as well as disposition. At the same time, it had also focused on organizing the data in
a secured process along with its ethical documentation process.
Moreover, the end of the section had provided with advanced health records strategy in
alignment with National Electronic Health Records in New Zealand as well. The newly designed
strategy had concentrated on stabilizing and enhancing HER system. In addition, it had also
selected activities including expected durations on every initiative to be taken further. Hence, it
was suggested to have a successful position in the utilization of integrated data as well.

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Table of Contents

Introduction 4
PART A: Analyze the dataset of preterm births for Waitemata DHB in New Zealand 5
I.Development of presentable graph from the information in the given table 5
II. Critical Analysis of four causes for the given trends 5
Smoking 6
Alcohol 7
Demographic Factors: 7
Dietary Habits 7
Income level 8
III Possible Causes of Decision to improve outcome related to the ratio of Preterm Births in
Waitemata 9
Decisions: 9
Development of Action Plan for reducing the above Preterm births 9
PART B: Develop an information management plan for a health organization in alignment with
the national information health strategy 11
Themes outlined in the Health Information Strategy 11
Development of electronic health records 11
Use of decision support tools 12
Recognition of the need for connectivity 12
Agreement on common standards and minimum data set 13
Increasing coordination of care in general practice 13
Use of telehealth 14
Consumer involvement 14
Managing Access 14

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Smart system 14
A framework for information management plan 15
Planning and creation 15
Authorized quality assessment and access restriction 16
The organization, storage and documentation 17
Distribution and disposition 17
PART C: Developing Electronic Health Records Strategy for Health organization 18
Electronic Health Record strategy for Waitemata District Health Board 18
Critical Analysis of how National EHR strategy health goals for Waitemata District Health
Board 21
Conclusion 22
References 23

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Health information has been considered to be an authentic survey of health care practices as well
as the quality of patients' care. In other words, having an electronic health record can be based on
information collected by Health information Management professionals with respect to a chronic
aspect of a disease. On the other hand, health information management practice has been
accepted as a suitable method of managing key tracks and information about a chronological data
gathered from either primary or secondary method of survey (Filoche et al. 2018). In this respect,
the paper draws attention to the major aspects of the health information management system for
the purpose of identifying the key facts and information about the cause of preterm births for
Waitemata District Health Board, New Zealand.
Moreover, it has thrown the focus on improving the potential outcome in respect of causes of the
given trends and practices in the DHB as well as looking to the National Information Strategy for
the country itself. Further, it has emphasized on analyzing electronic health record strategy that is
necessary for a health organization in achieving health goals in the mentioned District Health
Board as well.

PART A: Analyze the dataset of preterm births for Waitemata DHB in New
I.Development of presentable graph from the information in the given table

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Maoris Preterm

Pacifics Preterm

Indians Preterm

Asians Preterm

Europeans or other
Preterm birth
















Graph 1: Rate of Preterm births in Waitemata DHB

(Created by the learner)

Based on the graphical overview, it has been acknowledged that Preterm birth is a common trend
that is identifiable in the graph itself based on the data collected from the annual report placed
from behalf of Review Committee of Perinatal and Maternal Mortality in the year 2018, as
studied in the above-given table.
II. Critical Analysis of four causes for the given trends
The reasons behind preterm birth ratios among Maoris in New Zealand as well as other habitats
in the nation is due to various associations as well as links that can be a crucial factor here.
According to a medical journal opined by Filoche et al. (2018), the preterm delivery of a child is
not only a burden to a single nation to the global health care association. In other words, it tries
to determine that concentrating on the premature birth of a child can be controlled by managing
some habits that are vulnerable for women in the stage of Gestation or a maternity (Yu et al.
2018). Looking at the trends in the above graph, it has been so far acknowledged that the

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majority of nations are facing these problems during birth from the past few decades staring from
2009 to 2016.
On the other hand, Soneji & Beltrán-Sánchez (2019), commented that smoking causes a major
impact on the nature and pattern of a womb of a mother during the 37 weeks of Gestation period.
In this respect, it has been discussed on various aspects of other commentators that mothers
leading their lifestyle has no major changes before and during pregnancy in many cases, which
has to lead to such a rate of Preterm birth case so far.

Graph 2: Probable Cause of Preterm Birth before 37 weeks’ Gestation

Source: (Soneji & Beltrán-Sánchez 2019)

For evidence, it has been forecast based on a multi-disciplinary collaborative studying pattern
that has identified that most of the cases that took place are due to the high proportion of
expectant mothers having smoking habits prior to 3 months before delivery. In fact, the women
lying between the age group of fifteen or within the thirty years have also suffered similar
situations. Hence, it has been evident based on multiple regression analysis models.

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Apart from the above discussion, it has also been thrown light on another important aspect of the
Preterm Birth causing factor is due to alcoholism trends among women especially found more
interested during the stage as well. Wall et al. (2016), has stated that alcohol intake is a habit that
cannot be overlooked by the medical regulatory body and health experts. Compared to other
ethnicities, Maoris had a higher rate of Preterm birth due to the changing demographic factors as
well as alcohol is a common factor added to this key issue (Oni et al. 2019). Based on this
contradiction, it has been encountered further that mothers living in New Zealand and Australia
face the majority of an economic burden as well that intends to adapt this alcohol intake as well.
Demographic Factors:
Dietary Habits
It has been obtained from a detailed study and analysis that most of the women living with
families tend to grow well during the end of 37 weeks with healthy habits. However, as per
online review NZ Herald (2020), it has been acknowledged that due to premature birth babies are
inclined to have weaker immune systems or in some cases have medical issues in health
concerns. This happens due to housing deprivation in many cases living single mothers as well as
living alone during the stage of 37 weeks of gestation.

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Figure 1: Dietary Components
Source: (Wall et al. 2016)

According to the cohort study, it has been identified that maternal socio-demographic
characteristics as well as lifestyle, antenatal dietary consumption is necessary as per survey (Wall
et al. 2016). In other words, it gave a record that women without a habit of smoking or alcohol
intake also faces this kind of situation due to the absence of such components of diets, as placed
above ( 2020). Hence, analyzing all nutritional guidelines reported by SAS
software has been considered to be evident as the major cause of the trends that are observed
Income level
Income is the significant factor that has affected mainly on the growing trends in the income
factor that has a direct link with the social burden for women especially without any income
support. According to Walani (2018), global data says that low to middle-income families has
inefficiencies in terms of controlling medical facilities for vulnerable risks that appear in the

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form of neonatal death. This kind of cause cannot be avoided, even with a monetary contribution,
as contradicted by many. Hence, it cannot be denied that considering the above factors and
causes, drawing attention to income level would be ineffective but not be avoided from this
perception. In fact, the identified causes are not limited to one in the case of Preterm Birth trends.
III Possible Causes of Decision to improve outcome related to the ratio of Preterm Births in
The identified causes above and trends have compelled to take some serious decision for
developing this state of despair in the health care services found in Waitemata, New Zealand.
 Need to change lifestyles of women through regulatory implications: Adopting a
healthy lifestyle can be appropriate in changing dietary habits under ethical approval of
WDHB in collaboration with Health Ministry in New Zealand (,
 Strategies need to be modified in association with the Ministry of Health: It can be
effective in changing approaches from behalf of the medical practitioners towards
mothers especially the gynecologists. This needs to embed with the incorporation of
norms mandatory for a child's safer birth (Donovan et al. 2019). In fact, strategies need to
be legally implemented so that for affecting a new life would be a punishable offense for
mothers by living unhealthy life during pregnancies.
 Policy enhancement decision in respect of quitting the habit of smoke or alcohol
intake: Even this decision can be effective if it is manipulated in the society mainly at
Waitemata DHB for controlling the lives of children in a better way.
Development of Action Plan for reducing the above Preterm births
Current Status Core ENAP Indicators Intervention Actions Implementation

Income Status  Maternal mortality

 Care Attendants at
 Still Birth rates

Counseling and
This can be effective in
terms of all pregnant
women facing all kinds

This can be conducted
by hiring experts for
medical counseling

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of troubles and trauma
during the time of

Unhealthy Dietary

 Breathing problem
 Anemic in
 Loss of Blood

Offering time-bound
prenatal continuous
services by medical
experts. It would be
effective in terms of
motivation among
those women having
involvement in wrong

Experienced Medical
Practitioners are
required other than the
existing one at

Smoking and
alcohol habits

 Raising neonatal
infections in child
 Low birth weights
 Antenatal nutrition

The women had a
higher risk of Preterm
delivery need to be
supported with
evidence-based visiting
programs at home to
awaking them in terms
of key facts.

Required association
of professional
organizations in this
initiative to proceed
with the mentioned


 Issue in
 Cesarean output
with complications

Engaging multiple
communities together
forming awareness
about antenatal and w
ell prenatal stage of

The necessity of
regular auditing and
visiting process at the
household premises
under personal
caregivers to check the
status of dietary habits

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pregnancy as well. and mental status

Table 1: Action Plan for reducing Preterm Birth ratios

(Created By Learner)

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PART B: Develop an information management plan for a health organization
in alignment with the national information health strategy
Themes outlined in the Health Information Strategy
Information systems helped in better output with the rising demands and played a significant role
in helping decision making in planning and funding of care in hospitals.

Figure 2: National health strategy of New Zealand and it's interlinking
Source: (Government Digital Health – Health Informatics New Zealand. 2020)
Development of electronic health records
From an online review, New Zealand Data and Information Management Principles –
data.govt.NZ (2020), it was thought to convey information along with coordinate services;

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nevertheless, it was quite impractical and therefore multiple pockets of single EHR have been
thought to be implemented for safer and easier management.

Figure 3: New Zealand's distributed, EHR model
Source: (Ministry of Health NZ. 2020)

Use of decision support tools
The precise usage of decision support tools like computerized physician order entry and nurse
order entry along with other e-prescribing methods have been seen due to the increased demand
in supporting clinical decision making. Support at service level and patient-level included
planning of services, reviews of peers, medication error trends and plans for care, individual
actions of the clinics, service orders respectively (Ministry of Health NZ. 2020).
Recognition of the need for connectivity
With an increase in connectivity, greater security to access the patients' data, access to
scheduling processes, linking pharmacy procedures, and handling messages exchanged between
the care settings have been initiated. Vendors have been thus offering innovative measures
regarding high communicative bandwidth like image sharing (Ministry of Health NZ. 2020).
Agreement on common standards and minimum data sets

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Minimum data sets from hospitals contain some information but lack common standards due to
no proper agreements at the country level. Models surrounding community care or compliance
models, security, and privacy models all to some extent lack a general standard thus there has
been a vivid requirement of a consistent and standardized reporting system (Ministry of Health
NZ. 2020).

Figure 4: The linkage between health and information strategies

Source: (Ministry of Health NZ. 2020)

Increasing coordination of care in general practice
Clinical functionality enables reviewing of test results, making appointments, analysis of
population-based trends, order prescriptions, and so on. Through the use of technology,
individual care such as self-monitoring of blood pressure and blood glucose level, online groups
for supporting patients and clinical chat rooms have been devised (Ministry of Health NZ. 2020).

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Use of telehealth
In order to provide care to remote and disadvantaged areas, the internet and technology have
been vastly used for treating patients in a home-based atmosphere. The goal was to provide
primary care and increase opportunities through specialist services to clients even when they
reside in inaccessible and remote regions (Ministry of Health NZ. 2020).
Consumer involvement
Educating and informing the clients along with monitoring and managing care regimes and self-
management systems, service providers need to be trained well through better tools for customer
involvement as they like to be more informed regarding their own issues. Service providers by
integrating information could enhance customer participation in sharing and exchanging
knowledge (Ministry of Health NZ. 2020).
Managing Access
Access to quality knowledge by providing targeted information regarding the care providers
through supporting systems enabled the clients to be directed towards appropriate centers and not
get diverted along with the increasing demands of the health care systems (Government Digital
Health – Health Informatics New Zealand. 2020).
Smart system
Developing an improvement culture that also includes the research system through innovation
with the use of technologies like robotics, genomics, nanotechnology, New Zealand has been
utilizing smart systems for consistent and reliable services (New Zealand Health Strategy
launched. 2020).
A framework for an information management plan

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Figure 5: Waitemata DHB logo
Sources: (Waitemata DHB 2020)

Planning and creation
Devising a perfect plan by the Waitemata DHB in accordance with the National Health
Information Strategy would be effective in terms of finding health care records. In this respect, it
has been vigilant from the current health care situation that by creating a framework, health
information can be better formatted and distributed with sensitive information (Information
management plan – Praxis framework. 2020). It requires high responsibility and assurance that
the plan would involve correct storage, accessibility, and destruction or be archived safely.

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Figure 6: Waitemata DHB core design principles
Sources: (Waitemata DHB. 2020)
Authorized quality assessment and access restriction
The quality assessment has been recognized as a significant part of integration and transparent
treatment. However, its access may vary with particular concerns in different situations that need
different levels of security. Adhering to the policies at the national level like Privacy Act, 1993,
and Health Information Privacy Code, 1994, it restricts the permitted level of accessing the data
without authorization that Waitemata DHB needs to implement more carefully (Government
Digital Health – Health Informatics New Zealand. 2020).

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Figure 7: Information management plan

Source: (Information management plan – Praxis framework. 2020).

The organization, storage, and documentation
Most of the DHB including Waitemata release discharge summary without any consistent record
that could be used by the care providers subsequently. From an online review New Zealand Data
and Information Management Principles – data.govt.NZ (2020), it can be conventional that
organizing, storing, and documentation with a greater consistency enables care providers with
appropriate access and receive the discharge summaries. In other words, despite the region of
discharge and involving emergency departments, mental health, community events for
exchanging information on a national level, it would make this procedure more secure and
Distribution and disposition
The information received during treatments should be authentic for genuine purposes of services
and this requires identification of key stakeholders like the Ministry of Health, ACC, and PHOs.
Others include HISO, NGOs, and other DHBs (Regional Information Strategy Waitemata

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District Health Board. 2020). During data distribution, security clearances required permits and
procedures issued by the national health strategy could not be ignored. As influenced by Sligo et
al. (2017) abiding by the policies would enhance transparency and thus distribution easier. On
the other hand, disposition requires either data destruction after a substantial period of time or
archiving it as per requirement. The Waitemata DHB lacks vivid disposition measurements and
thus needs to develop this in alignment with the National Health Information Strategy.

PART C: Developing Electronic Health Records Strategy for Health
Electronic Health Record strategy for Waitemata District Health Board
Electronic Health Record is an advanced way of keeping and maintaining a patient's medical
records with the aid of electronics. As there is a wide range of variety and complicacy associated
with EHR systems, the approach has become intimidating for healthcare organizations (Abburu
& Muralikrishna, 2017). The case has not been any different for the medical organizations of
Waitemata district, New Zealand. Several trials have been carried out to review the potential of
EHR systems and policies related to its implementation in New Zealand (Honey & Westbrooke,
2016, July). Considering the fact that the utilization of the EHR system has not been reached its
optimum level, the same can enable large healthcare organizations to obtain a better outcome
that eventually reflects on the organization’s operating model.
Hence, a strategic plan for a successful EHR implementation has been provided below:


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Assess the
organization's readiness

The first step of EHR system
management involves assessment of
the current scenario of the
organization regarding its aims, also
technical and financial readiness
(EHR Implementation Plan: Your 8-
step Checklist. 2020). The design of
the next implementation approaches
should be based on that

4 to 6 weeks

Strategic planning and

This segment is very crucial in the
context of the EHR initiative taken
by any healthcare organization. This
includes the planning of capital,
selection of vendors to the adoption
of those plans. All essential factors
like budget, decision making,
governance structure, work plans,
management, and lastly
implementation would decide for the
EHR system's success.

6 to 8 months

Evaluate and select This step includes a demonstration of
the EHR processes followed by its
evaluation. Evaluation is conducted
based on the potential of record
systems. Then finally a suitable
selection is done considering the
efficacy of a system only after
intensive research.

2 to 3 months

Implement the system Designing- An accurate

implementation of an EHR system is
likely to transfer a healthcare
organization entirely and a pre-
designed approach would ensure
improvement in data quality, patient

12 to 18 months

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care, and experience because of the
smooth workflow (Fragidis &
Chatzoglou, 2018).
Building and Testing- Next step
would include the building of the
newly chosen system and its testing.
Technical as well as tactical
activities are likely to be conducted
in this step relating to the clinical
design of the plan

Go live Training and Activation- This step
includes training for new technology
users. This is important to
understand the responses from the
system in real-life cases. Before
activation, such activities ensure long
term sustainability of the system.

10 to 12 weeks

Stabilize and enhance This step should be considered as the
most sensitive one as after a
successful go-live an EHR system
needs to be upgraded and maintained
in order to retain and also enhance its
performance. To manage the on-
going system, issues need to be fixed
and the system needs to be optimized
fully and all these are left on the
organization only.


Table 2: EHR Strategy
(Created By learner)

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Figure 8: State of EHRs in New Zealand
Source: (Oderkirk, 2017)
According to the above diagrammatic view, it can be acknowledged that the nation has faced
several challenges in the healthcare field like cost escalation, emerging demands from the aging
population. Oderkirk, (2017) opined that although it has influenced the National EHR strategy to
focus on the successful implementation of a single EHR system; yet it has not proved to be
considerable. In this respect, Waitemata DHB could opt for an effective EHR management plan,
as prepared in this report. This could be a meaningful approach to convert healthcare data into
supportive information.
Critical Analysis of how National EHR strategy health goals for Waitemata District Health
The Waitemata DHB promises the Waitemata community to deliver the best possible care for
each client who relies on their healthcare services, both directly and via any organization with
the aid of PACs (Waitemata DHB. 2020). They have prioritized patient's wellness promotion
through preventing, curing, and ameliorating health issues to minimize suffering. In order to
ensure seamless care from their side, the adaptation of NEHR strategies would be conventional
in approach. Achieving the position of the nation's leader in the field of medical aid, a successful

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EHR approach could be the best option for the DHBs. This would redefine and transform their
purposes, priorities, and values (Whiddett et al. 2016). Moreover, the health boards would be
able to utilize integrated data that would facilitate clinical practices to a great extent.

From the overall scenario, it can be acknowledged that New Zealand has always shown concern
for people's health and focused on improving their ideas to facilitate the development of the
healthcare system. The national platform has been found to encourage the incorporation of
modern technology to test its viability at different times. It is also recognized that the preterm
birth of infants has been a significant health burden for New Zealand. Healthcare-related
inequities within communities have driven preterm deliveries in Waitemata. Regional health
boards have taken up their own processes to improve the health of pregnant women and preterm
infants alongside minimization of preterm birth rate. In addition, health information strategies
have been suggested for wider management implementation of EHR in controlling challenges
among the Waitemata districts as well.

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Abburu, S., & Muralikrishna, I. V. (2017). GIS-based Interoperable Public Health Information
Infrastructure Through EHR And OGC Standards. ASCI Journal of Management, 46.
Donovan, G. H., Michael, Y. L., Gatziolis, D., Mannetje, A. T., & Douwes, J. (2019).
Association between exposure to the natural environment, rurality, and attention-deficit
hyperactivity disorder in children in New Zealand: a linkage study. The Lancet Planetary
Health, 3(5), e226-e234.
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Filoche, S., Cram, F., Beard, A., Sim, D., Geller, S., Edmonds, L., & Lawton, B. (2018). He
Tamariki Kokoti Tau-Tackling Preterm: a data-linkage methodology to explore the
clinical care pathway in preterm deliveries. BMC health services research, 18(1), 374.
Fragidis, L. L., & Chatzoglou, P. D. (2018). Implementation of a nationwide electronic health
record (EHR). International journal of health care quality assurance.
Government Digital Health – Health Informatics New Zealand. (2020). Retrieved 27 July 2020,
from (2020). Retrieved 25 July 2020, from
Honey, M. L., & Westbrooke, L. (2016, July). Evolving National Strategy Driving Nursing
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Oderkirk, J. (2017). The readiness of electronic health record systems to contribute to national
health information and research.
Oni, H. T., Khan, M. N., Abdel‐Latif, M., Buultjens, M., & Islam, M. M. (2019). Short‐term
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