Aotearoa BadgerNet Perinatal Spine

The Aotearoa Perinatal Spine is a secure information-sharing system that will enable a single point-of-care clinical record for each pregnancy in Aotearoa New Zealand, even where multiple health professionals using different IT platforms are involved in providing maternity care.

There is no human user access directly into the Perinatal Spine.  The Perinatal Spine is an interoperability module to the national BadgerNet Platform which provides a nationally hosted women and children’s health care record solution for the Aotearoa New Zealand perinatal care community. 

Currently, health data relating to a pregnancy can be stored across several different health professionals and systems. This can lead to unnecessary duplication or cause delays in care while the relevant health data is brought together, which can put māmā and pēpē at risk.

The Perinatal Spine will ensure that health professionals have access to the most up-to-date and complete clinical information about a pregnancy. This will:

• improve continuity of care

• lift the standard of care and help health professionals identify when early intervention may be required
• enable better communication with māmā and whānau and make it easier to engage in effective shared care planning

• reduce time spent on administration.

There is also currently some inconsistency between maternity health professionals in what health data is recorded and the way in which it is recorded. This makes it difficult to analyse and report on performance, identify gaps in service delivery and determine which areas to target for improvement.

The Perinatal Spine will ensure clinical maternity records are consistent and meet the requirements of HISO 10050.2022 (also known as HISO2), the updated Maternity Care Summary Standard introduced in April 2022. This will enable high-quality point of care information, reporting and data analysis, improve performance monitoring, help identify equity issues and inform enhancements in service design.

By supporting maternity health professionals to deliver a consistent level of care, making it easier to identify equity gaps, and enabling better communication and shared care planning, the Perinatal Spine will help improve equity for Māori, Pacific peoples and high needs groups.

The IT vendor engaged to deliver the Perinatal Spine also provides the BadgerNet Maternity, Neonatal and Hearing Screening systems currently in use in Aotearoa.

The initial Perinatal Spine access group will be maternity health professionals that use either BadgerNet, Expect Maternity or Maternity Plus as their Maternity Clinical Information System (MCIS). These MCIS maternity providers meet the access criteria defined by Te Whatu Ora (Certification Requirements) as they:

• are direct source third party maternity providers that will securely interact with the Perinatal Spine by submitting and exchanging data that forms the live maternity record
• have aligned their MCIS with the HISO2 Maternity Care Summary Standard and will be able to provide and receive all relevant data fields to the live maternity record
• will meet the criteria outlined in the Privacy Impact Assessment, and Terms of Use specifically for Perinatal Spine purposes.

The initial integration with the Perinatal Spine for the group of health professionals using these systems will take place during 2023 and 2024. This will be a phased approach that will see data elements progressively added to the Perinatal Spine.

Initially the Perinatal Spine will be used to support booking communications between community midwives and birth facilities and will progress to the full HISO2 data elements over time. This will enable those health professionals to access and update a single HISO2-compliant clinical record for each pregnancy and securely share live clinical information, regardless which Certified local MCIS is used.

The Perinatal Spine will then be made available (mid-2024) to integrate with the remaining direct source MCIS Vendor IT systems within Aotearoa New Zealand that meet the Health New Zealand | Te Whatu Ora Certification requirements.  

We acknowledge there will be other data sources that would like to connect to the Perinatal Spine that are not direct source third party maternity providers.  In these cases, we will need to understand the rationale for that Perinatal Spine connection, and how the compliance needs of the Sector would be met. If any scenarios were approved, requirements would be defined during the onboarding process and incorporated into the roadmap planning, noting the priority for direct source Certified MCIS.

It is anticipated that all direct source maternity providers will be able to be connected to the Perinatal Spine by around mid-2025. From that time, every pregnancy in Aotearoa New Zealand will be able to have a comprehensive single point-of-care clinical record regardless of IT platform used.

Personal information is held and managed in accordance with the Privacy Act and Health Information Privacy Code. Health NZ is responsible for providing stewardship over this data and ensuring that robust data security and privacy controls are in place.

All data within the Perinatal Spine will be stored on an encrypted database and server within the Microsoft Azure platform hosted in Sydney, Australia. Health NZ recognises the importance of Māori Data Sovereignty principles and will review the storage location in future when equivalent Microsoft Azure services become readily available in New Zealand.

All access to the Perinatal Spine by health care providers is tracked and can be audited. The audit log can be reviewed if there is any suspicion that someone has accessed health information inappropriately.

Your health care provider will hold records about you as required by the Health Retention of Health Information) Regulations 1996. Maternal health care records must be retained for a minimum of 20 years, and paediatric information for a minimum of 20 years or until the child is 25 years old (whichever is the greater). This reflects the minimum retention requirements of the Health Retention of Health Information) Regulations 1996 and the potential ongoing importance of pregnancy records to a māmā and their children.

There will be limited information sent to government agencies (as is currently the case). This will include, for example, information to register births, record immunisations, and to prepare statistical reports.

The information will also be used to help plan health resources, review services used, and contribute to national collections. Any reports produced will not contain information that would identify you personally (reports will be used only on a non-identifiable statistical basis). Any research will be subject to standard ethical requirements.

All access to anonymised health data will be in accordance with the governing legislation and policies that can be found on the Manatū Hauora website. Any requests from researchers requiring identifiable data will also need approval from the relevant Ethics Committee.

Read the Privacy Statement for the National Maternity Record system

The adoption of the new Maternity Care Summary Standard with the Perinatal Spine integration will improve maternity services within Aotearoa New Zealand.

Manatū Hauora and Health NZ worked with health professionals, responsible authorities, interested groups, IT vendors and others to identify the information to be covered by the Standard to ensure it meets the needs of pregnant wāhine, pēpē, whānau, midwives, other health professionals, maternity providers and health agencies.

We also carried out a public consultation on the Standard, which included inviting organisations representing Māori, Pacific and disabled people to share their perspectives. Over 700 submissions were received during the consultation process, of which about 180 resulted in changes.

Similarly, during the development phase for the Perinatal Spine, we are engaging with a number of stakeholders including IT vendors, the Office of the Privacy Commissioner and the Government Chief Privacy Officer. This will help ensure the Perinatal Spine is implemented in a way that protects data security and privacy.

The Perinatal Spine is a secure information-sharing system that will enable a single point-of-care clinical record for each pregnancy in Aotearoa New Zealand, even where multiple health professionals using different IT platforms are involved in providing pregnancy care. The Perinatal Spine will also ensure that clinical maternity records are consistent and meet the requirements of the updated Maternity Care Summary Standard HISO 10050.2022.

The initial access group are maternity health professionals that use either BadgerNet, Expect Maternity or Maternity Plus as their Maternity Clinical Information System. The initial integration with the Perinatal Spine for the health professionals using these systems will take place during 2023 and 2024.  This will be a phased approach that will see data elements progressively added to the Perinatal Spine. 

There are currently four phases which will introduce specific information from the HISO 10050.2022.  All of the preparatory work for Phase One has now been completed and the Perinatal Spine is now live. 

Phase One will enable participating maternity health professional to:

• electronically send a subset of booking information to a nominated birth facility in preparation for a pending birth,
• ensure up to date information is supplied by community midwives and birth facilities if the women’s/person details should change,
• update the birth facility with the current Lead Maternity Carer details for a woman/person if this information changes.  

The subsequent Phases will enable information exchange between participating parties, and progressively align this information to HISO 1005.2022.  We anticipate that all point of care maternity providers will be able to be connected to the Perinatal Spine by mid-2025. From that time, every pregnancy in Aotearoa New Zealand will be able to have access to have a common, comprehensive shared set of HISO aligned clinical records regardless of maternity provider.

For further information about the Perinatal Spine or the Maternity Care Summary Standard, maternity providers and IT vendors are encouraged to contact:

Teresa Omundsen, Health NZ Data & Digital Programme Manager teresa.omundsen@health.govt.nz