Published on the 09/04/2026 | Written by Heather Wright
Unfulfilled transformation promises erode digital health trust…
New Zealand’s health workforce says technology progress is real, but fragile, with trust in digital transformation eroding after years of pilots, restructures and short-term initiatives that have failed to scale.
Kōrero Mai: Voice of the Digital Health Community in Aotearoa New Zealand, a report from HiNZ (Health Informatics New Zealand) based on conversations with more than 200 clinicians, administrators, technologists, industry experts, students, advocates and policy stakeholders, shows respondents acknowledge genuine gains in areas such as electronic referrals, e-prescribing, telehealth and AI, with progress happening ‘but in pockets’. But those gains, respondents warn, are being undermined by fragmentation and cyclical resets that erode confidence among the workforce.
“This is not because the workforce is resistant to change, but because they are tired of change that promises transformation and fails to deliver it.”
The report follows a 2024 Voice of the Workforce special report from HiNZ, which flagged widespread sector concern about the erosion of digital capability across the sector and comes as documents released under the Official Information Act show Health NZ knew last year that cutting data and digital roles would increase risks to patient care and hospital resilience, even as the restructure – which proposed cutting $100 million from the digital services budget and slashing data and digital team from 2000 to 1460 (many of the roles were already vacant) – proceeded.
The poor state of New Zealand’s health IT has been a focus for years, with Health New Zealand grappling with an outdated infrastructure, including an estimated 6,000 applications and 100 digital networks, inherited when district health boards were disbanded, replaced with a centralised system.
Change that fails to deliver
A central finding in the report is that trust in digital transformation itself is weakening. “This is not because the workforce is resistant to change, but because they are tired of change that promises transformation and fails to deliver it.”
Participants pointed to a familiar pattern: Pilots that never move into production or scale, contracts that end before benefits are realised and initiatives framed as discrete projects rather than long-term system capability. Digital change is being repeatedly ‘reset’ with momentum lost each time organisational structures or priorities shift, the report says.
For tech leaders, it highlights a credibility issue. When systems do not endure, confidence drops, making subsequent change more difficult to implement and increasing resistance at the frontline. Each reset, respondents said, reduces confidence that future initiatives will deliver lasting value, and they warned that when systems don’t endure, clinicians and digital teams become less willing to invest time and effort in new tools.
Skills not the constraint
Contrary to long-standing assumptions, Kōrero Mai finds the health workforce does not lack technical ability. Instead, professionals report having the skills needed to engage with modern systems, but lack confidence that those systems will functional reliably and be supported over time.
“The professionals already have the skills required to engage with technology. What is lacking is the confidence that systems will work, that investment will continue and that support will be available.”
Participants in the korero mai (open conversation) reported that training is frequently undermined by system churn, with platforms retired, restructured or under-resourced before benefits can be realised. As a result, digital confidence is being eroded not by lack of competence, but by lack of continuity.
“Participants stressed that digital transformation is not a cost-saving exercise in the short term, but requires sustained investment in people: This involves training, change management and roles dedicated to making systems work in practice,” the report says. It notes reductions in digital service roles have left fewer people available to train, support and optimise systems.
Resilience warnings
Concerns about confidence and continuity are reflected in internal Health NZ documents which the PSA gained under OIA. End user Impact of Digital Change – Consequences was written around March 2025 as Health NZ refined its proposals to slash the IT workforce and flags increased risks to patient care and hospital resilience.
It found risks ‘will almost certainly elevate as technical debt becomes unsustainable and the modernisation/transformation required to meet the future needs of the sector is delayed’.
The report also noted existing weaknesses in system resilience, including limited business continuity planning and ‘minimal’ hot-failover mechanisms, leaving core systems vulnerable.
Those vulnerabilities were highlighted in a series of high-profile IT outages earlier this year. In January a major outage impacted hospitals in the lower North Island with clinicians unable to access patient information, just days after a widespread outage affected the Southern district. Auckland and Northland hospitals were also knocked offline in January, with staff resorting to paper-based systems and whiteboards during the 12-hour outage. They were also affected by an outage in February.
Kōrero Mai also notes the ongoing issue of lack of interoperability across systems, with clinicians navigating ‘dozens’ of systems, multiple log-ins and manual workarounds to deliver routine work. Patients are required to repeat stories and critical information is ‘frequently’ lost between settings.
It calls for acceleration of interoperability and shared records as a national priority, saying incremental progress is no longer sufficient. “Clear milestones, accountability mechanisms and clinical leadership are required to ensure interoperability delivers real value to frontline care.”
A ‘fundamental shift’ away from experimentation towards sustained, system-level capability is also required. “Digital health can no longer be framed as a series of projects, pilots or technology deployments…
“Interoperability, for example, is not simply a technical problem but a systems trust issue. A ‘single source of truth’ is about more than shared records, it represents shared understanding across organisations, professions and communities.’
Showing what alignment can deliver
Among the success stories, and an example of what is possible when technology aligns with real clinical needs, is the ‘rapid normalisation’ of AI in clinical and administrative settings, the report says. AI scribes, transcription tools and assistants have moved from pilots to business as usual in many environments. Participants reported tangible productivity gains and reduced administrative burden from the tools. For some it is enabling better eye contact with patients, more thoughtful consultations and reduced cognitive load at the end of long shifts.
Interestingly, workforce attitudes towards AI have also shifted, with fear of replacement increasingly replaced by recognition that AI is a tool which if governed well, can strengthen, rather than dimmish, roles.
That issue of governance, however, comes with a warning, with the report cautioning AI’s future success ‘depends on governance that centres people, culturally responsive design, transparency, accountability and strong human oversight’.
Incremental system unification has also seen genuine progress and received a thumbs up from participants, particularly in regions where consistent platforms are used across departments. The national rollout of electronic referrals and wider adoption of electronic prescribing were also cited as practical wins. “These initiatives demonstrated that when proven solutions are scaled thoughtfully, they can deliver immediate benefits to both clinicians and patients.”
There’s also been a ‘meaningful’ shift in how rural needs are recognised, the report says, with technologies such as satellite connectivity enabling mobile and remote care models that were previously impossible and telehealth now widely accepted as a legitimate and valuable mode of care delivery.
The report concludes that the key challenge for 2026 is not the volume of technology being deployed, but the credibility of digital transformation itself. “The opportunity for 2026 is not simply to implement more technology, but to rebuild trust in digital transformation itself.”
