Abstract
This article reviews the impact of successive public sector restructuring, limited central government oversight, and shifting policy on health care information and communications technology (ICT) development in New Zealand. Through the period discussed in the article (late 1980s - present), health purchasers and providers developed information systems in isolation from one another with minimal central coordination or monitoring. The result is a complicated and entrenched ICT architecture, and numerous technical and organisational problems which government has limited capacity to influence. These issues require attention if present policy goals of interoperability, which drives integrated care, are to be achieved. The article discusses current health sector developments aimed at rectifying some of the difficulties. The key lesson from the New Zealand case is that there is a significant role for the state in health care ICT governance and regulation if interoperability is to be achieved.
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