Tāmaki Innovation Campus


Dr Karen Day Dr Karen Day

“My dream began when I was a disability rights activist in South Africa in the 1980s and 90s, when we began to change the world.“   Dr Karen Day


If interoperability is the holy grail of IT in healthcare, then a developer challenge could well be the key to finding it.

Riding on the success of a health IT hackathon held on Tamaki Campus two years ago, Dr Day, senior lecturer in the School of Population Health, and colleagues are finishing a four-month developer challenge, looking at the challenges of interoperability. 

The developer challenge builds on the concept of a one-day hackathon by having participants build solutions to an information challenge over a number of months, during which they get support from experts and access to information and resources. 

Underpinning this is the premise that changes to organising and managing healthcare delivery will positively impact the outcomes achieved, increase safety, or improve the patient experience. One such opportunity is management of adverse events: where efficient reporting is hampered by the lack of standard data formats, because each medical record system has its own proprietary approach to data storage. Some data can be shared but most cannot. Consequently, it’s difficult to report adverse events with data from several applications that are not interoperable.

The developer challenge focusses on FHIR (Fast Healthcare Interoperability Resources); a new standard for electronic healthcare information exchange supported by the Ministry of Health.  FHIR, created by HL7, an international standard setting organisation specialising in data interoperability, is designed to address this type of challenge and support the digitalisation of healthcare.  FHIR, a new specification based on emerging industry approaches, can be used as a stand-alone data exchange standard, and in partnership with existing standards.

Dr Karen Day describes herself as a health informatician with a dream. That dream is giving a health informatics voice to people living with long term health issues. “To achieve this dream, we need to build a health informatics competent workforce, turn the doctors' and nurses' computers to face their patients, and leverage technologies to deliver care where it counts – in our patients’ space, where amazing healthy things can happen,” she says.

The latest amazing healthy thing is the developer challenge. Since its launch at HINZ late last year, 40 + participants registered, formed groups and began work late 2017. Even its own advertising runs against the norm: Want to take part on a fun challenge to create cool apps that directly impact patient care? Interested to learn how to use the new HL7® Fast Healthcare Interoperability Resources (FHIR®) standard that is taking the world of healthcare information exchange by storm?

This challenge was running from December 2017 to March 2018 and will end in a full day, hands-on event with submitted solutions judged by health sector leaders. Prizes will be awarded for the top three submissions.

The developer challenge, titled “Developers on FHIR” was being run by HL7 New Zealand, the local affiliate of HL7 international in collaboration with the University of Auckland and supported by Microsoft.

The objectives of the challenge are to expose a wide a range of programmers, developers, clinicians and system architects to the development of FHIR solutions, to actively engage students and academic departments so they gain experience of real-world development processes and interact with the vendor and healthcare communities, to give direct access to FHIR experts, and to demonstrate how FHIR based applications can add value.

Dr Day says the beauty of the developer challenge is the variety of skills and mindsets it attracts. This diversity is its strength, bringing people together who offer their unique skills and experience in a generous environment hothousing a developers’ challenge.

This developer challenge aims to improve data sharing through interoperability.  She points, though, to the downside of great IT being developed by people with little experience in healthcare; an area she describes as conservative and highly specialised.

“Healthcare is by its very nature, conservative, but with the speed of innovation and the time from development to implementation getting shorter, we are in serious danger of getting left behind.”

“Our issues are that we traditionally like to test, evaluate, verify, plan and fund, whereas the way we need to move – and the way hackathons help- is to overthrow that model, build some software and throw it out with the instructions “try and break it”.

“It stimulates a rapid development and testing regime that allows us to determine no or go, right at the outset.”

The day long hackathon on March 17 will culminate with a judging process followed by prizegiving. 




Update from Karen Day 19/03/2018 - Summary of the hackathon


We started off with a brief opening, and then invited the participants to start working on their solution or attend a presentation by David Hay on how FHIR works. Dr Hay was one of the founding developers of FHIR and gets pretty fired up about how it works and what its potential is!

There were enough participants to form four teams. We had clinicians and software developers in the teams. Some teams had started in the weeks preceding the event but others started on Saturday. There was a FHIR expert for each team and everyone worked really hard during the day.

They gave high quality presentations at the end of the day. What they achieved in one day was impressive – other two-day events have not achieved the high standard or completeness that our teams achieved. They each selected an aspect of adverse event reporting to work on. Three of the teams built a working application prototype and demonstrated how it worked in their presentation, i.e. they showed how a person would log an adverse event in the app and gave examples. They gave great explanations of how they had used FHIR. The judges were very impressed with the quality of the work and creativity they saw. The team that won was called Ad Rec and they created a solution that assisted with reporting adverse reactions to medications. The third team did a ‘cold start’ on Saturday, i.e. had not had an opportunity to build their team or start working on their app before Saturday like the others.

HL7 New Zealand was very impressed with the work and strongly recommended to all the teams to showcase their work in June when HL7 does a showcase event of FHIR and other interoperability initiatives in Auckland.