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Te Whatu Ora Health New Zealand Digital Services has started a national project to standardise oral health data in the New Zealand public health system.
This comes as it moves towards national platforms, common data models, and consistent digital operations amid a patchwork of over 4,000 clinical and business system applications – many of which are at or near their end of life.
In an interview with Healthcare IT News, Douglas Healey, digital and ICT manager for Hauora Māori Service at Te Whatu Ora, confirmed the new national project with the Oral Health Clinical Network.
It involves creating a single, national clinical code set aligned with the Australian Dental Association (ADA), rationalising legacy codes, and ingesting oral health data across settings into the year-old New Zealand Health Data Platform (HDP).
He also mentioned a plan to consolidate 19 existing dental practice management systems – provided by Titanium Solutions – to four regional instances.
The oral health data standardisation project, which started in mid-2025, builds on the earlier national Electronic Oral Health Record project that has established a minimum dataset and four regional agreements to implement Titanium's dental practice management software.
National alignment
The project to align oral health data codes in New Zealand with the ADA follows this criteria:
- codes that are unsafe, unclear, or obsolete are retired
- high-use codes are preserved and mapped into the national set
- codes that do not map to ADA or that block reporting are redesigned
- local codes that reflect regional contracts or service models are reviewed with funding teams, so the intent is preserved.
Healey said customised local codes that support "unique service offerings" are maintained in place under a hybrid model. "Each code is mapped to the national ADA-aligned set for reporting. The region can still keep the local version to support day-to-day service delivery. This protects local workflows and ensures full national reporting."
Local configuration will be limited and governed under a national change process, added Healey, as a national ADA-aligned code set will become the default in future Titanium software deployments across public dental settings in the country.
Three groups oversee these changes: a clinical coding group from the Oral Health Clinical Network reviews and tests changes against real workflows; Te Whatu Ora Digital Services provides the technical and data governance, including the code alignments with New Zealand's Health Information Standards Organisation (HISO) and SNOMED CT standards, the architecture, and HDP requirements; and a national steering group signs off on the final code set and the migration approach.
Move to HDP
Moving oral health data into the HDP begins with extracting code sets, reference data, and selected clinical records from all 19 Titanium instances and assessing data quality.
Local codes are then mapped to a national ADA-aligned reference set and staged for HDP loading, with each Titanium instance updated to the new National Health Index format to enable deterministic and probabilistic matching of duplicate patient records.
The staged data is transformed into HDP's canonical FHIR-based model and loaded through secure, audited pipelines, with regions receiving dashboards to reconcile remaining duplicates and recurring data quality issues.
"Once oral health sits [on the] HDP, it can link with immunisation, primary care, child health, and hospital datasets. This supports integrated planning, longitudinal care, and equity reporting," Healey said. The ingestion of oral health data will run for about a year.
Systems consolidation
Te Whatu Ora envisions "more consistent recall, triage, preventive care, and referral workflows" once the system shifts to four regional instances of the Titanium software.
Clinicians may also see better dashboards and reporting that reflect national definitions using HDP – and once a single national code set is in place, likely between 2026-2027.
When asked if the organisation considers a single national instance in the future, Healey said: "The move to four regional instances is a safe and staged approach. It aligns with regional service structures and reduces risk."
"The design retains the option for a future single national instance," he added.
Separate business cases and dedicated funding will be required for each regional instance. "Planning work is underway, but funding decisions have not yet been finalised," Healey shared.
Besides coding
As part of the standardisation of oral health data, Te Whatu Ora is also creating workflow templates for recall, triage, preventive care, and mobile services. Minimum datasets are being developed for each course of care.
The organisation is also creating national reporting specifications, data quality rules for completeness and accuracy, and standard privacy and access controls across all regions.
"These standards support consistent service delivery and strengthen equity monitoring across the country," Healey claimed.
