INTROduCTION
New Zealand has one of the world’s most highly automated primary care systems. All of New Zealand’s 1,100 general practices use an electronic medical record (EMR) system and the services of a health system integrator (HSI), a specialized information technology company that has expertise in integrating and supporting electronic clini- cal messaging, online communications, and security systems to facilitate and support communications with other parts of the health sector.1 Primary care doctors have