Publication date: 9 September 2021
Waitaha Primary Health is using a multi-faceted, whānau ora approach to support people in their rural communities who find it harder to access health care.
The Canterbury-based primary health organisation (PHO) provides services from Cheviot in the north, to Tinwald in the south, to Hanmer Springs in the west, and east to Akaroa.
The initiative has received funding from the Ministry of Health’s Digital Enablement Programme, which provides support for innovation in digital health care. The programme has a particular focus on co-investing in projects that improve access or participation for people who do not access health services and need to. It’s all about improving equity.
The Ministry is working closely with project teams, sharing learning between participating organisations as a community of practice and looking for opportunities to help others learn from these initiatives as they adopt and promote these or similar services elsewhere. The projects are examples of the types of innovation that will be supported by the better access to information enabled by the Hira programme.
Hira will be an ‘ecosystem’ of data and digital services that will enable consumers to access and control their health information through their choice of website or application using a digital device such as a smartphone, tablet or computer. New Zealanders will be more empowered to manage their health, wellbeing and independence. Organisations can work together to share information so that people don’t have to repeat personal details multiple times. Clinicians can harness digital technologies to improve services. The sector and digital innovators can design and contribute innovative data and digital services, making Hira more powerful.
TeleOra has a focus on encouraging whānau to use online health services. It also includes working with internet service providers to get faster broadband to rural areas and encouraging general practices to increasingly provide online access to their services.
Waitaha’s Māori health advisor/kaihautū Pari Hunt says the aim of the TeleOra programme, which is under development, is to support whānau with the tools to improve online access to health care.
‘TeleOra will be delivered to Māori and Pasifika via our Maori and Pasifika health workers, and will also include the delivery of a comprehensive cultural competency programme to practices.
‘It is ultimately about providing a service that is equitable. Telehealth reaches more people, improves the quality of health care and reduces costs to patients. We would like to see TeleOra facilitate access to secondary and tertiary services, as well as to primary care, and to services provided by non-government agencies.’
Waitaha chief executive Bill Eschenbach says the TeleOra pilot will initially involve practices in the Hurunui and North Canterbury regions.
‘Each practice will require the ability to communicate through telehealth to those significantly affected by travel barriers and geographical challenges. We will train whānau ora navigators who will work with practices to contact patients – via telephone in the first instance. Patients and whānau will be encouraged to use patient portals, so they can make appointments and see their health records and results.
‘Navigators will also encourage whānau to have their screening and health checks.’
Pari says the telehealth approach showed great promise during last year’s COVID-19 lockdown, and again recently, as practices have been contacting people about getting their COVID-19 vaccination.
‘During lockdown we saw a significant increase in Māori and Pasifika using telehealth. It was so convenient; not having to find a park, not having to use the car, not having to wait in the waiting room, not sitting with other sick people, not having to take other younger whānau members if you were a single parent – the benefits go on and on.
‘And just over the last week we have been seeing again how well the approach works, as we begin rolling out the COVID vaccine in Ashburton. One of our kaimahi is ringing people who are eligible, using a whakawhanaungatanga approach. That has been really effective, people are very engaged. Of the 245 or so people spoken to so far, only seven did not want the vaccine, and we haven’t had anyone not turn up for it.’
The PHO is being supported by Te Ohu Urupare; a Māori health leadership response upholding Te Tiriti responsibilities of the Canterbury health system. Its mahi is guided by the principles of Te Tiriti.
- Tino Rangatiratanga: providing for Māori self-determination and mana motuhake in the design, delivery and monitoring of health and disability services.
- Equity: being committed to achieving equitable health outcomes for Māori.
- Active protection: acting to the fullest extent practicable to achieve equitable health outcomes for Māori.
- Options: providing for and properly resourcing kaupapa Māori health and disability services.
- Partnership: working in partnership with Māori in the governance, design, delivery and monitoring of health and disability services. Māori must be co-designers, with the Crown, of the primary health system for Māori.
Bill says the PHO’s approach has a strong focus on empowering communities and whānau to self-manage their health.
‘We want to see better access for Māori and Pasifika to primary and community health services, greater participation in those services, and a better health care experience for them. That’s how we’ll start to address some of the inequities we see.’
He says as well as the benefits to patients, the programme will support clinicians to become more confident in using data and digital technology to improve people’s health.
Pari says learnings from the TeleOra pilot will help make the PHO’s whānau ora approach even better.
‘I went to Tuahiwi marae on the weekend that experienced a beautiful model for delivering the COVID vaccine coordinated by Māori Indigenous Health Institute (MIHI). People greeted us at the door, there was kai, there were all sorts of things happening. It was a really good experience – the jab was secondary. We want people to experience a whānau-friendly approach that leaves whānau with a mana-enhancing experience.’