Publication date: 9 September 2021
Taranaki kaupapa Māori health and social services provider Tui Ora is developing a digital health hub in Waitara. The aim of the project – Tatai Ora – is to improve connectivity and provide accessible health care for Waitara-based Māori and vulnerable people, such as those who are older, have a disability, live alone, or don't regularly access health care.
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.
General Manager Whānau Ora, Tamara Ruakere, says Tui Ora’s experiences during the COVID-19 lockdown showed digital health services could meet the needs of whānau, and the Tatai Ora project seeks to build on this.
‘We had quite the success during COVID with engagement with whānau through technology. So when the opportunity for digital enablement funding came up, we saw it as a way to build on what we had already learnt in terms of our GP service.
‘We are looking for new ways to be innovative, to take away as many barriers as possible so whānau are able to access services. Digital technology is so quick. It’s nice for people not to have to go far from home, and still feel they’ve got something out of it and have been helped.’
The digital health hub will be located in Waitara, and the digital enablement funding will go towards digital devices such as laptops and tablets, soundproofing rooms, and improving the stability of the WIFI. Whānau will be able to connect digitally to health services in New Plymouth, without having to travel there.
Waitara is about 15 kilometres from New Plymouth and while that might not sound far away, says Tamara, in reality the distance can be a significant barrier. ‘Tui Ora primary health has a lot of patients who reside in Waitara and the surrounding areas. To get from Waitara to New Plymouth comes at a cost for people in a number of ways, including sometimes having to take half a day off work.’
Tui Ora clinical director Dr Bernard Leuthart talks about a patient who recently faced a long journey to see him.
‘I had someone coming in at twelve, and I wanted to change the time and see her at 2pm. So I phoned her at about 9.30 and she said “I’m already walking”. She was walking from north of New Plymouth, for about two hours, to get here.’
To house the digital health hub, Tui Ora has leased a building in Waitara, that was previously a general practice.
As well as supporting primary care, the digital enablement on site will also support other Tui Ora services, such as Tamariki Ora, Stop Smoking, Public Health, and possibly Youth Services.
‘We really want to bring the place to life and the digital enablement is the catalyst,’ says Tamara:
‘For example, if they don’t have the technology at home, whānau will be able to come here, book a room and have a counselling session on-line.’
Bernard says Tui Ora is committed to doing something that is different and innovative:
‘We want to give people a “Rolls Royce”, top notch service – good access, quality care, quality kit – in contrast with the service they might expect or be used to.’
He says the Tatai Ora approach will also help grow an effective health workforce.
‘It supports registered nurses to work at the top of their scope. Part of the project is to have a dedicated nursing team who can do some of the things I would otherwise be doing. They’re “driving the stethoscope” to some degree, working in a safe environment where they have virtual contact with me. They can use this experience in their master of nursing or nurse practitioner training.’
Tamara says one of the biggest challenges will be working on the project in an environment with so many other pressures:
‘Rolling out the COVID vaccination clinic, MMR – there are a lot of pressures for Māori providers. We are a small team and don’t have a lot of resource. We have to maintain business as usual services while responding to the pandemic. But the Ministry has been great about understanding those pressures and being flexible with timeframes.’
She says the project is about a lot more than just about putting in place digital tools:
‘It’s also change process for us. It’s changing how we do what we do, bedding that in, having the opportunity to reflect on what’s working well, and tweaking things as we go. We won’t get it all right to start with. We are starting to think about the evaluation; what do we expect to get from this project, what does success look like?’
Bernard says it is very gratifying to see people realising they can play a bigger part in managing their own health:
‘During COVID, when people got engaged with the technology, there was sometimes this “aha” moment, when they felt “I got myself well, I feel like I’ve had a healthier experience, I’ve taken another step for me”.’