Hutt Valley hospice will use telehealth to provide services to more people in need

Publication date: 9 September 2021

Lower Hutt’s Te Omanga Hospice is testing a suite of digital approaches, with the goal of removing barriers to access to their services for those in need. The hospice, which is based in Woburn, provides palliative care to those living with a terminal or life-limiting illness in Wellington’s Hutt Valley.

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.

Te Omanga Hospice project lead Alex Godden-Steele, IT Systems and Training manager, says while the hospice strives to provide a free service to the people of the Hutt Valley, in reality there are costs for patients and their whānau.

‘These include transport, time off work, finding carers for others, the cost of phone calls and so on. We are seeking a way of giving people access to our services without them being inconvenienced by the additional cost that can occur.’

Recognising that everyone has different needs, the hospice will be testing five complementary approaches.

  • Microsoft Teams rooms and collaboration bars. This will enable patients to remotely access their health care providers when personal attendance is a barrier.
  • An 0800 line for patients, so they can phone the hospice for support at any time, free of charge.
  • Providing mobile phones to patients who don’t have them, so they can contact the hospice or their GP when they need to, while they are in hospice care.
  • Providing iPads for patients to use so they can have online meetings with hospice medical staff and counsellors. Hospice nurses will take these to patients in aged care facilities, to use with them.
  • The PalCare Home app. PalCare is the core medical tool used by the hospice. The app add-on will allow hospice clinical staff to have meetings with patients and whānau on a one-to-one basis.

Alex says the most complex offering is the telehealth meetings, which will be enabled by the use of Microsoft Teams and the collaboration bar[1], the iPads and the PalCare Home app.

‘People’s needs are unique and providing a purely face-to-face service doesn’t work for everybody. We need to be able to take the service to where people are. Enabling people to dial into appointments with hospice doctors and nurses, or for counselling sessions, will stop them potentially having to catch multiple buses across the Hutt Valley, to get to us in Woburn.

‘There are also those who have to work through their terminal diagnosis. With telehealth, they can go into a private room at work and dial in, rather than having to take a day off work, unpaid.

‘The collaboration tools, software and devices will help facilitate interdisciplinary team meetings, where the GP and hospice doctors and nurses can talk with the patient and their whānau.’

Alex says the hospice will work with primary health organisations, with a view to enabling some telehealth meetings to take place from Hutt Valley GP surgeries.

‘While the patient may not be able to visit us here in Woburn, they might be able to get to their GP surgery and dial in from there. The GP can come to the meeting and only have to spend half an hour of their day, so they have more time to spend with other patients. We would also like to provide the same tools and service at the marae in the Hutt Valley.’

Chief executive Biddy Harford says the hospice’s experience during the COVID-19 lockdown led to the need to have different ways of communicating with patients – especially for whānau.

‘During lockdown we were an essential service and still operational but had to use different methods to support our patients.

‘It would have been great if patients in the inpatient unit could have had access to zoom in their rooms to talk to family members. Patients were only allowed one other person with them due to COVID-19 restrictions and a lot of people couldn’t have funerals either. There has been a lot of delayed grief – it has an ongoing impact.

‘During COVID we ramped up our internal use of Teams,’ says Alex. ‘It made us really re-evaluate where the gaps are and how we would plug them. Which is why we started putting together the IT strategy. When the Ministry of Health funding offer came out, we already had a plan. The funding will help us put that plan into action.’

Alex and Biddy say the most exciting thing about the project is being able to provide services to more patients. ‘Patients will get the care they need, when they need it, where they need it. Some people don’t access palliative care and we want everyone that needs it to have it,’ says Biddy.

The Ministry funding will be used to trial the different approaches to see what will have the biggest impact on the groups in greatest need, with a particular focus on equity. Evaluation will look at things like device usage, call volumes through the 0800 number, and feedback in the existing patient and whānau surveys.

The hospice network is very interconnected, so if this works well it could easily be a model that is rolled out across the country, they say.

[1] The Teams collaboration bar is like a TV soundbar but with a built-in camera and Teams software, making telehealth appointments easier to manage at remote sites

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