New technology initiative means people with cardiovascular disease can monitor their own health

Publication date: 9 September 2021

Mid-North health services provider the Ngāti Hine Health Trust is undertaking a project that will enable people with cardiovascular disease to monitor their own health, in places that suit them.

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.

Ngāti Hine will deliver remote patient monitoring and care of patients who have either have cardiovascular disease or are at risk of developing it.  Each person will be given a monitoring plan and device, and will register their daily vital signs and any symptoms of deteriorating health. Patients will receive feedback, access to coordinated treatment, educational material and the ability to communicate virtually with their assigned Whānau Ora navigator.

Photo of Tania.
Tania Pritchard, Ngāti Hine manager tikanga, people and practice

Tania Pritchard is the manager tikanga, people and practice for Ngāti Hine, which has offices in Whangarei and Kawakawa.

She says the initiative focuses particularly on Māori males between the age of 35–40 and over who have cardio events. There are two specific cohorts – those who have regular hospital admissions; and those at risk who are enrolled with four general practice teams in the mid-North.

‘We are seeing Māori men who don’t make it to 55 – they’re dying earlier, and it would be totally preventable if they had the right support,’ she says.

‘Many of those we are working with are employed in jobs where it’s difficult to get time off work to go to health appointments – they might be truck drivers or forestry workers. They are often the main income earners and would rather continue to work, even though they’re unwell. This means they might not see anyone until they are really sick. If we can pick up earlier that something is wrong – via the monitoring device – they can be treated more quickly.’

She says people who are part of the initiative will be given an iPhone or iPad with an app that lets them monitor their own health.

‘For example, they will be able to take a simple blood test via a finger prick, take their temperature, record their weight etc. The app sends the details to the lab for processing, or straight to a clinician. 

‘It also records responses to a number of clinical health and wellbeing questions – such as what their mood is like, whether they are feeling tired, have chest pain or difficulty breathing. All that information goes into a database for our clinician to make clinical assessments.’

She says the clinician’s role is to monitor the data and give feedback in a way that is easy to understand.

‘The app also has a type of “library”, where individuals can look up information about their condition for themselves. If they have any questions, they can ask the nurse. This prompts a two-way conversation when the person is ready for it, and led by then. This is better than being bombarded with information up front, and not taking it in. It gives individuals a greater ability to manage their own health and progress.’

Ngāti Hine is partnering in the initiative with health care technology company Orion Health, which is developing the software. The funding received from the Ministry of Health will be used to support the clinician who will monitor the data from the devices and the lab results, and to purchase the devices themselves.

Tania says challenges ahead include finding a clinician who is really familiar with software and technology, and understands the monitoring of data, Ngāti Hine will also need to introduce general practices to the programme and get their support.

She says experiences during the COVID lockdown of 2020 showed people were keen to use technology.

‘During COVID we had a small population with complex health conditions that we monitored. We supported them with iPads, and they talked to the GP using telehealth. Families just embraced the technology – once they had been given a tutorial on how to use the devices, they were away. They found it fantastic.

‘We thought, “If this approach worked during COVID, it could work with this cohort at other times”.’

She says the cardiovascular disease monitoring initiative is an exciting new direction for Ngāti Hine.

‘It’s moving ourselves forward, being more innovative. Traditionally, we have been all about home-based, outreach-type face-to-face services. For a kaupapa Māori service this is really going outside the box. Our nurse will be able to video conference with individuals, so there will still be face to face interaction, but via telehealth, rather than in person. That will all be very new to us, and will be a big learning experience.’

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