Online general practice pilot aims to provide easier access to health care for high-needs groups

Publication date: 9 September 2021

ProCare Health Ltd, the country’s largest primary health organisation (PHO), is trialling an online service that will enable high-needs patients to easily find another GP if theirs is unavailable. High-needs patients are those registered with a very low-cost access practice (VLCA), and community service card (CSC) holders.  

The initiative has received funding from the Ministry of Health’s Digital Enablement 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.

ProCare general manager strategic development, Paul Roseman, says the ‘accessible virtual general practice for high-needs patients and whānau’ project aims to provide timely health care to those who need it most.

‘If a patient goes online to book an appointment, they are initially presented with their own enrolled practice – because we recognise the importance of continuity of care. However, if their practice is full or there isn’t an appointment available at the desired time, the patient is guided to another practice. This practice will offer access to high needs and CSC patients at the enrolled practice co-payment rate, whether or not that practice is a VLCA.

‘The appointment may be online or face-to-face. If you would like a face-to-face appointment, the system will look for the next available appointment at a practice near you. If you’d like an online appointment, we can place a higher priority on finding an appointment at a time that suits you – because a virtual GP can be anywhere.

‘Even if the patient rings the practice, it’s entirely possible the practice receptionist could use the platform to suggest an appointment at another practice and book it.’

Paul says ProCare is very conscious that high-needs populations can have a number of challenges getting to health care appointments, such as lack of transport and having to find childcare or getting time off work. So, while virtual consultations offer some significant advantages to this group, it is important to address any remaining barriers.

‘For example, for online care, you need a digital device that has enough data for a video consultation. We are looking into zero-rating data, which will make virtual health care a lot more accessible to high-needs populations – it should be as accessible to this group as it is to the rest of the country.’

He says the accessible virtual general practice project also supports the health sector reform’s vision for joined up digital infrastructure and capability.

‘In the future it will be possible for a patient through their single access point – whether that is their patient portal or their practice website – to access a range of services that are inside and outside the practice. Practices will be able to present themselves as groups to patients in a way that will make better use of the workforce, but also make booking appointments and working with providers a lot easier for patients.’

The pilot will see the service available 7am to 9pm, 7 days a week. The extended hours will be supported by online consultation service CareHQ, which is a joint venture between ProCare and Southern Cross Health Society.

Introducing the online service is a social project as much as it is a technology project, Paul says.

‘There are so many social dimensions – promoting it to communities and encouraging them to adopt it, and talking with practices to get them on board, and address some of the barriers they might see.’

ProCare is currently working with practices to ensure all are signed up to the PHO’s summary health care record.

‘When you see a GP that is not your own, it is important they have access to a summary of your notes – so they know what medicines you are on and what conditions you are being treated for. From the patient’s perspective, this makes the consultation safer. From the GP’s perspective they can deliver a more effective consult because they already have some of the person’s background information, and don’t have to ask about it again.’

He’s excited about the potential to provide a service to the people who need it most.

‘We want those groups that face so many barriers to be able to have access to health care easily, from wherever they are. We discovered through lockdown that there is an amazing amount of health care that can be safely and effectively delivered through virtual means. We would like to normalise online care and really focus on the patient experience.’

The pilot will run for 12 weeks. The evaluation will include consideration of whether the project has improved access to health care for groups with high-needs; the level of support from practices; and how well the technology has worked.

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