Publication date: 9 September 2021
Three young innovators are trialling a way to make it easier for people to enrol in general practice. Fourth year medical student Theresa McLean is the director of Telesphoros Tapui Ltd, which has received funding from the Ministry of Health’s Digital Enablement Programme.
The programme provides support for innovation in digital health care, with 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.
The Telesphoros team consists of Theresa, her brother Thomas who is able to program and create accessible technology through design and language, and friend Xavier English who takes care of stakeholder engagement and promotion.
Theresa says it is important for people to have access to primary care, and the first step is enrolment with a general practice. However, currently, this can be frustrating and time consuming. It can be especially hard for those finding it difficult to access health care, whether because of poor mobility, lower literacy, or lack of time and money to go through an arduous process, that can exclude some people.
‘At the moment, you either ring up and ask if you can enrol or you come in. This is of course presuming you can get time off work and you have a car and childcare. You come in, fill out a three-page form, the receptionist skims it over, and it is sent to the PHO. In around 25 percent of cases in Rotorua, they find an error, and so you have to come back in and correct the form. And then you have to do it all again in three years.’
Rapid Rēhita is a website that enables people to enrol online, using a simple process. People are sent a link, so can enrol without leaving home. Care has been taken to make the website as easy to use as possible. In addition to this, the technology will be able to reduce error rates by validating inputs, as well as integrate with the national enrolment service. This will save processing time for staff, and simplify the requirements for patients.
People can do a geographical search on the website to find the GPs in their area and see who is taking on new patients. This is important as nationwide, there is a shortage of GPs able to enrol new patients.
‘You can find a GP who is accepting enrolments, and then enrol while you are consciously thinking about it. We have tried to find a way to put everything in one place – a one-stop shop.’
At the moment, once the enrolment form is completed, it is encrypted and sent to the general practice as a PDF.
Theresa says some of the Ministry funding is going towards taking this one step further.
‘We are going to have the encrypted data sent to the national enrolment service, and do things like automatically check a patient’s passport, or visa. From there, it can be pulled down to the PMS, so receptionists won’t have to spend so much time manually entering and checking forms. This the most exciting part, as currently no other software like this exists, and it will significantly streamline the process.
‘GPs can also use the platform to re-enrol people and pre-enrol newborns. They can limit enrolments, if they have things like geographical constraints on enrolling.’
With the help of the digital enablement funding, Rapid Rēhita will be offered free to all general practices in the Rotorua area, and some rural practices, for a year.
‘Practices will be provided with support and updates. We will get ongoing feedback from them and make adjustments, so the service is as good as it can be. We will be gathering data to see which groups we are reaching and what methods are working best. The rest of the funding will be used for translation and developing the service’s integration with the national enrolment service.
Theresa says it is vital the service is easy-to-use, intuitive, and built for the local population.
‘This is reflected in the inclusion of te reo Māori options on the website, and easy to use language. We also plan to introduce other languages. The form also guides all people in all situations through enrolling, whether they have just moved to Aotearoa New Zealand, or are living in emergency housing.’
While developing a simple online enrolment service is something Theresa had been thinking about for a few years, the COVID-19 lockdown of 2020 gave her the final push.
‘I was working at a general practice, and we had to enrol people over the phone and then they had to come in and sign the form by hand. People didn’t want to come into medical centres then and we didn’t want them to come in if they didn’t need to. My brother Thomas, came home because of COVID, and we worked on the new website together.’
Rapid Rēhita is currently being piloted in three general practices, in Rotorua, Auckland and Wellington, and initial results are very encouraging.
‘So far we have had two errors in about 200 forms – a 1 percent error rate down from 25 percent for completed hard copy forms. When we used to send paper forms out and try to get people to fill them in, we would have very little success. Now we are getting a steady stream of re-enrolments happening online.’
Theresa says to remove barriers, they are in the process of trying to become zero-rated, so people can access the website without incurring mobile data charges.
‘There is also the potential for people to enrol online in the practice, using a tablet. We have been connecting with other service providers in Rotorua, such as the Maanaki Ora Trust so when they go to see their families, they can also enrol them. The dream is for service providers in the community to identify that vulnerable unenrolled group and assist them in enrolling on the spot.’