What is Digital Enablement?
Consumer experience and health services that can be provided closer to home are a key element of this programme. There is currently a particular focus on care provided in primary, community and planned care settings (planned appointments or interventions in hospitals, community settings and GP practices).
The programme includes:
- supporting health providers to develop or further develop innovative digital services and technology
- directly commissioning organisations to provide innovative and creative digital ways to deliver health care, with the aim of improving health because of the benefits provided by the technology (eg, more accessible, lower cost)
- capturing and sharing learnings and other outputs from commissioned initiatives to encourage re-use and deliver value across the health system.
Digital enablement is about using tools and services to help all consumers to access health care services digitally. This includes:
- telehealth – the use of technologies to deliver health care to patients through digital means
- teleworking – enabling health staff to work when they are away from their usual physical workplace
- digital inclusion – supporting all health consumers to access digitally enabled health services, with a focus on equity and partnership with Māori.
Funding for innovation in digital health care services
DHBs and other primary and community providers have been given the opportunity to apply for funding to build and support their innovative digital services and technology.
Planned care considers medical and surgical activity in a way that is not limited to hospital settings or groups of health professionals. Rather than supporting just hospital-based care, it refers to services delivered in the most appropriate setting, by the most appropriate person, based on a person’s clinical needs.
Providers were invited to submit proposals for funding for planned care initiatives. Funding has now been allocated, and projects have begun. Each DHB has a timeframe for reporting progress on their projects. The Ministry will work closely with DHBs to provide support, and progress and learnings will be shared across the sector.
Six planned care initiatives with national application were identified during this process. They have similar concepts from across the sector. It is more efficient to develop a single similar approach that can be tailored for each organisation, than several different approaches.
Telehealth monitoring for heart failure patients
Ko Awatea is leading the co-design of an in-home remote monitoring and treatment programme for Māori and Pacific heart failure patients in the Counties Manukau community. Patients will measure and record their weight and blood pressure levels on a daily basis. The monitoring will be supported by video/telephone appointments, with the aim of reducing the number of in-person follow up appointments in primary and secondary care.
Telehealth in planned care
Counties Manukau Health is working with vulnerable patients who have heart failure to design an in-home telemonitoring programme. There are about 10,000 hospital admissions related to heart failure in New Zealand each year. Māori and Pacific peoples are almost twice as likely to be affected.
Telehealth workflow integration
MidCentral DHB is rolling out a programme to support the continued use of telehealth as an alternative to in-person consultations across the DHB. Aims include enabling people to have increased and equitable access to appropriate telehealth, and for telehealth technology to be available to all clinicians who require it.
Electronic shared care planning
Bay of Plenty DHB is undertaking a project to provide access to an electronic shared care planning platform for consumers and providers in the region.
The project will support the He Pou Oranga Tangata Whenua model of care by improving equitable access and timeliness of care. While the provision of an electronic shared care planning platform is shown to have wide benefits, this project will identify conditions and surgical pathways where there is inequitable access resulting in poorer health outcomes – for example, cancer treatment and ear, nose and throat surgery.
A platform will be introduced for surgical pathways in areas with a high proportion of Māori and patients with complex needs, and will be integrated into patient management systems. Information will be available to the patient and their whānau, and their health care team –which may include general practice, community and secondary services.
Enterprise scheduling platform
Bay of Plenty DHB is implementing an ‘enterprise scheduling platform’, to enable better management of outpatient appointments. The platform will build the foundation to move more easily to patient portals, kiosks and referral management. It aims to support the redesign of services so they are more equitable and consumer-centred, with care delivered in the right place at the right time and with the right people. For example, scheduling will allow whānau to be present, in person or via telehealth; and cultural preferences can be recognised and met.
Outpatient clinic scheduling and room-booking system
Waitematā DHB is introducing an outpatient clinic scheduling and room-booking system that will improve patient and staff experience, and access to planned care. Patient flow throughout the clinics will be improved therefore affording the patient a better experience. The system will replace the current paper-based approach, integrating with existing systems to improve the management and use of clinic and treatment rooms. The new system will support efficient resource allocation – staff, equipment and consumables.
Primary and community care
A number of primary and community care providers have received support from the Ministry’s Digital Enablement Programme to help them improve people’s access to general practice, and other community health services. These projects are now underway.
Digital enablement oversight group (DEOG) Te Tiriti partnership rōpū
The programme works with the digital enablement oversight group (DEOG), that has representatives from the Ministry of Health, Cancer Control Agency, NZ Telehealth Leadership Group, consumer representation, and Māori representation.
The DEOG works in partnership with Te Rangapū Tiriti, sharing power in decision-making, planning and monitoring across critical digital enablement projects (partnership projects).
The DEOG and Te Rangapū Tiriti provide advice to the Ministry on effective and equitable ways to increase digital access to health care, as well as supporting information sharing and collaboration, and monitoring outcomes. They seek to align priorities and work programmes across the sector.
A main focus of the programme is to increase digital equity, so everyone has the same level of access to health services through digital means. There is a strong focus on equity of health outcomes and partnership with Māori.
Capturing innovation due to COVID-19
During the initial response to COVID-19, many primary care and community health service providers quickly introduced digital ways of communicating with consumers to provide care. While digital communications cannot entirely replace in-person service delivery, in many cases it provides an effective and convenient alternative way of delivering health services.
However, as COVID-19 lock downs eased, the use of digital communications has not been maintained, with most providers reverting to predominately in-person provision of services. The digital enablement programme encourages the greatly increased availability and use of services such as telehealth. It seeks to build confidence in these services, increasing their use, and supporting their provision to patients closer to home if appropriate.
Regular sector updates
Organisations will provide regular progress updates to Te Whatu Ora, including a final evaluation. We will work closely with hospitals to provide support, and progress and learnings will be shared across the sector on this website and in sector publications.
Get in touch
The Digital Enablement Oversight Group (DEOG) would like to hear from non-governmental organisations (NGOs), community organisations and vendors about current projects and services that use digital means to support new and innovative ways people can access health care. DEOG wants to ensure it is up to date with new innovations, and any challenges being encountered.
We recognise the importance of having transparent, two-way engagement with you, in a range of ways. If you would like to provide information to DEOG, you can do so by contacting the Digital Enablement programme manager on DigitalHealth@health.govt.nz. They can then discuss the next steps with you.
We are particularly interested to know about any of the following areas:
- What gaps did you identify and how is your product/service addressing these?
- What are you doing that is different to traditional models?
- What outcomes are you getting?
- How are you measuring these outcomes?
- What is the impact of your project/service on improving equity and health outcomes?
- In what ways did consumers and clinician initially engage with the project/service? In what ways have they remained engaged?
- How would you describe the outcomes of digital inclusion?
- How has digital literacy been addressed?
- What have you learnt along the way for your initiative to be a sustainable digitally enabled service?