My View: Improving health equity at Hato Hone St John

VIEW - Malcolm Kendall, Hato Hone St John Kaitohutohu Māori – Hapori Manaaki (National Māori Advisor – Community Health)

Last year, Hato Hone St John launched its new organisational strategy, Manaaki Ora. This heralded a journey towards achieving better health outcomes and equity for everyone - particularly for Māori and Pasifika. 

An ongoing area of focus for us has been the leveraging of enabling technologies to extend the reach of our trusted clinical workforce with communities of highest need.

Manaaki Mamao (meaning remote care) is a great example of digitally enabled innovation that increases the utility of our workforce while improving health outcomes.

At its core, Manaaki Mamao is a community based telehealth service that helps people to better control previously problematic hypertension (high blood pressure) from the comfort of home. Given the risk implications for stroke and heart disease, and the lack of discernable warning signs, blood pressure is an important vital to monitor proactively.

In 2021, Hato Hone St John received one-off funding from the Ministry of Health to pilot the service and we have since seen over 120 Māori and Pasifika patients monitored. Its proven success confirmed for us that this service is an essential ingredient in our aim to improve health equity across Aotearoa New Zealand.

One of the highlights has been the guidance given by our tangata whaiora/patients. Our team tailors their approach to best meet tangata whaiora needs and works at a pace that they are most comfortable with. 

Our approach is underpinned by the understanding that for a service like this to work for Māori and Pasifika, there must be a trusted relationship where they feel in control and at ease.

Insights

The results of Manaaki Mamao speak for themselves, with blood pressure readings trending downward, especially in the first 12 weeks when patient motivation to make positive health changes is high.

Other key benefits include a deeper understanding of what is required to reduce blood pressure in a practical way. Even a small reduction can reduce the health risks and we’re with them on their journey with support on medication adherence and monitoring of their general health and wellbeing. We also refer back to their care provider if urgent follow-up is required.

Overall, health literacy has improved, and patients have shared how they really value having autonomy over their health and how they now trust more in the healthcare system. 

GPs have also found it useful as a tool for improving visibility of their patients’ ongoing health as well as to more accurately inform patient medication management. Being able to see the blood pressure reading and trends also helps GPs to have more meaningful patient consults because there is more insight at their fingertips.  

For Hato Hone St John, proactively monitoring people with uncontrolled hypertension means we may just avoid sending people an ambulance later on when things could be far more serious. 

Next steps

Hato Hone St John has ambitions to grow the service over the next two years, allowing us to serve more Māori and Pasifika whānau. Ultimately the goal is to see it expand to encompass other conditions such as diabetes, COPD, and mental health and wellbeing. 

 We are looking at further innovations such as a whānau app, but first, we need external funding support to ensure we can continue to support and grow the service and make a difference to Māori and Pasifika health equity.

 Hato Hone St John is currently reaching out to our donors, partners and other leaders in the health sector but equally we’d be happy to hear from any potential sponsor who’d like to know more about how they can support us to continue delivering this important work in the community.

At a glance

120 current participants 

71% Māori, 29% Pasifika  

84% of current patients are actively engaged

30,992 vital readings 

1,480 video calls 

Average call time = 15 minutes  

28 GPs and 4 clinics have referred patients 

45 proactive interventions/referrals to other services.  

Point of difference

• Manaaki Mamao embraces a tikanga people led approach to address health inequities
• We work with patients, healthcare providers and technology partners to deliver care. All care centers on the patient and whānau
• Hauora (Māori health) or mainstream healthcare providers own the relationship with the patient and refer them to the service
• Spritely provides locally based software co-designed with people who struggle using technology. This technology utilises Spark’s mobile network
• For more information please see our short video demonstrating the service https://vimeo.com/stjohnnz/review/758904325/b70bcfc56a

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

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