My View - The Future of telehealth in New Zealand

VIEW - Ruth Large, emergency and rural hospital doctor and chair of NZ Telehealth Forum 

Following the recent decision by Health New Zealand Te Whatu Ora to discontinue funding for the NZ Telehealth Forum, chair Ruth Large reflects on its achievements and sets out a path for advancing the future of telehealth across Aotearoa. 

Established in 2012, under the ‘better, sooner, more convenient’ healthcare banner, the NZ Telehealth Forum is an advocacy group established to enhance equitable healthcare delivery.  

Over the past decade, the Forum has actively engaged with an international and national network of healthcare workers and providers across NGOs, GOs and public/private sectors to share and learn together. We coordinate thought leadership and advise on matters related to telehealth and its implementation, supporting, advising, and providing insights and resources to support telehealth development. 

Twelve years since the formation of the Forum, as its Chair, I am proud to reflect on our achievements and share my vision for the future of telehealth in New Zealand. 

Current State of telehealth in New Zealand 

New Zealand Telehealth has earned international admiration for its early adoption of the medium, particularly in the fields of dermatology, paediatrics and renal medicine.  We have been admired for our innovation, highlighted by the creation of the National Telehealth Service in 2015. This service, which unified multiple health lines under a 10-year contract, is globally recognised for its pioneering approach.  

Telehealth became an indispensable part of our healthcare system during the Covid-19 pandemic. The Forum played an important role during that period providing expert, evidence-based advice including advocacy to the MoH to provide a waiver for e-prescribing, to GPNZ and MCNZ to guide policy and to ACC to fund telehealth delivery. 

Whilst post pandemic has seen growth occurring amongst independent, privately owned telehealth providers, most providers in primary, secondary and tertiary sectors are struggling to maintain momentum amidst the published desire from Health New Zealand for telehealth practice to become the norm.  

Last year the Forum undertook a stocktake of public hospital telehealth delivery, indicating that the gains in telehealth made during the pandemic period are reversing and that there is an uneven playing field in telehealth delivery across the motu; a postcode lottery of telehealth service delivery is evident. This is backed up by the recent HQSC ‘windows on quality’ published in June 2024.  

Since the publishing of the stocktake paper,  there have been further reductions in telehealth “back office” roles and publicly provided telehealth services, with the consequent loss of core intellectual knowledge. Particularly heart breaking has been the loss of change management and project roles in the telehealth space which evidence shows us are the real game-changer roles that make telehealth sing.  

In the context of providing only rhetoric to feed telehealth growth, and in the absence of clear strategy for how, where, when, and who will best benefit from telehealth it is no surprise that we have been unable to sustain the telehealth momentum. In the absence of senior decision making, telehealth has become a political hot topic with the potential to polarise the sector which distracts us from the heart of the matter, which is good patient care.   

Future opportunities 

In a political sphere that gives us no clear goal to aim for there is a vacuum created and we must band together to fill this opportunity and gather momentum again. 

Here are some key areas of suggested focus to build momentum around, many of these outlined in the PACE whitepaper

1. Prioritisation of a Telehealth strategy, we have an opportunity for true transformation. If we continue to see telehealth as merely a replacement tool instead of an opportunity to put patients first then we lose the whole benefit of telehealth in the first place.
2. Patient-centric care: Time and again patients tell us that they have jobs, family and commitments, they are making decisions to attend health appointments based around what else is happening in their lives. Our free healthcare is pretty expensive if you take into context time off work, travel, parking fees and paid childcare. Focusing on patient experience, particularly for those who are under served is critical and any service must be designed in context and available to those who are under served as a priority. Nowhere is this better exemplified than on  Matakana Island. 
3. Hybrid models of care: By integrating telehealth with in-person visits, we can create a more holistic, patient-centred, hybrid approach to healthcare. Examples include Tend Health 
4. Technological Advancements: Embracing new technologies such as artificial intelligence and machine learning will enhance telehealth services. These technologies can help in early diagnosis, personalised treatment plans, and efficient patient monitoring. 
5. Equity and Accessibility: We need to work towards eliminating digital divides and providing the necessary infrastructure, support and ensure these services are stable and sustainable.

This is not the end for the NZ Telehealth Forum which remains committed to advancing telehealth in New Zealand . Together, we can create a healthcare system that is accessible, equitable, and efficient for all New Zealanders. 

Picture: Ruth Large, emergency and rural hospital doctor and chair of NZ Telehealth Forum 

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

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