Transforming health equity with InterSystems TrakCare

FEATURE -  Industry Innovation Article - InterSystems

The InterSystems TrakCare implementation team at Te Toka Tumai Auckland is actively supporting the improvement of equity gaps.

Tū Pono Āroha replaces three fragmented legacy systems at Health NZ Te Toka Tumai Auckland with a single integrated platform from InterSystems.

The new patient administration system (PAS) supports around 145,000 inpatient and more than one million outpatient visits per year.

The project has embedded equity at its core, ensuring that everyone has equal access to high-quality healthcare, with a particular focus on Māori, Pacific, and disabled communities.

Enacting equity

Clinical and equity lead Tū Pono Āroha, Jen Chesbrough, presented on the project during Digital Health Week NZ in Hamilton in December 2024. 

She said that from the outset, the project recognised that while digital systems provide the potential for equity, it is people who must enact it.

Tū Pono Āroha was the name gifted by chief of tikanga, Rangimarie Dame Naida Glavish, and means ‘loyalty to all services with compassion’, which has served as a guiding principle for the project. 

Chesbrough said that engagement with a wide range of stakeholders both locally and nationally revealed a common theme of lack of visibility of inequities in the current systems. 

The team worked with InterSystems to develop a system that supports staff in providing holistic care.

The PAS is fully compliant with the new HISO standard on iwi affiliation and includes use of an equity icon, making critical information more visible to hospital staff. 

“We are fortunate that InterSystems worked with us to develop features like capturing a patient’s ethnicity alongside their name, age, and date of birth. It also differentiates between sex and gender and includes pronouns, helping to reduce unconscious bias among clinicians,” Chesbrough said.

The equity icon ensures that non-clinical staff, such as schedulers and ward clerks, can access information on a patient’s additional needs without breaching privacy. 

“If someone is hearing impaired, visually or mobility impaired, or has care navigators involved in their care, the equity icon allows staff to take these needs into account right from the first engagement,” Chesbrough explained.

This type of functionality is now available to InterSystems global customers.

Enacting Te Tiriti
Auckland nurse manager Marina Parata has a team of 10 kaiārahi nāhi -clinical nurse specialists who look at Māori equity. These navigation roles were introduced during the pandemic in response to fewer people attending for surgery.

At Digital Health Week, she said a key focus of Tū Pono Āroha was enacting Te Tiriti o Waitangi. 

Group sessions with all project members, including InterSystems staff, introduced Te Tiriti o Waitangi and offered participants the opportunity to reflect on how their roles and the project as a whole were enacting Te Tiriti, particularly in terms of equity.

“A significant takeaway for many was the realisation that data is a taonga/ treasure or a gift,” she explained.

Parata told conference attendees that one of the most significant changes TrakCare brings is improving appointment scheduling to remove barriers for Māori patients. 

“For many patients, the first interaction with the hospital is through letters, and our goal was to remove any barriers the wording might create. Patients were often booked into appointments without consideration of their personal circumstances - childcare, work, transport, or other barriers - leading to missed appointments,” she explained.

 “Now, we can see when doctors or nurses have clinic availability and talk to the whānau in real time to find a time that suits them, not just the system. We are not just booking patients in, we are making sure they can actually attend.

“This is really helping us get these patients in so that they are not missing appointments. It is a really, really valuable change, and we will see the full impact over the next few months,” Parata said.

Ongoing impact

The project’s impact is expected to grow over time, as the governance groups created to maintain TrakCare will continue identifying and addressing inequities. 

Says Chesbrough: “The replacement of our patient administration system allows us to collect and display information essential to equitable care and puts that information in the hands of all who need it.”

If you have any questions re the above feature article, please contact the editor Rebecca McBeth.

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