Our View: Digital health must not leave communities behind

VIEW - Vic MacLennan, Kris Dempster-Rivett, co-chairs, Digital Equity Coalition Aotearoa (DECA)

Aotearoa is on the brink of a major shift in healthcare delivery, with the Government’s planned 24/7 digital health service set to launch in July. While this initiative has the potential to improve access to care for many, it also risks deepening existing inequities for the thousands of New Zealanders who are digitally excluded. 

As we outlined in our recent letter to Minister Simeon Brown, this digital-first approach will fail unless it is designed to serve all communities, not just those who are already well-connected. We urge the Government to address key concerns before rolling out this service, ensuring that digital healthcare enhances access rather than creating new barriers. 

Digital Health is Not Accessible to All 

The World Health Organisation (WHO) has made it clear that digital health services are not accessible to everyone. Those most at risk of being left behind include: 

• Older adults who may lack digital literacy or access to the necessary devices. 
• Low-income and rural communities where broadband is unreliable or unaffordable. 
• Disabled individuals for whom accessibility features in digital health platforms are often inadequate. 

Research consistently shows that digital exclusion translates directly into healthcare exclusion. The Government must take proactive steps to ensure this service does not further marginalise those already struggling to access healthcare. 

Lessons from Past Failures 

Internationally, we have seen what happens when digital health initiatives are implemented without considering equity. Scotland’s NHS digital service was intended to be a “digital front door” to healthcare, yet it was plagued by limited functionality, poor integration with GP services, and data security concerns. The result? A costly failure that left patients frustrated and disengaged. 

Closer to home, successful hybrid digital health initiatives—such as those piloted by the Ministry of Health in partnership with local communities—have proven effective but lacked ongoing investment. The Pokapū o te Taiwhenua Network, for example, used Starlink technology to deliver telehealth services to rural Māori communities, improving appointment attendance and health outcomes. On Matakana Island, Starlink-enabled telehealth services empowered nurses to deliver care directly in patients’ homes, overcoming prior connectivity barriers. Despite their success, these programmes have struggled to secure continued funding, highlighting a gap in the Government’s commitment to hybrid healthcare delivery. 

Barriers for Healthcare Providers 

It’s not just patients who will be impacted—healthcare providers are also raising red flags. A study in NPJ Digital Medicine highlights significant barriers to the integration of digital health solutions, including: 

• A lack of training and resources for healthcare professionals. 
• Poor interoperability between digital systems, leading to fragmented care. 
• Concerns about data security and patient safety. 

If clinicians are not equipped and supported to use new digital platforms effectively, the system will fail both patients and providers. 

Recommendations for an Inclusive Digital Health System 

To ensure the success of the 24/7 digital health service, the Government must act on the following recommendations: 

1. Invest in Digital Inclusion – Fund community-based digital literacy programmes and provide affordable access to devices and connectivity. 
2. Maintain Hybrid Models of Care – Ensure in-person healthcare remains accessible, particularly for those who cannot engage digitally. 
3. Support Healthcare Professionals – Provide training and resources so that clinicians can confidently use and advocate for digital health tools. 
4. Guarantee Data Security & Transparency – Establish clear policies on patient data usage and protection. 
5. Co-Design with Communities – Work directly with Māori, Pasifika, disabled communities, and low-income households to develop a system that meets their needs. 
6. Enable Zero Data Access – Ensure the service can be accessed via the Government’s Zero Data Portal, eliminating cost barriers related to Wi-Fi and mobile data. 

New Zealand has the opportunity to lead the world in equitable digital health, but only if we take a thoughtful, inclusive approach. We urge Minister Brown and his colleagues to engage with digital equity advocates, healthcare providers, and communities to ensure this service is designed to benefit all, not just those who are already digitally connected. 

DECA stands ready to collaborate and support this effort. Now is the time to ensure that Aotearoa’s digital health future is one that truly serves everyone. 

Vic MacLennan and Kris Dempster-Rivett are Co-Chairs of the Digital Equity Coalition Aotearoa (DECA), an organisation dedicated to ensuring that every New Zealander has the opportunity to participate fully in the digital world.

Image: Vic MacLennan and Kris Dempster-Rivett, co-chairs, Digital Equity Coalition Aotearoa (DECA)

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