US HealthTap tech a “poor fit” for New Zealand’s health system

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eHealthNews.nz editor Rebecca McBeth

The US HealthTap technology implemented by Waikato DHB as part of its virtual health programme was a “poor fit” for New Zealand’s public healthcare system and had no interoperability with existing clinical systems, a new report says.

The DHB has released an independent report from EY that it commissioned into its online health system, SmartHealth, provided by HealthTap.

The report outlines a number of problems with the roll-out of the service, including the lack of clinical engagement in the project and interoperability with existing clinical systems.

It says there were several technological issues early on and that the US product was a “poor fit” for New Zealand’s public health system.

Waikato DHB started implementation of HealthTap in October 2015 and commissioned an independent assessment of it in February 2018. The DHB chose to cancel its contract with the US company in April this year after spending more than $25 million on the project.

When it decided to discontinue the service, the Board cited as reasons issues with uptake among the population and lack of outcomes. It also considered the $7.2 million cost of renewing the contract was not justified.

SmartHealth included a free out-of-hours online doctor service plus online outpatient consultations with a hospital specialist, both provided on patients’ mobile phones and smart devices through HealthTap.

The EY assessment says the “big bang” approach taken to the implementation did not work and that a phased introduction would have been better and adds that the DHB was unrealistic about the timeline, uptake from the public and impact on the organisation.

Also, it states that there was no implementation plan setting a clear direction to monitor progress against and no collaboration with other DHBs in the region or with the primary care sector.

However, it notes that HealthTap performed well where it met a particular clinical need and that many people who used it were very positive about the experience.

Waikato DHB’s interim chief executive Derek Wright says there were clear failings in how the Board rolled out this system and he will ensure the organisation learns from these. 

“The report shows that we introduced a new system too quickly, without proper collaboration with staff, the community and other providers and the organisation was not ready for this huge change,” he says.

“We should have involved our clinicians early on to identify the need, rather than buy a service then work out what we were going to do with it.

“And we needed to have introduced this as a pilot in targeted areas, so we could fine-tune the system and introduce it gradually, rather than try and get all our services signed up at once.”

While the DHB will not “rush to replace HealthTap Hospital”, Wright says the report shows that virtual care is still an important strategic direction for Kiwi health providers and that Waikato hospital clinicians will continue to use telehealth solutions.

The DHB will expand the Cisco Jabber video conferencing system, which is already in use, to prevent people travelling to Waikato Hospital unnecessarily.

The DHB has published the original business case that was presented to the Board in July 2015.

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