Telehealth reduces health inequities for whānau

Telehealth reduces health inequities for Māori whanau, according to new research published in the New Zealand Medical Journal (1 April).

The researchers, all Māori and working in the health sector, interviewed Māori patients and health providers about use of telehealth (phone or video) versus consultations during the first March 2020 lockdown and analysed the results to identify themes.

“We knew telehealth had the potential to improve access, but we wanted to hear first-hand what was useful,” says Associate Professor Matire Harwood in the University of Auckland’s Department of General Practice and Primary Healthcare.

“It turned out it enabled tino rangatiratanga - patients felt able to self-determine ‘when I can access care and who I can talk to’. They said, ‘I felt listened to’ and ‘It was a partnership’,” Matire says.

The other advantages included saving travel time and costs, and being more convenient for people to fit around work and whānau commitments.

“On the other side, health literacy was a challenge, with doctors asking patients for their temperature or blood pressure; making assumptions people had thermometers at home. Some patients said there were words used they hadn’t heard before,” Matire says.

“In the clinic, nurses do those tests before the appointment. Doctors are assuming people know what needs to be done and are able to give them the health data they need.”

The researchers concluded there needed to be an option for face-to-face
consultations, but telehealth did have potential to reduce inequities.

“This year, the Government has recognised Māori health providers fill in gaps in care and have directly funded Māori and Pacific providers,” Matire says.

“Māori providers could use this as an opportunity to come up with innovative ways to move more into the telehealth space. For example, a colleague reminded me yesterday of an Alaskan model where, in rural areas like the East Coast, there could be medication vending machines. After a telehealth consultation, the patient could get a code and go to the vending machine to get their medication.”

However, these need to be supported by good telecommunication, with whanau having access to phones, good broadband, mobile coverage, affordable data, as part of a national communications plan.