Closing the gap, not widening it: How telehealth in primary care can support continuity of care

October 2026

A collective view from the NZ Telehealth Forum Digital Health Equity Network 

Telehealth works best when it grows from the relationships whānau already trust

Telehealth has opened up real possibilities for whānau who have long found the system hard to access, those in rural areas and in outer suburbs with patchy public transport, in households juggling shift work and childcare, or in communities where the nearest general practice is an hour's drive away. Being able to consult a clinician from home can remove the petrol cost (which have been challenging over the past 6-months), the half-day off work, the childcare puzzle, the long wait in a room that was never quite designed with them in mind. That is worth celebrating, and worth building on.

At the same time, there's an opportunity in front of the Digital Health Equity Network to make sure this progress reaches its full potential, by helping virtual care grow from a person's existing relationship with their own registered provider, wherever possible, rather than only through a one-off consult with a clinician they've never met. This isn't a criticism of the platforms making virtual care possible today; it's a call to invest just as much in enabling the providers whānau already know and trust to offer that same convenience themselves.

Accessibility and continuity, working together

For many whānau, especially Māori and other underserved communities, equity isn't just about reaching a clinician — it's about reaching a clinician whānau have an established relationship with: one who knows your whakapapa of illness, your family context, the plan you made together last time, the medication that didn't agree with you. Continuity of care is where trust gets built, and that trust is often the precondition for everything else primary care is trying to achieve.

Equity work happens over time, consult by consult, relationship by relationship.

A hybrid model

National telehealth providers have an important and legitimate role to play, particularly for transactional, episodic care, the kind of consult that doesn't require ongoing clinical history, or that fills a genuine gap when someone's own enrolled provider can't yet offer a virtual option. Used this way, national platforms are a valuable safety net and access point, especially while general practices, particularly rural, high-deprivation, and Māori- and Pacific-serving practices, build up their own capability to deliver virtual care.

A hybrid telehealth model done well, means whānau always have somewhere to turn, and are gradually offered more chances to receive that care from a provider who already knows them.

So what? 

If the health system wants to lead on equity, we collectively need to broaden the conversation from "can whānau get online care" to "how do we help whānau get online care from the provider who already knows them, with national platforms supporting where gaps remain." In practice, that could look like:

• Funding and infrastructure that help primary and community care providers, build their own virtual care capability, alongside (not instead of) national telehealth options.
• Scale the digital equity investment (devices, connectivity, digital literacy support) paired with relationship continuity, so access and trust grow together. 
• Procurement and commissioning approaches that recognise and support both parts of a hybrid model: national providers for transactional and gap-filling care, and registered providers at the centre of ongoing virtual care for their own patients.
• A shared commitment, across funders and providers, to designing accessible and continuity together, rather than trading one off against the other.

Telehealth has real potential to close long-standing equity gaps for whānau underserved by a system built around geography, transport, and 8am phone queues. That potential grows even further when virtual care is offered as an extension of existing relationships of trust, with national telehealth providers playing a valued supporting role alongside enrolled providers who are being resourced to do more of this work themselves. Accessibility and continuity, working hand in hand, is what real equity looks like.