Ka Ora Telecare - National Rural Telehealth Service

November 2023

Despite lingering questions surrounding a new rural telehealth service, the overall response from rural communities and rural health advocates reflects contentment and relief, signalling a potentially positive change in healthcare accessibility for underserved regions.

The introduction of a new rural after-hours telehealth service delivered by Ka Ora Telecare, which is formed by three existing health organisations Reach Aotearoa, Practice Plus and Emergency Consult, aims to reach rural communities as a priority group identified in Te Pae Tata, and alleviate some of the pressure placed on rural general practices. Its introduction has offered a glimmer of hope to rural communities that have long grappled with limited access to quality healthcare and is viewed as a positive step towards achieving Pae Ora.

“For those in our most isolated communities, who may only have a landline and no access to the internet, this service is a real step forward in accessing after-hours care when it is not an emergency,” Dr Sarah Clarke, national clinical director, Primary and Community Care, Te Whatu Ora says.

“Alongside this we know that our rural healthcare providers have been under pressure due to workforce shortages with staffing after hours rosters only adding to that pressure, so this is a way we can offer additional capacity and continuity of care to providers and their patients to improve the wellbeing of our rural communities.”

The service, which includes after-hours medical advice through initial consultations with a nurse or kaiāwhina, free of charge, and followed by a referral to a doctor for further consultation, if necessary, is designed to complement existing rural healthcare practices and provide them with additional capacity during after-hours and overflow period. “We maintain open communication channels to ensure co-ordinated care, facilitating a seamless patient experience between in-person and telehealth services,” Jess White from the Ka Ora Telecare leadership team says.

Ka Ora is taking proactive steps to ensure widespread utilisation of its service through community outreach initiatives, forging collaborations with rural healthcare providers, and implementing continuous awareness campaigns. There is a focus on engaging rural communities to ensure a comprehensive understanding of the service's benefits and accessibility.

One of the questions around the new service is the rationale for kaiāwhina triaging, which Mrs White clarifies do not undertake triaging. “Clinical triage is left for the registered nurses. Kaiāwhina provide culturally appropriate support and whakawhangatanga while also ensuring that patients receive the right level of care promptly. This system helps streamline the consultation process, making it more efficient.”

The service was rolled out on November 8 and is now live and operational with a number of practices and patients and whānau already using the service. Engagement and communication with practices on-boarding will be on-going. Jess says regular evaluations, community feedback and adapting to changing rural healthcare needs play a key role in ensuring the sustainability and growth of the service. “We are committed to evolving our services, focussing on accessibility, effectiveness and patient-centred care.”

“Ka Ora Telecare will be regularly monitored and evaluated for effectiveness in improving healthcare outcomes and access in rural communities. We use a range of metrics, including patient feedback, service usage data, and healthcare outcomes.”

“The results of the evaluations are used to refine and enhance our services. This includes expanding our services where needed, improving existing processes, and addressing any identified gaps or challenges.”

Anticipating a few initial challenges for patients while implementing such a vital service, such as technology issues, language barriers, and cultural differences, wouldn't be an unreasonable expectation. “Ka Ora Telecare offers consultations via landline or mobile phone. We continuously assess and adapt our services to meet the technological needs and capabilities of rural communities,” Mrs White says.

The service offers translation services as well as health professionals who are proficient in Te Reo. “Additionally, our staff are trained to use interpreting services; respect and integrate tikanga and kawa into consultations, ensuring cultural appropriateness and sensitivity.”

“We strive to create an inclusive service that is responsive to the unique requirements of our diverse rural population,” she adds.

Hauora Taiwhenua Rural Health Network are assisting Ka Ora in providing rural general practices information via its newsletter, website and co-hosting webinars. The rural health advocate organisation has said in a recent newsletter that they are reassured that the service contracted by Te Whatu Ora and Te Aka Whai Ora has the key elements that were developed through a co-design process with their representatives last year.

"Hauora Taiwhenua is delighted to be working with Ka Ora Telecare through their massive effort to roll out the rural afterhours service out in time for the summer holiday period,” Marie Daly, general manager, Hauora Taiwhenua Rural Health Network says. 

“As a rural ‘mother’ I know how invaluable this service will be for our rural whanau and fantastic that everyone who is visiting rural areas over the summer holidays, regardless of where they live, will be able to use it. The rural general practices in our ‘holiday hotspots’ will be relieved to have this additional support.”

Rural communities can access the service in two ways, by calling 0800 2 KA ORA (0800 252 672) directly or via referral from their rural healthcare provider. The 0800 service will provide after-hours clinical telehealth care (5.00pm – 8.00am) on weekdays, and 24 hours a day on weekends and public holidays. The service is staffed by kaiāwhina, nurses, GPs and emergency medicine specialists. The service will provide access for people in rural areas whether they are enrolled or unenrolled with a primary care practice.