For those operating within Aotearoa’s $2.9BN Healthtech sector, there’s little doubt that now is our moment to shine.
Globally, the Covid-19 pandemic and its resulting demands on health providers have fast-tracked appetite for digital health solutions. Locally, the legislative health reforms that came into force in July 2022 has created the opportunity to completely reframe our approach to health.
In other words, politicians, health leaders and clinicians alike expect that tomorrow’s health system will be heavily reliant on digital technologies and services – and the pandemic has encouraged New Zealanders to be open to using them.
As a nation, we have never been more ready to embrace digital health technology. But how well equipped is our industry to deliver a digital health ecosystem that truly enables better health outcomes?
The maturity of Aotearoa’s digital health firms (which average 36 years in operation) and their rate of growth (12.1% CAGR over five years) suggests that our emerging digital health ecosystem will benefit from access to solutions created by well-established local innovators. However, Spark Health CEO Dr Will Reedy says there is more to consider in terms of developing an effective ecosystem – particularly around addressing issues of health equity.
“Aotearoa’s legacy of health inequity is well documented. Statistically, Māori and Pasifika peoples, along with the disabled and members of our rainbow community, are amongst those significantly disadvantaged within the current system. That’s why, as technology becomes central to the way we approach health services, it’s time to engage in meaningful korero that goes beyond technical capability,” he says.
Promoting health equity through a patient-centric model
Traditionally, our health system has operated in a provider-centred way but, to promote better outcomes for all New Zealanders, Reedy points to growing evidence that moving to a patient-focused model is vital.
“When you look at health systems around the world that have been undergoing this process it’s clear that, to successfully migrate to a digital ecosystem, we need to be completely patient-centric. That means thinking about meeting the unique needs of various communities, rather than providing broad solutions that assume the population’s needs are homogeneous,” says Reedy.
“Overseas, examples such as the US-based Ayana Therapy app (a digital service that connects marginalised and intersectional communities with culturally competent mental health providers) are showing real impact in offering care that minority communities find accessible and effective,” he says.
Translating that into a local opportunity, Reedy gives the example of poor representation of te whare tapa whā within the current health system.
“New Zealand health practitioners are highly capable of helping their patients with taha tinana (physical health) and taha hinengaro (mental health). For Māori patients though, the two other cornerstones which make up te whare tapa whā – taha whānau (family health) and taha wairua (spiritual health) – fall outside of their remit.
With Māori being overrepresented in many areas, including diabetes, cancer and cardiovascular disease, one way of promoting equity is to focus on incorporating taha whānau and taha wairua into the digital health solutions we make available,” says Reedy.
He points to the LGBTTI community as another example.
“The 2013 ‘Counting Ourselves’ national survey looked at the health and wellbeing of more than a thousand members of our trans and non-binary community from around Aotearoa. Of the respondents, 36% had avoided seeing a doctor because they were worried about disrespect or mistreatment as a trans or non-binary person.
If we want to be successful in creating health services that trans and non-binary Kiwis feel comfortable about accessing, we need to consider their perspective at the same time as we reinvent our approach.”
Facilitating diversity and inclusion
Reedy believes that tomorrow’s digital health ecosystem has the potential to be a catalyst for achieving equitable health access for minority groups – but he stresses that a greater focus on facilitating diverse perspectives is needed.
“Within the current health system only 4.3% of doctors are Māori, despite Māori making up 16.5% of our population. While the level of disparity is reducing fractionally each year, we have an opportunity to close the gap faster by providing digital solutions that embrace a Māori perspective on care,” says Reedy.
However, he says, the only way to achieve this is by developing a diverse digital health technology workforce that offers a full range of perspectives which can be leveraged.
“Minority representation in the health sector is something that Spark Health is passionate about. Right now, our team includes people from a range of communities, and we are taking action to increase our level of diversity further.”
Among the initiatives that Spark Health has been involved with is Project Waiora – a programme designed by specialist consultancy Rea as part of its efforts to support Māori and Pasifika in building careers within the technology industry.
“Project Waiora was an incredible experience, whereby members of communities who are overrepresented in poor health statistics were able to tackle key issues head-on. The passion of those involved and the invaluable insights that their work proved just how beneficial it is when you include members of a community in the development of digital health solutions to meet its specific needs,” says Reedy.
We are all on the journey together
In addition to building diversity into the organisations tasked with delivering the various components of tomorrow’s digital health ecosystem, Reedy says there are broader issues that need to be addressed as well.
“The creation of a digital health ecosystem that secures better outcomes for New Zealanders is something that no single organisation or government department can deliver. For example, if you look at statistics around access to the internet, many of our minority communities are significantly disadvantaged – only 71% of people with disabilities report having access to the internet, while Māori households are 16% less likely to have internet access in comparison to non-Māori households.
Considering that these communities face significant challenges around health provision already, it is critical that the health tech sector and other stakeholders lean into solving challenges like data security, connectivity and device access. Ultimately, a true ecosystem is diverse and interdependent. By working together, we can create real opportunity for our health sector.”
