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Changing the Lives of Those with Poor Healthcare Access

In a country where universal healthcare is provided as a public good, you might wonder why anyone has poor access to healthcare. The reasons are myriad and complex, but the fact remains many people do have poor access, and those same people also tend to have worse health outcomes. This has given rise to well-researched health inequities.

Health Equity

To achieve health equity we must first understand how and why inequities arise, then plan to overcome them with targeted initiatives that improve access to healthcare where it is needed most. Funding initiatives that create low-cost equity of access for priority populations in priority areas can reduce inequities and increase life expectancy.

Priority populations include Maori and Pasifika, rural populations, older people, and people in financial hardship. These groups aren’t mutually exclusive, they overlap, which leaves many people particularly disadvantaged.

Disease Burden

Within these groups there are also priority health issues that demand more attention due to the significant burden they impose on people. Disease burden can be measured in terms of disability adjusted life years (DALYs). This was the starting point for a 2010 NZ study, which ranked 8 major risk factors based on their negative social and economic impact. Other prioritising criteria included the existence of effective preventative interventions and the contribution of the risk factor to health inequalities.

One of the top three major risk factors that researchers from Otago University identified as “highest priority” was high blood pressure.

High blood pressure was given the highest priority because:


International research shows that telemonitoring is one of those preventive interventions that high blood pressure is amenable to. Telemonitoring works by using technology to connect patients with health professionals so they can be monitored in their own home. Among other things, telemonitoring has been proven to be effective at reducing blood pressure for patients with hypertension. The challenge has been how to create an affordable telemonitoring service for priority populations, many of whom have poor access to devices and limited experience of technology. Bear in mind there is little capacity in the health workforce to manage a new telemonitoring program.

Manaaki Mamao

In New Zealand, Hato Hone St John has stepped up with an innovative new community heart program. The program is called Manaaki Mamao and it uses telemonitoring to help Maori and Pasifika with diagnosed hypertension get their blood pressure under control.

The six-month program, which is fully funded, provides patients with an easy-to-use telemonitoring system created by Spritely. It’s easy for patients to participate from home, there is no cost and patients are empowered to manage their own health with clinicians monitoring their progress remotely.

If we can identify the most at-risk people and use telemonitoring technology to routinely engage with them, then we can create better health outcomes through earlier interventions. Actively monitoring at-risk people and helping them to manage chronic illness can prevent ill-health.


Prevention is better than cure. This phrase is “often attributed to the Dutch Philosopher Desiderius Erasmus in around 1500. It is now a fundamental principle of modern health care”. Prevention has always been a priority for public health. Through the long history of vaccine development to modern day cancer screening.

Perhaps no-one made the case for prevention more poetically than writer Joseph Malins. In 1895 he wrote a wonderfully apt piece of prose called “The Ambulance Down in the Valley”

"Said one, to his peers, 'It's a marvel to me That you'd give so much greater attention To repairing results than to curing the cause; You had much better aim at prevention.'"

To read the entire poem (recommended) click here.

Prevention is also enshrined in New Zealand’s current health reforms. The Pae Ora (Healthy Futures) Act 2022, established Te Whatu Ora (Health NZ) and Te Aka Whai Ora (The Maori Health Authority) to, among other things,

“prevent, reduce, and delay ill-health, including by collaborating with other agencies, organisations, and individuals to address the determinants of health”.

When we invest in prevention, we save the health system money in the long-term. These savings can be used to improve healthcare for patients and working conditions for healthcare professionals.

When we strategically invest in prevention, we can reduce inequities and achieve even bigger returns for society. To get maximum value from prevention, we need to identify the main areas of need, and strategically target investments to prevent illness in those areas.

Rehabilitation and Recovery

Unfortunately, not everything is preventable. That’s why we have rehab and recovery. Telemonitoring can help with that too. Remote monitoring has been shown to improve health outcomes for people who want to bounce back from an adverse event, recent surgery, or a new diagnosis.

When recovering patients struggle to access health care and clinicians struggle to connect with their patients, things can be missed, and people can end up readmitted to hospital.

Telemonitoring that is easy-to-use and simple to access can reduce ED visits, hospital readmissions and medication errors. It can also reduce pain through regular assessment and consultation.

Telemonitoring increases clinical contact and enables earlier interventions. This reassures clinicians and patients by actively helping them to manage and comply with their treatment plans. This can make a material difference to health outcomes following something like cardiac surgery.


The core benefits of telemonitoring should be obvious. Among other things telemonitoring can:

The problem is that the people who could benefit from telemonitoring the most, are often the people who struggle to access it, compounding inequities in the health system that already exist due to poor access. Equity-led telemonitoring can address this.

Spritely telemonitoring is a hugely cost-effective way to overcome access issues for some at risk people who could benefit from active observation and more routine interactions with health professionals.

Remote monitoring using Spritely can save the health system money and improve outcomes for patients. If you are a health professional wanting to improve healthcare access for your patients then please get in contact.