Piki Te Ora: empowering better health together 

Te Whatu Ora and Te Aka Whai Ora believe that everyone deserves equitable access to the best possible healthcare, regardless of where they live.  

We are excited to introduce Piki Te Ora, a Remote Patient Monitoring pilot, that partners with four rural communities to co-design and co-develop a better way to improve and support people who are living with long-term health conditions. 

The primary goal of remote patient monitoring, in the context of Piki Te Ora, is to make healthcare more accessible and effective and to empower patients and their whānau to take an active role in their health management. 

What is Piki Te Ora remote patient monitoring?

Remote Patient Monitoring, as part of the Piki Te Ora initiative, is a healthcare approach that allows healthcare providers to collect and monitor health information from patients in remote or rural areas. Here's what it involves: 

Data Collection: Patients use a mobile application called Piki Te Ora to input and upload their personal and health information. This data can include vital signs, symptoms, using medication and other relevant health data. 

Secure Transmission: The data is securely transmitted to a central healthcare system where it can be accessed by healthcare providers. 

Continuous Monitoring: Healthcare providers can continuously monitor the patient's health remotely. They can set thresholds or alerts for specific health parameters. If any data falls outside normal ranges or triggers an alert, the healthcare provider can take appropriate action. 

Better Decision-Making: This real-time monitoring allows for more informed and timely decisions regarding the patient's care. It can lead to early intervention, preventing health deteriorations and reducing the need for hospitalization. 

Patient Empowerment: Patients are actively involved in managing their own health. They have access to their data, which can help them understand their condition better and take actions to improve their health. 

Community Collaboration: The program may involve collaboration with local communities, healthcare providers, and individuals to ensure that the monitoring process is designed with the community's input. 

What is happening in the pilot?  

Te Whatu Ora is partnering with Te Aka Whai Ora and four pilot communities of 15 users each to co-design and co-develop a better way to improve monitor for whanau with long-term health conditions. 

This voluntary project spans two years and aims to collect health information from those who wish to participate. The intent of this pilot is to identify and collect the right health information in a readily consumable, equitable, and accessible way for both users and clinicians. Our goal is to enable better and faster health decisions for those who live in rural areas, ensuring that geography is never a barrier to receiving quality care. 

These four locations began as community hubs for COVID-19 and have been identified by Te Aka Whai Ora as locations where we can continue to support growing their community model of care: 

The communities are:   

  • Te Tai Tokerau – Whakawhiti Ora Pai 
  • Ngāti Porou Tairawhiti – Ngati Porou Oranga 
  • Matakaoa - Manaaki Matakaoa and Ngati Porou Oranga 
  • Chatham Islands – Te Whatu Ora and Ha te ora o te Wharekauri 

Piki Te Ora mobile phone application: Your health at your fingertips 

A critical component of this project is Te Whatu Ora Piki Te Ora mobile application, which is designed for both Android and iOS platforms. Te Whatu Ora engaged Alphero to build the Android application and is developing the iOS version in-house. 

The purpose of the Piki Te Ora application is to: 

  • Collect and collate personal and health information about an individual. 
  • Make it available for them to read, understand, and act upon (future releases as applicable). 
  • Make it available to the individual's health provider to inform clinical decision making (future releases). 

In this pilot, the Piki Te Ora application is available to individuals on phones generously provided by that Samsung. 

How is this pilot being funded? 

Te Aka Whai Ora has invested $2.3 million into four whānau-led pilots in remote rural areas to test the effectiveness of remote patient monitoring in achieving improved hauora outcomes and reduced rates of hospitalisation and visits to emergency departments for whānau living with long-term conditions. Te Aka Whai Ora is working alongside Te Whatu Ora to support hauora Māori partners based in Te Tai Tokerau, Te Tairāwhiti, and Wharekauri to deliver the whānau-led pilots. Te Aka Whai Ora is funding the service delivery costs, and Te Whatu Ora is providing remote patient monitoring devices and supporting technology. 

Our partners: 

Our partners in this pilot include: 

  • Communities in:   
  • Te Tai Tokerau – Whakawhiti Ora Pai 
  • Ngāti Porou Tairawhiti – Ngati Porou Oranga 
  • Matakaoa - Manaaki Matakaoa and Ngati Porou Oranga 
  • Chatham Islands – Te Whatu Ora and Ha te ora o te Wharekauri 
  • Te Aka Whai Ora – Commissioning/Relationships 
  • Alphero – Consumer-based platform Piki Te Ora 
  • BPAC – primary care clinical platform (future release) 
  • Quantum – Security 

Your data security is our priority 

Rest assured, your personal health information will be held in strict accordance with Te Whatu Ora's Privacy Statement, alongside other relevant regulations, such as the New Zealand Privacy Act 2020 and the Health Information Privacy Code 2020. We have implemented robust security measures to store your information securely, following Te Whatu Ora privacy standards, which outline necessary security protocols and best practices for handling personal data.  

Privacy statement for Remote Patient Monitoring Pilot 

Te Whatu Ora is partnering with Te Aka Whai Ora and four pilot communities of 15 users each to co-design and co-develop a better way to improve the monitoring processes for people particularly Māori with long term health conditions.  

This Remote Patient Monitoring Pilot is a voluntary project spanning two years to collect health information from those who wish to participate.  The intent of this pilot’s approach is to identify and collect the right health information in a readily consumable, equitable and accessible way for both users and clinicians, so better and faster health decisions can be made for those that live in rural areas.   

Keeping the information safe 

Your personal health information will be held in accordance with Te Whatu Ora’s Privacy Statement alongside other relevant regulations such as the New Zealand Privacy Act 2020 and the Health Information Privacy Code 2020. Security measures are in place to store information securely by following Te Whatu Ora privacy standards, which outline necessary security protocols and best practices for handling personal data. 

Who can see and access what information? 

Individual: Participants cannot see all their personal and health information within the Piki Te Ora application. The individual can: 

  • View their vital health information the time it is taken 
  • View their personal and health information in Google Health Connect or device applications 

 

Individual’s whanau: Individuals can decide to share their information with whānau or any other person if they choose to. In a future state, plans are underway to allow automatic alerts to those a participant wishes to include.    

 

Te Whatu Ora – Data and digital: We (and our contracted partners – eg. Alphero and BPAC) will have access to the information to undertake service improvement, information management, security and privacy related activities. This access is governed by standard operating procedure within Data & Digital and all access is controlled by role and logged in accordance with the HIGG and the NZISM. Binah and Atomic do not have access to any of the information. 

 

Te Aka Whai Ora:  Will not be able to access individual level information. 

Te Whatu Ora will make available to Te Whatu Ora aggregated and de-identified information resulting from our analysis of the Piki Te Ora application and this pilot.  

Community partners (and individual’s clinicians): It is expected, on or around December 2023, that an individual’s clinician will be able to view within their PMS the vital health information about the individual that has been collected and collated by the Piki Te Ora app.    

What’s the purpose for the collection of personal information? 

As outlined above, this pilot will go live in 2023 and will run for a period of two years. 

There are several purposes of this Project, including: 

  • Trialling the Piki Te Ora application in the Pilot. 
  • Providing vital health information to individuals in rural communities who may not ordinarily engage in the health sector.Enabling individuals to view, understand and act upon their own vital health information, including those with existing long-term health conditions; and 
  • Enabling (in releases expected around December 2023), an individual’s clinician to view the health information within their Practice Management System, supporting the provision of health services to the individual. 

As this Project is a pilot, it may be that purposes change slightly over time once as the Project progresses and benefits of making this information available to individuals and clinicians is realised. 

As the Project progresses, if the lawful purposes of collection change from those stated above, the Project team will engage Te Whatu Ora  Privacy and this Privacy Impact Assessment will be updated as required. 

What’s being collected? 

Personal Information 

Source 

Purpose 

Full Name 

NHI 

Date of Birth 

Contact information (email and phone) 

The Project does not collect this demographic information directly from individuals. 

An individual logs in to the Piki Te Ora app via My Health Account. The individual is required to have an “Identification Level 3” My Health Account to access Piki Te Ora app. 

As Piki Te Ora integrates with My Health Account, the application pulls the demographic information from My Health Account and makes it available to view within an individual’s profile: 

Personalised the Piki Te Ora app experience for the relevant individual 

Blood pressure 

Heart rate 

Heart rate variability  

Oxygen saturation 

Breathing rate 

Parasympathetic activity 

Sympathetic stress 

Pulse respiratory quotient 

Binah Wellness Score 

Te Whatu Ora has built the Binah.AI Algorithm into the Piki Te Ora app. 

This feature enables an individual to complete a “Health vitals scan” from within the Piki Te Ora app using the camera on their phone/device.  

Following a 60 second scan of the individuals face, the information listed to the left is visible from within the app. 

 

There are two purposes for collecting this information: 

  1. For the person to have information about the state of their health 

For them to share this with others. Initially this will be with their healthcare provider (contracted to Te Whatu Ora and Te Aka Whai Ora). This allows the provider, Te Whatu Ora and Te Aka Whai Ora to deliver care and improve the care that is delivered 

Weight 

Gifted consumer grade scales and Google Health Connect 

Te Whatu Ora has gifted consumer grade smart scales to individuals involved in the pilot. 

The Piki Te Ora app does not collect this information directly from the scales itself, but via the Google Health Connect application.  

The Google Health Connect application is an “intermediary” application that collates information from various devices. As Piki Te Ora integrates with Google Health Connect the collated information is visible in our application.  

Systolic blood pressure  

Diastolic blood pressure  

Heart rate  

Heart rate variability 

Respiratory rate  

Oxygen saturation in Arterial blood by Pulse oximetry  

 

Samsung Smart Watch and Google Health Connect 

Samsung gifted individuals involved in this pilot smart watches. 

The Piki Te Ora app does not collect this information directly from the watch itself, but via the Google Health Connect application.  

The Google Health Connect application is an “intermediary” application that collates information from various devices. As Piki Te Ora integrates with Google Health Connect the collated information is visible in our application. 

 

Symptom Survey initially including two questions: 

 

  • Do you have any symptoms? 
  • Do you have anything else to tell us? 

ATOMIC 

Survey available within the Piki Te Ora application. 

We note that it is expected that the symptom survey will be made available to individual’s daily. The frequency of availability of the survey may change based on optimal user experience. 

Symptoms 

  • Short of breath 
  • Tiredness or weakness 
  • Ankle swelling 
  • Rapid or irregular heartbeat 
  • Wheezing 
  • Cough 
  • Chest pain 
  • Poor sleep 
  • Weight gain 

If an individual selects that they do have symptoms from the daily Symptom Survey, they are given a list of pre-set symptoms that they can “select” that apply.  

There is no free-text field for symptoms. 

It is expected that the list of symptoms may change over time and across the Chronic Diseases we wish to capture. 

Feedback Survey 

  • How do you rate this service (1-5) 
  • Do you have any feedback you want to provide? 

Survey available within the Piki Te Ora application. 

We note that it is expected that the feedback survey will be made available to individual’s once a week. The frequency of availability of the survey may change based on optimal user experience. 

IP address 

Links clicked on 

Date and time visited the app 

Operating system on the device 

 

Google Analytics on the back end of the Piki Te Ora app 

Please note we treat IP address as Personal Information in accordance with the recommendation of the Office of the Privacy Commissioner. 

 

Any other personal health information collected by an individual’s smart device that they voluntary connect to the Piki Te Ora app. 

 

If individuals have their own smart devices (e.g., a Fitbit) they are welcome to use those smart devices and connect them to the Piki Te Ora app. As a consequence of the voluntary connection, Te Whatu Ora can collect additional personal and health information about the individual. 

The Piki Te Ora application will not integrate directly with other smart devices- currently it integrates with Google Health Connect. 

Enable individuals to use their own devices to collect and view information about the state of their health (and in later stages make it available to their health care providers) 

How long will the information be kept for? 

This information will be stored in accordance with the Public Records Act and Health Information Regulations 1996 – along with the other information held in the FHIRworks service. 

All information collated from the various information sources in the Piki Te Ora app will be retained for 10 years. 

How can a person view or change any information about them?  

Because this is a voluntary pilot, all whānau members can choose to provide all, some or none of the data/information, and can ask to opt out or be removed the program at any time if they so wish. 

To be removed from the pilot please contact your Kaiawhina with your local health provider.