The global health system faces many challenges; many of which have been highlighted by the Covid-19 pandemic. In March 2020 it became obvious that the health system was under-resourced to deal with any serious pandemic. By way of example, in our home country of New Zealand, ICU bed number per capita is one third of the OECD average. In addition, we are in a situation where demand for healthcare outstrips supply. In our mental health system, for example, wait-times to see clinicians are incredibly, and probably dangerously long; access is difficult, and in-patient services are limited. Finally, not only is our system under-resourced, the global health system is characterised by inequities. Who you are, and where you come from, determines both access to, and outcomes from, healthcare.
In a system where there is unmet need and a strain on resources, healthcare tends to focus on, and is consumed by, those who are on the ‘very unwell’ end of the wellbeing spectrum. As a result, preventive health programmes and initiatives are limited. Preventive programmes focus on keeping the well in good health, help to support those who are moderately unwell, and help support patients to self-manage their health conditions so as to avoid disease progression. When we consider the prevalence of long-term health conditions, such as diabetes or various cardiovascular conditions, and the rise of psychological distress, this represents a real problem. When we fail to deliver preventive health care, timely healthcare, and healthcare that focuses on self-management, we fail to reduce the risk of people developing co-morbidities and becoming very unwell; and; we fail to decrease the overall disease burden. This is a huge challenge for a health system that is already struggling.
In this context we need to change the way we deliver healthcare and the way in which people consume healthcare.
First and foremost, we need to address inequities in health. Your health, and healthcare, should not be contingent on who you are, where you live and what you want or need. Second, and relatedly, we need to remove barriers to consuming healthcare such as access and cost. This is particularly important for mental health. Third, we need to focus more on preventive health programmes. If we can focus more on prevention, we can reduce disease onset and associated psychological distress and subsequently reduce the need for healthcare per sae. This should reduce demand on already over-stretched services. Finally, we need to proactively support those who are managing long-term health conditions to reduce disease progression, enhance quality of life, and ensure good adherence to treatment.
To this end, Pukeko Health is launching a suite of online health programmes to meet these healthcare challenges and demands. Our programmes cover the wellbeing spectrum, and are designed to help people proactively manage their health and wellbeing so as to keep well and to manage their health when they are faced with psychological and/or physical health problems.
Our programmes, which are delivered via a phone app, are designed by health experts and clinicians, and are therefore evidence-based. Each programme provides patients with easy to read “psychoeducation”, followed by interventions, and easy “to-dos” or action plans. The programmes have been designed to mirror or replicate what a patient would experience if they were face-to-face with a clinician. This adds to the power of our interventions; unlike most other apps our products are multi-faceted and in-depth, which gives the user the key information, skills and training that we believe they need. The utility of the programmes being delivered via an app also means we are in a good position to keep engaging with patients and setting reminders and challenges as they continue to use the programmes and attend to their health.
At present, our programmes are on: sleep (how to get a good night’s sleep!); stress management; healthy eating (establishing a healthy relationship to food); exercise (how to get moving more); employee wellbeing (and managing distress in the workplace); and, there are comprehensive programmes on anxiety management and depression management. Our programs are collaborative; along with those we have developed we have also licensed NIHI’s clinically proven and published self management programs (Diabetes, Exercise, CVD, Cardiac Rehab, smoking cessation). Each of these programs have proven outcomes, published in leading clinical journals, including the BMJ and Lancet.
While many of our programmes can be used as prevention tools (e.g. eating well or exercise) or stand-alone interventions (e.g. stress management) a key feature of our programmes is that they can be used to help support clinicians and health workers. In particular, and as aforementioned, wait-times to see a health professional can be incredibly long. For example, standard wait-times in the public sector to see a psychologist are around six to seven weeks, if not longer. As such, our programmes are designed to help bridge the gap between referral and being seen. By doing so, not only are we preventing co-morbidities from occurring or disease progression, we are helping to deliver healthier, and less distressed, patients to clinicians. This should mean desirable 1:1 therapy outcomes can be achieved more quickly helping clinicians to reduce the time that people are waiting to see them. In addition, our programmes have also been designed to be used in conjunction with seeing a clinician. For example, for psychologists, our programmes can be used to aid with patient ”homework” (e.g. meditation exercises), or for generalist and specialty practitioners, our programmes can help support these clinicians by helping support their patients to manage their health at home, manage their sleep, or manage stress.
Supporting clinicians is at the core of the Pukeko Health platform. Our platform allows our programmes to be used in conjunction with health or mental health coaches. When our platform is used in this way, coaches are able to regularly engage with people as they work through the programmes. Coaches are able to chat with patients, set up action plans or goals, and measure their progress. In this way, coaches are able to provide people with high quality care to enhance their outcomes and engagement in the programme, such as reaching health goals. We are also able to tap into a health workforce that is currently underutilised and thereby reducing demand on clinicians who are already at (or past) capacity. The utilisation of health-coaches again can be used as a standalone intervention, to manage long wait-times, or to enhance outcomes as a patient engages 1:1 with a clinician.
Pukeko believes that it has some solutions to the issues and demands of our current health system; and; especially In the context of a pandemic, when our wellbeing, and particularly our mental health, has never been so challenged .
Like to find out more? We’d love to hear from you. You can contact our Clinical Director, Emily, on: [email protected]