A virtual health app launched by Waikato District Health Board in May last year, has attracted only 853 video consultations in 18 months, roughly 10 a week.
The SmartHealth virtual health care service, believed to have cost the DHB $17 million, has attracted a total 2422 consultations in that time, according to figures released to the Herald under the Official Information Act.
That would put the cost of the app so far at just over $7000 per consultation, considerably more expensive than a visit to the doctor.
So far 6923 patients have activated accounts out of 9181 people who have signed up to SmartHealth, which offers appointments via smartphones, tablets and computers.
Waikato DHB virtual care and innovation executive director Darrin Hackett said the target is for 12,000 patients to be signed up by the end of this year, 15,000 by the middle of next year and 20,000 at the end of 2018.
The targets appear to have lowered since earlier this year.
He said there were 2827 clinical staff signed up to the system but only 1392 had "claimed accounts" or were active users.
The information also showed the number and cost of smart devices bought by the DHB for staff to implement SmartHealth. They include:
• 1031 iPads and accessories $1.47 million
• 210 iPhones and accessories $350,386
• Data plan for iPads and iPhones $245,606
• Computer and miscellaneous equipment $198,899.
Hackett said the move to a mobile workforce was needed by the Waikato DHB and would have been undertaken regardless of the deployment of SmartHealth.
In total the DHB spent $2.8m on making the workforce mobile, including infrastructure investment to enable use of the devices. It also spent:
• $627,668 on support services for patients and doctors to make the system work.
• $338,643 on a public information programme to raise awareness among the public and staff and encourage sign-up.
• $497,569 on system integration between the clinical records of HealthTap, Waikato DHB and the patient's GP.
Including the mobile workforce costs the total spend was $4.27m.
However the DHB would not release the costs for HealthTap, the American interactive company that powers SmartHealth.
That cost and the strategic business case for SmartHealth, presented to the board in July 2015, were withheld because the DHB is "undertaking preliminary negotiations for the renewal of licences".
The DHB is reviewing its contract with HealthTap ahead of the end of the trial period in May next year.
Waikato DHB interim chief executive Derek Wright said the review was not about discontinuing SmartHealth because virtual health would continue.
The review would determine whether the DHB continued with HealthTap or moved to a "homegrown" provider, starting with a workshop for board members on Tuesday to set the terms and references.
He said there had been a lower than expected uptake of SmartHealth but that virtual health was important to save both patients and doctors time and money.
When asked if the link between HealthTap and Waikato DHB was broken after the resignation of former executive Dr Nigel Murray over an expenses scandal, Wright said the DHB still used the company but that Murray had been a champion of HealthTap.
The board was presented and signed off on the proposal for HealthTap in one month, in mid-2015 and Murray and board chairman Bob Simcock made the final decision over committing to the company based in Silicon Valley, near San Francisco.
In May HealthTap set up an Asia-Pacific hub in Hamilton, but its employee Anita Hogan left after five months in the job.
She hot-desked for a few weeks at the DHB's KPMG office, which is undergoing a $14.7m refurbishment to house 800 staff.
Wright said the DHB was unaware if HealthTap had employed someone to take over Hogan's role but that there was no room for a HealthTap employee at DHB premises.
A lawyer and communications manager for HealthTap have not returned Herald calls.