A virtual health system set up by Waikato District Health Board will compete with another one designed by GPs and patients, according to a health leader.
SmartHealth, previously called VirtualDHB, was launched last week on the same day as My Indici, a tele-health system created by Pinnacle, the primary health care organisation for the Midlands region which takes in parts of the Waikato, Taranaki, Gisborne and Taupo.
Both systems offer patients the ability to talk to a doctor or book appointments via their computer or smartphone.
Pinnacle chief executive John Macaskill-Smith said the DHB's SmartHealth service, which includes free after-hours doctor care, will be in direct competition with My Indici but the DHB is adamant that is not the case, saying the two systems are different.
Macaskill-Smith said DHB heads knew Pinnacle, which represents about 400 GPs across 90 practices who treat almost 500,000 patients, were building a similar system but went ahead with SmartHealth anyway.
He said SmartHealth, which he believed had cost $15 million, had limited functions compared to My Indici, and that its data was stored offshore.
SmartHealth is powered by HealthTap, an interactive health company based in the United States.
Macaskill-Smith said it meant New Zealand patient information given to SmartHealth would be held by the American multi-national company.
Data from My Indici, which extended to all community and Maori health providers as well as non-government organisations, would be kept locally as part of the patient's GP and hospital record, he said.
"It [Indici] does everything that HealthTap does and a hell of a lot more, and they knew that. We showed them that," Macaskill-Smith said.
"Why are we confusing the public by trying to enrol them in two different systems? It makes no sense."
While SmartHealth had already signed up 3000 patients, Macaskill-Smith said the current system run by Pinnacle called Manage My Health and supported by MedTech, had 70,000 patients who regularly interacted with the service.
They would be transitioned to My Indici once it was fully operational.
Pinnacle medical director Dr Jo Scott-Jones wrote to the DHB in September and October expressing grave concern about SmartHealth, including that doctors providing the service could be New Zealand-registered but resident overseas.
Waikato DHB clinical director for primary and integrated care, Dr Damian Tomic, said SmartHealth was not a GP system but included an out-of-hours "doctor service".
That included GPs, emergency doctors and urgent care physicians.
As well SmartHealth incorporated all medical professionals including doctors, nurses, hospice workers, district nurses, mental health workers and non-government organisations.
Tomic, a GP himself, said Waikato's out-of-hours doctor service was in crisis because patients either had to wait long hours or travel long distances if not in Hamilton to consult with a doctor.
"We're changing how we're providing our out-of-hours service. This is an extension of how the district health board wants to offer out-of-hours services to its population," Tomic said.
The fact a New Zealand-registered doctor could be consulting patients for SmartHealth from the United States was not a problem and not unique, Tomic said.
Liability for any adverse outcomes lay with ACC, he said, and the doctor still had legal coverage.
Doctors had a two-hour training initiation to work on SmartHealth and 50 GPs from Hauraki PHO had signed up along with some clinicians from Waikato Hospital.
Tomic admitted there had been some reluctance from clinicians but said that was standard with any major change.
DHB executive director of virtual care and innovation Darrin Hackett said SmartHealth data would also be stored on a cloud service in New Zealand and that the DHB had sought approval for the system from the Government as well as the Medical Council.
Hackett said it would also work with MedTech and a patient's consultation notes would be available to Waikato Hospital and his GP.
The Ministry of Health said it would monitor SmartHealth and evaluate it when there are more users.
Chief technology and digital services officer Giles Southwell said Waikato DHB was granted an exemption to store health information overseas in March last year.
"The ministry views SmartHealth as a complementary service being piloted for two years by Waikato DHB, to support provision of health services.
"Indici on the other hand, is a cloud-based patient management system which also allows video consultations during usual general practice hours."