New Zealand's biggest private childcare chain has signed up to Dr Lance O'Sullivan's health-by-email service, amidst mounting concerns for pre-schoolers' health in low-income communities.

BestStart Educare, which runs 280 centres from Kaitaia to Invercargill, has announced a national rollout of O'Sullivan's iMoko health service in a statement naming former Health Minister Tony Ryall as the group's new chief executive.

It's a massive step up for iMoko, which has just moved its base from Kaitaia to Auckland and hired information technology entrepreneur Jodi Mitchell as its new chief executive to lead its expansion nationwide.

It comes as a new Ministry of Education evaluation of targeted funding for centres with "at-risk" children has found 70 per cent of the centres face "a major challenge" of children with respiratory and skin infections.

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Seventy per cent of the centres also reported increased use of drugs in their communities, contributing to "high cases of head lice, dirty clothes and dirty nappies".

"One service reported that there were occasions where teachers needed to wash children's clothes for them," the evaluation says.

"One service reported bite marks on teachers and another reported that, after one violent outburst, another child required stitches."

Dr Lance O'Sullivan, with 7-year-old Brennan Morgan at Kaitaia's Te Kura Kaupapa Māori o Pukemiro in 2013, started diagnosing children in Northland schools by email in 2012. Photo / File
Dr Lance O'Sullivan, with 7-year-old Brennan Morgan at Kaitaia's Te Kura Kaupapa Māori o Pukemiro in 2013, started diagnosing children in Northland schools by email in 2012. Photo / File

O'Sullivan, who was Kiwibank's New Zealander of the Year in 2014, started offering medical diagnoses and prescriptions to children at remote Northland schools by video link and email from his Kaitaia general practice in 2012.

He started a further trial last year in 10 South Auckland kindergartens, which now also includes five kindergartens in West Auckland, and is planning a trial with 15,000 children in Otago and Southland.

KiNZ Ōtara manager Lisa Frank, who initiated the South Auckland trial after hearing O'Sullivan speak last year, said her centre had used the service about 50 times for its 50 children since the trial started nine months ago.

"They are getting the right medicines in a timely way. That means we have less absence from the centre, which obviously supports their learning," she said.

All teachers in the centres have been trained in using the iMoko app.

KiNZ Ōtara centre manager Lisa Frank measures the height of 4 year-old Yaron Koehler which goes onto to his iMoko medical file. Photo / Brett Phibbs
KiNZ Ōtara centre manager Lisa Frank measures the height of 4 year-old Yaron Koehler which goes onto to his iMoko medical file. Photo / Brett Phibbs

"When we notice a child with a skin infection or head lice, we can do an iMoko health assessment," she said.

"We take their weight, height and temperature, and we do a description of what's happening for that child and take some photos and we send all that information through to the team, and the team assesses whether there is any intervention necessary.

"Most of the children do have to have antibiotics or some creams. The team sends a prescription to the pharmacy and then the parent goes to the pharmacy to pick them up, or sometimes if the parent can't go we will go ourselves.

"Sometimes we swab children if they have a weeping wound and we take the swabs to Labtests."

Frank said the iMoko team usually rang within 20 minutes of receiving a referral.

She said it was "absolutely wonderful" that the service was going nationwide in BestStart centres, which include ABC, EduKids, TopKids, Montessori, First Steps, Early Years and Community Kindy.

"I'm so happy for the whole of New Zealand because I just know that the benefits for our tamariki have been outstanding," she said.

"If we can address the issues in early childhood, it will seep through when they get to school and they will be ready for learning."