A multimillion-dollar virtual health system set up by Waikato District Health Board is failing to attract the targeted numbers of patients and doctors.
SmartHealth was initially aimed at covering 30 per cent of all outpatients, many of whom have to drive hours to Waikato Hospital for an appointment which might only take five minutes.
The virtual health system, believed to have cost $15 million, offers appointments via smartphones, tablets and computers, to save time and money for patients and doctors.
But sources close to the health board claim the actual figure of outpatients using SmartHealth was less than 1 per cent in the most active service, more than two years after the DHB began setting up the system.
Hospital services include paediatrics, oncology, orthopaedics, maternity and many more.
The most successful service in terms of the SmartHealth initiative only had a take-up of less than 1 per cent of outpatients, the sources claim.
In documents released to the Herald under the Official Information Act, it states the DHB's target is for 40 per cent of outpatients to be using SmartHealth by December, and 40 per cent of all contact with patients to be through SmartHealth.
In a July report, under significant issues, the possibility of a wider service failure to embrace SmartHealth was identified, and listed as possibly having a "major" impact.
SmartHealth was launched as a pilot in November last year, the same week as a GP-run virtual health system known as My Indici.
In a letter this month to the Ministry of Health complaining about Waikato DHB, the organisation responsible for My Indici - Pinnacle Midlands Health Network - said the health board continued to invest in SmartHealth "with no apparent accountability".
The letter said SmartHealth provided free access to after-hours doctors in direct competition with its publicly-funded GPs.
"SmartHealth is a narrowly focused solution that replicates a portion of the functionality in our Indici patient health information system," the letter states.
"It beggars belief that the DHB has committed $15m-plus of public money and made no effort to consult in a meaningful way when they knew of our plans for Indici and continue to persevere with SmartHealth despite poor uptake."
In March the Herald revealed the controversial project cost taxpayers almost $92,000 in travel by Waikato DHB staff to the United States.
The travel, for "project initiation", was undertaken by DHB chief executive Dr Nigel Murray and board chairman Bob Simcock as well as five trips for managers, and four for clinical staff between November 2014 and April 2016.
Murray's expenses of $18,239, related to the project, are now part of an investigation into his alleged unexplained spending since becoming CEO in July 2014.
DHB executive director of virtual care and innovation Darrin Hackett said 7800 patients were signed up to the service but admitted on further questioning that only 48 per cent of that figure, or 3744 people, had used the service.
Hackett said the target was to have 10,000 patients signed up by now and 20,000 by the end of the year, out of a possible 400,000 people in the Waikato DHB catchment area.
It was unclear how many of the 3744 patients had a video consultation, with a lot of patients using text messages.
When asked about the less than suggested 1 per cent take-up for outpatients, a DHB spokeswoman said Hackett did not have figures around the percentages yet, or around how many of the 2800 doctors signed up to SmartHealth were actually using it.
The spokeswoman said Hackett could not account for the claims and the DHB believed the renal service alone had an uptake in excess of 1 per cent.
SmartHealth was now linked with Healthline so that Waikato callers were being offered one of the virtual health doctors. They can then sign up after the consultation.
It also incorporated all medical professionals including doctors, nurses, hospice workers, district nurses, mental health workers and non-government organisations.
Meanwhile HealthTap, the American company that powers SmartHealth, set up an Asia-Pacific hub in Hamilton in May.