After-hours doctors for the failed SmartHealth app cost Waikato District Health Board almost $670,000 in less than one year.
And a review of the controversial virtual health project by EY (Ernst and Young) is costing taxpayers $240,000.
The figures, admitted by the DHB under questioning from the Herald, add another $908,000 to the $18 million online doctor service that was canned last Monday after only attracting 10,000 users in two years.
And the amounts don't yet take in the after-hours cost for the latest financial year.
The $668,000 spend, between September 2016 and June last year, to contract 12 after-hours doctors has been labelled madness by one critic who pointed out the service was in direct competition with after-hours clinics also funded by the DHB.
The funding could have had a "massive impact" in primary care services, according to John Macaskill-Smith, the chief executive at Pinnacle Ventures - whose parent group represents 400 GPs across the Midland region.
"That money could have been put toward subsidising patient co-payments in places like [24-hour clinic] Anglesea or real primary care places."
He said the money could have been funnelled into existing after-hours doctors in rural and remote areas.
"Once again $700,000 could have been paid to GPs right across the region to increase that service around after-hours.
"When you divide those costs by the number of patients who go through it, some of those consultations could have been thousands of dollars. It's just madness."
However Waikato DHB interim chief executive Derek Wright said the DHB was already spending $5m annually on primary care out-of-hours services across the district, including keeping Anglesea Clinic open 24 hours.
"But despite this and despite the SmartHealth access being on over Easter our emergency department was still incredibly busy."
He was now focused on improving after-hours care, one of the only popular services offered by SmartHealth.
Waikato DHB virtual care and innovation executive director Darrin Hackett said a total of 1911 SmartHealth after-hours consultations had taken place since the service began in September 2016 using two doctors rostered on duty at one time.
"As well as answering contacts from patients, they also answered written questions within the app and provided Kiwi health information content," Hackett said.
The service ran from 6pm to 11pm, Monday to Friday and 8am to 8pm on weekends and public holidays, and doctors were paid a rate of $150 per hour.
Of the GPs and urgent care doctors recruited to run the service, one was a Waikato Hospital emergency department doctor contracted separately by the DHB.
SmartHealth was launched in May 2016, but the app came under pressure last year when targeted users failed to sign up.
The Herald revealed in March last year that disgraced former DHB chief executive Dr Nigel Murray, former chair Bob Simcock and some staff spent almost $92,000 travelling to California to assess the app, provided by American technology company HealthTap.
A US$10.5m contract proposal [NZ$16m], was driven by Murray and Simcock and rushed through board approval within one month in mid-2015.
The business case for the proposal has never been made public and the cost of the contract was only released by the DHB following a damning Audit New Zealand review of the procurement process in December last year.
The Office of the Auditor-General is now investigating that procurement.
Late last year the DHB commissioned EY at a cost of $240,000 to review SmartHealth but before the review could be completed the DHB announced last Monday it would shelve the app ahead of contract renewal negotiations with HealthTap due in May.
Chief of staff Neville Hablous said the DHB decided to quit SmartHealth because it was facing severe financial pressures and could not afford another $7.2m to renew the contract for a third year with HealthTap.
The EY review, due at the board in late May, is expected to expose the total cost of SmartHealth, which the Herald believes to be in excess of $18m, including equipping staff with smart technology such as iPads and more than $339,000 in marketing and advertising.
Its brief included:
• Reviewing the implementation of the HealthTap technology;
• Identifying whether the DHB met key performance indicators;
• Progress made and barriers to implementation;
• Assessment of costs and benefits;
• How third parties found the system and an assessment of the reliability and usefulness of the technology.