Background and aims
Rates of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among New Zealand Māori and Pacific are among the highest reported in high income countries. Successful delivery of secondary prevention improves health outcomes.
Methods
A business case was approved by the Ministry of Health and funded through a Labour 2020 Manifesto commitment. The 4-year project was initiated in July 2022. Salesforce was approved as the platform. Key informant interviews were completed with existing secondary prevention services and sector stakeholders. Systems requirements were approved and a minimum viable product built and tested. Two existing rheumatic fever (RF) services participated in a pilot phase (Northland, Waikato) with patient data migrated from the existing RF registers, followed by a staggered rollout to other regions.
Results
Twelve of 18 RF services have been onboarded to the RFCCS with data migrated for 794 patients. Average patient age is 19 years (range 5-63 years), 54% male, 96% Māori or Pacific. Current diagnoses are ARF (77%), ARF recurrence (5%), and non-acute RHD (17%). Current RHD severity is none (35%), mild (28%), moderate (12 %), severe (21% - including those post valve repair (5%) or valve replacement (15%)). Early benefits include supporting patient transfer, shared care between two services, and improved prophylaxis timeliness reporting.
Conclusions
Systems, processes, and workforce vary by service requiring flexible design and implementation. National systems are important for identifying and addressing equity gaps. Rollout to all services will be completed in 2025, with ongoing enhancements of the solution planned.