What Community Told Us About Digital Health
Over the past few months, Kowa has been working in partnership with the Agency for Clinical Innovation (ACI), through its Integrated Digital Enablement Accelerator (IDEA) team, to yarn with Aboriginal Communities across NSW about digital health.
The project brought together two of ACI's key programs — Patient Reported Measures (PRMs) and Virtual Care (VC) — into one coordinated, respectful conversation, rather than running separate consultations that risk overwhelming Community with repeat requests for input.
Why yarning
We used a Collaborative Yarning Methodology to guide the engagement — a Culturally embedded way of sharing knowledge and experience, grounded in relationship, trust, storytelling, and deep listening. Four sessions were held across NSW (in-person in Tweed and Nowra, and two online), bringing together Aboriginal Community members, Aboriginal Health Workers, Elders, and NSW Health staff.
This work was underpinned throughout by the NSW Aboriginal Health Impact Statement (AHIS) principles — trust, Cultural respect, holistic approaches, and genuine partnership.
What we heard: the V.I.T.A.L. framework
The findings from the yarns came together under five themes:
Virtual — Digital health should support, not replace, in-person care. Hybrid models work best, particularly for people in rural and remote areas, and virtual care should help keep Mob on Country rather than adding extra steps to a care journey.
Integrated — Systems need to be joined up, so people don't have to repeat their story to every service. A single, connected record reduces frustration and helps ensure nothing falls through the cracks.
Trustworthy — Trust is the foundation. Communities want transparency about how data is collected and used, systems that go beyond Cultural safety into genuine anti-racism, and design that reflects strength and resilience rather than deficit.
Accessible — Cost, device access, internet limits, and complex log-ins remain real barriers, especially for Elders and people with lower digital literacy. Removing these barriers is essential if digital health is going to reach everyone.
Localised — There's no one-size-fits-all answer. Digital health needs to be co-designed with each Community, reflecting local Culture, context, and ways of working.
The bigger picture
A few messages came through again and again across every session:
A well-trained, well-supported Aboriginal workforce is central to making digital health safe and effective.
The digital divide is real, and access must mean more than a service simply existing — it has to be usable and supported.
History shapes trust — past experiences of racism or feeling unheard in the health system continue to influence how people engage with new technology, which is why relationships need to be built in person first.
Feedback must be valued, and offered in ways that are simple, flexible, and Culturally respectful.
Where to from here
The full report sets out detailed recommendations across five areas: strengthening the Aboriginal workforce in digital health, keeping virtual care hybrid and relational, improving accessibility, building trust through transparent systems, and localising solutions through genuine co-design.
These findings and guidelines have been shared back with participating Communities, and will help shape how ACI's Virtual Care Principles and PRM resources are refined before wider release.
This work reflects Kowa's ongoing commitment to Aboriginal-led, Culturally safe approaches to health innovation — ensuring Community voice sits at the centre of how digital health is designed and delivered.