Ever increasing computer competence of health professionals allows health organisations to purposefully explore the potential of networked computers to enhance healthcare provision. In 2010 the Waikato District Health Board, on behalf of the Midland District Health Boards, successfully submitted a proposal to the New Zealand Ministry of Health to fund an e-project, Improving Nursing Utilisation of Evidence to Inform Clinical Practice. This project focused on the development of registered nurses' and midwives capability to access internationally recognised electronic resources to directly impact on their on-going practice. During the first phase of the project 155 registered nurses / midwives across the midland region were provided access to a co-ordinated web-space and a procedures manual. During the pilot phase an identified target group was the “hard-to-reach” practitioners. The hard-to-reach population was described as those participants not located in a base / satellite hospital and included those involved in care for the aged and general practice.

As well as reviewing identified procedures participants were also asked to complete an evaluation survey on the e-environment created for the project. The survey instrument used contained 5 scales (computer competence, reflection, design, rule clarity and order and organisation) and 26 items. During the evaluation period 33 hard-to-reach participants completed the survey.
From the data generated it appeared the introduction of e-services for the hard-to-reach population in the health sector is timely. The data indicated a significant majority of respondents

• were confident and competent using computers and searching, retrieving, storing and manipulating information from the Internet
• were competent and confident in using web-based technologies to access point of care procedures
• found the web-space created visually appealing
• were able to clearly read all materials and the media used was appropriate to the information presented
• felt the procedures reviewed were presented in a logical manner, were current and appropriate to their current level of skill
• could access the appropriate software applications to complete activities assigned

The results of this study indicated centralised electronic access to policies and procedures would be successful for the hard-to-reach population in the health sector. However, it can be legitimately argued the manager-referred sample used in the pilot phase of the project were selected because they had the underlying information and communication technology skill set required to fully participate in the project. Therefore, it is recommended this project be extended to include a larger, more diverse, population to confirm these initial findings.