Australia’s National Digital Health strategy (2018-2022) Safe, seamless, and secure: evolving health and care to meet the needs of modern Australia, describes digital information as the “bedrock of high quality healthcare”. In the first of a series of articles, NZHIT examines the Australian strategy, the opportunities it presents for health IT companies and the parallel Digital Strategy work going on in New Zealand.
Australia’s project to realise the multiple benefits of digital health focuses on seven key areas and sets some ambitious targets.
The newly released National Digital Health Strategy promises that by 2022, it will: “deliver the essential, foundational elements of health information that can be safely accessed and easily utilised and shared.”
It has a strong focus on encouraging innovation and says that, “innovators, entrepreneurs and developers will be able to use these foundational elements to develop tools that patients and health professionals can use every day to measurably improve healthcare and health outcomes.”
The strategy is particularly important as a signal to the market about the government’s priority areas going forward, saying that it hopes to, “encourage investment in both the public and private health systems in the same direction.”
Seven key areas
The first of the seven key areas outlined in the strategy is the delivery of a My Health Record for every Australian by 2018 – unless they choose not to have one. Furthermore, it promises that by 2022 all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients.
More than 5 million Australians already have a My Health Record, which provides access to clinical reports of medications, allergies, laboratory tests, and chronic conditions. The strategy promises that patients and consumers will be able to access their health information at any time online and through mobile apps.
The Australian Government has committed $374.2 million for the national expansion and operations of the My Health Record system, and building the national digital health infrastructure.
The strategy aims to introduce digital communication for health professionals and their patients by 2022, aiming for paper-free communication nationwide.
It will also set new standards to allow real-time sharing of patient information between hospitals and other care professionals.
“By the end of 2018, a public consultation on draft interoperability standards will confirm an agreed vision and roadmap for implementation of interoperability between all public and private health and care services in Australia,” it says.
“Base-level requirements for using digital technology when providing care in Australia will be agreed, with improvements in data quality and interoperability delivered through adoption of clinical terminologies, unique identifiers and data standards.”
The first regions in Australia will showcase this comprehensive interoperability across health service provision within five years, it promises.
The strategy prioritises the introduction of e-prescribing, promising that by 2022, there will be “digitally enabled paper-free options for all medication management in Australia”.
“People will be able to request their medications online, and all prescribers and pharmacists will have access to electronic prescribing and dispensing, improving the safety of our systems.”
It also prioritises the development of new digital services to support newborn children, the elderly, and people living with chronic disease.
It says it will test the use of technologies such as telehealth and then promote these nationally once any obstacles have been overcome.
Similar to the approach being taken in the UK’s NHS, Australia plans to create a network of clinician digital health leaders and champions across Australia and a set of resources to help healthcare professionals use digital services.
Another NHS project that the Australian strategy is adopting is an initiative to have accredited health apps for the use of patients and health professionals. It also promises an improved developer programme to support the creation of new applications.
Problems and Solutions
The strategy provides an infographic detailing 12 of the problems facing healthcare in Australia today and pointing towards future solutions
These include that 1 in 10 people lose their child’s health and development book. The solution indicated is that this will be made available via an app. It also says that information on the cost and availability of specialists should be online as around one third of Australians do not see specialists because of lack of cost information.
New Zealand based Vensa Health chief executive Ahmad Jubbawey says this one page representation of some of the key problems and solutions is hugely helpful for companies wanting to enter the Australian market.
Vensa health, a customer engagement health platform, is already engaged with some Australian partners that Vensa would typically integrate with and hopes to be operational there within 12-15 months.
He is also planning on engaging at a higher level with the strategy team after he contacted Australian Digital Health Agency chief executive Tim Kelsey, who put him in touch with an industry liaison.
Jubbawey advises that being able to engage on both these levels is beneficial, if a company has the resources to do so.
“The formula is really simple if you want to go to Australia – understand the problem you want to solve, have a strategy on how you are going to enter the market, raise loads of money and execute like hell,” he explains.
He is also impressed with the Australian strategy’s commitment to a developer programme.
“If the government can invest in start-ups to create new products to solve traditional problems in new ways they absolutely should,” says Jubbawey.
“We are doing a lot to try and bring that thinking to our Ministry of Health.”
A bit of background
The strategy has been produced by the Australian Digital Health Agency, which was established in 2016 by the governments of Australia to lead the development of the National Digital Health Strategy and its implementation.
The Agency receives approximately $64 million per year from all jurisdictions through the Intergovernmental Agreement on digital health. But much of the funding to enact the digital policies outlined will be at state level.
An ADHA spokesperson confirmed to NZHIT that the jurisdictions and industry also contribute to the strategy through their own projects, programs, and funding.
“While not quantified at a national level, this work is critical to the successful implementation of digital health into health care delivery,” the spokesperson says.
The ADHA will now be consulting with stakeholders to develop a Framework for Action, which will be published later this year and will detail implementation plans for the strategy.
In response to a question about when the first tenders will be released relating to the various strands of the strategy, the spokesperson says only that: “work is already underway on many of the priorities identified in the strategy including the My Health Record national expansion.”
“The next phase of the strategy, the development of a framework for action, will build on this collaboration with industry and establish strong partnerships with industry and organisations to deliver digital health solutions.”
NZHIT chief executive Scott Arrol says the Australian strategy presents numerous opportunities for New Zealand companies.
“Australia’s a very important market and with this strategy it becomes more important because of the opportunities it can offer for those who are in a position to take advantage,” he explains.
Arrol’s expectation is that a significant amount of funding will need to be pledged to digitise Australia’s health system, but exactly how much and where it comes from is yet to be detailed publicly.
He says New Zealand is ahead of Australia in some ways, such as the use of a National Health Index to ensure every patient has a unique identifier, and this could give Kiwi companies a competitive edge.
“Australia see us as having that part of it nailed and New Zealand firms that have crossed the Tasman seem to adapt to the complexity in Australia pretty well,” he says.
Interoperability is another area where Kiwi firms could capitalise on work already done at home. NZHIT has created the ‘New Zealand Vision for Interoperability’, which a large number of members are already signed up to.
“This gives them an advantage as they’ve already thought through the dynamics of interoperability and understand the drivers that influence this being achieved, especially the non-technological aspects such as leadership, change management and the multiple stakeholder-level concerns that have to be taken into account as a high priority”, Arrol says.
What’s happening in New Zealand?
New Zealand’s own Digital Health Strategy is due to be released at the end of this year.
Ministry of Health, Chief Technology and Digital Services Officer, Ann-Marie Cavanagh tells NZHIT that the newly released Australian Digital Health Strategy is one of many being reviewed as part of the development of New Zealand’s own Strategy.
“The Ministry of Health collaborates with the ADHA through the Australia-New Zealand Leadership Forum and through other channels where there are topics of mutual interest and opportunities to share information and learnings, as well as co-operate on common challenges,” she says.
“This recognises that despite the differences between national health systems, many health challenges and digital implementation approaches are similar across jurisdictions.”
When asked about the level of investment the New Zealand government is planning on making in health IT, she says this is: “subject to prioritisation against non-IT investment needs across multiple organisations including the Ministry and DHBs.
“The Digital Health Strategy will help to guide investment decisions but will not specify a detailed investment plan,” Cavanagh adds.
A Vision for the future
The MoH has already created a health technology ‘vision’ for 2026 that focuses on a commitment to interoperability and creating policies and standards for data security, access and use.
It also talks about flexible funding models and “align(ing) incentives to support different delivery models and smart use of technology”.
It says there should always be a virtual option for healthcare and technology can help to remove isolation by connecting communities.
Part of this vision for the future is the National Electronic Health Record Business Case project. An indicative business case for this programme has been produced and is going through the Treasury Better Business Case Process and will be released once it is approved. From there the MoH will produce a Detailed Business Case, then go through a procurement process and contract award.
Targets and innovation
Chief executive of Melon Health, a mobile health platform for prevention and management of chronic disease, Siobhan Bulfin believes that New Zealand’s upcoming digital strategy will likely align closely with the focus of Australia’s. She says it is good to see specific targets in the Australian strategy and she hopes to see New Zealand follow suit and incorporate measurable outcomes.
She adds that having a national digital health strategy could help DHBs and PHOs get funding approved for technology projects as they can reference back to a national strategy in business cases.
“It provides some comfort that there is a focus on digital health from the top and that might filter down to help companies within that area,” she says.
Bulfin believes that while government can encourage more agile adoption of innovative solutions, the real change in New Zealand needs to happen at DHB level.
While there are some forward-thinking DHBs and PHOs, Bulfin says health providers can be hesitant to try new things. A commitment to long-term investment in technology is needed to ensure projects move past pilot stage.
“Innovation means embracing new ways of doing things, so in order for that to be successful we need organisations that are receptive and open to change and willing to try to do something different,” she says.
Arrol adds that a clear vision for health technology in New Zealand is essential, and supports the work being led by the MoH, but believes that at the same time there needs to be an aligned innovation framework established to support the strategy.
“Both the public and private sectors need to have a means to work together that creates sustainable innovative solutions, which encourages investment and discourages a siloed local or regional approach that is not scalable on a national or international level,” he says.
My Health Record Timeline (405 KB)
My Health Record Timeline (405 KB)