With barely two months under his belt, but a tonne of kilometres already clocked up running around the country listening to stakeholders from all walks of the health spectrum, the new head of the Australian Digital Health Agency (ADHA), Tim Kelsey, is charged up and ready to fire the starting gun on what might be a new beginning for Australia’s health future – one with some semblance of sensible and practical digital health strategy development and execution.
If he could wrangle even half of the herd of cats that has wandered our digital health landscape in the last few years – the federal regulators, software vendors (eg, patient management systems and secure messaging vendors), health service providers (eg, pathology labs), state government health department empires, the politicians, the GP and specialist lobby groups and the media – it would be a promising start.
Today he announced the appointments of Associate Professor Meredith Makeham as the Chief Medical Advisor to the ADHA and Dr Steve Hambleton, a key player and digital health influencer and a past AMA president, as the “Senior Responsible Owner” for a number of high-priority clinical digital programs for the ADHA.
Just what those programs are is yet to be revealed, but a key area that seems to be in the sights of Kelsey early on is sorting out the mess that is secure messaging. Until now, vendors of all sorts of have fought over and resisted standardisation, and providers, such as Sonic Healthcare and Primary Health Care have often ignored standards, developing their own messaging systems and requiring certain clinical software vendors to adhere to their protocols.
It’s a very practical place to start. Maybe he can get rid of our fax machines and get most of our clinical communications standardised on the major patient management systems.
To do that he is going to have to get major patient management and secure messaging system vendors (and some emerging ones) and key suppliers such as the big pathology players to stop playing games and come to the centre for the good of everyone.
Interoperability between the messaging vendors is one important initiative likely to be on the table. Pathology providers dropping their bespoke systems will probably be another. The aim is a simplified menu for doctors and the patient management vendors.
Kelsey believes that without a big migration from paper (the fax machine largely) to digital, in the long run many of these businesses will not be sustainable. And he thinks that the key supplier businesses are starting to recognise this “greater good” imperative and will come to the party.
Even after all of this, someone is going to have to get a whole raft of specialist surgeries to use computers.
He told The Medical Republic he hoped standardising secure messaging, and at least two other practical and game-changing digital initiatives, could be up in at least a few geographies before the end of the financial year.
The UK standardising secure messaging was made easier by the fact that while doctors were free to choose which patient management software they used, the NHS (the government), paid for the systems. Kelsey wouldn’t be drawn on whether the ADHA might consider something as left field as this.
Although enthusiastic to get some practical runs on the board, Kelsey remains very wary of moving too quickly without proper stakeholder consultation and buy in.
He is only part way through travelling the country to listen to stakeholders and he says that the more he listens, the more the group is understanding about how to run the upcoming consultation process on the revision of the national digital health strategy.
“We’re going to have to have a lot of new conversations around how we make the digital health offering work to the advantage of people in this country,” he said.
The ADHA starts the national health strategy consultations in earnest early next month and Kelsey wants input from all points of the compass. He has, by law, one year to revise the National Digital Health strategy. After that, funding for the ADHA and other key parts of the digital health implementation process are all up for review.
To get anything done, and show runs on the board, he needs to implement practical programs while also consulting widely. Over the next few weeks he intends to announce quite a few more programs.
A key question for many is what is going to happen to the My Health Record, the controversial and expensive centrepiece of the national digital strategy, and, for some commentators, a potential millstone around the necks of the ADHA.
Kelsey is quick to reaffirm the importance of the MyHR as a program.
“The issue is not around whether it should exist, the issue is how do we make it much better quickly,” he told TMR.
A good sign is that he is clearly thinking way beyond the MyHR as well.
Few people doubt the value eventually of a universal, national electronic medical record system, but increasingly commentators are warning that there are far more practical steps that can be taken in the digital health landscape to achieve meaningful short term return for the country’s health system.
“We haven’t really addressed all the ways in which digital can properly deliver additional value to people,” he said.
“But big questions remain around digital inclusion and how we engage with the community to properly understand how we can add the best value.”
The energy and urgency exuded by Kelsey is palpable. And he’s a little charming to boot.
Let’s hope that this really is the start of a rebirthing process for digital health in Australia. The prize is way too important to stuff this up again.