Progress on digital health initiatives is hampered by data duplication and fragmentation across the states and territories.
Digital health initiatives have to start delivering on promised improvements before patients and health professionals outside the sector can be convinced of its relevance, says the boss of eHealth NSW.
Dr Zoran Bolevich told delegates at MedInfo23 last week that it was “time for digital health to grow up a bit and really start delivering”.
“As scary as some of the fiscal challenges that are ahead of us look, they also give us an opportunity to be a little bit sharper around how we’re delivering and how we are really adding value to health systems,” he said.
“There are so many areas in health where we can do so much better and actually turn value, and in turn savings, back to health to provide more health care.”
Dr Bolevich was joined on the panel by digital health leaders from across the country, including Victoria’s Chief Digital Health Officer Neville Board, deputy-director general of eHealth Queensland Dr Tanya Kelly and Anthony Lenzarini, Director of Health Support Services at WA Health.
Other panellists included Sandra Cook, Executive Group Manager of the Digital Health Record at ACT Health, and Dr John Lambert, Chief Clinical Information Officer at NT Health.
Many panellists, including Mr Board and Dr Kelly, emphasised the importance of prioritising citizen and community perspectives to ensure that digital health is making the right improvements for patients across the board.
“We know that the world doesn’t rotate around the provider in healthcare, we have to rotate around the consumer and really understand what the needs of the community are,” Dr Kelly said.
“It’s not about what I think a consumer needs or what the system thinks the consumer needs, it’s about what the consumer says that drives the health system. So [to make] digital health relevant and the health system relevant, it needs to be shaped completely around the consumer.”
According to Mr Lenzarini, the language used to describe digital health needs to be simplified in order to make it more relevant for those outside the sector.
“Every time we talk to senior executives and policymakers, people that we seek funding from, we make the language too hard. That confuses people, and it isolates the digital conversation rather than [making it] inclusive. That’s something we’ve got to get a lot better at,” he said.
In response to a question about improving digital health interfaces for primary care from Victorian GP and chair of RACGP eHealth Dr Rob Hosking, the panellists highlighted the projects currently underway across most states and territories to improve collaboration and interoperability between hospitals and primary care.
“In NSW there is very strong collaboration between the hospital system and PHNs, there’s a whole program of work that we are progressing jointly with,” Dr Bolevich said.
“There is a lot of desire [at the] policy level to actually move the dial. But I agree that ultimately, we will need to do that within some kind of a national coordinated framework.”
Dr Kelly added that digital health was likely to be the impetus for greater collaboration between the states and territories and the federal government to improve healthcare delivery and health outcomes nationwide.
“If there is a point of inflection or something that drives that sort of tipping point where we start to say, well, you know, we can’t operate as individual state jurisdictions and separate from the Commonwealth, digital is going to be a significant driver in that change,” she said.
“There’s a rising understanding of the importance of information sharing and portability.”
When asked about how best to use health data once it has been collected, the panellists agreed that more work needed to be done across the states and territories to harmonise the amount of data collected in order to limit fragmentation, as well as to understand what data was collected and why.
“From a data quality perspective, we miss out on so much. But if we’re not clear on why we want the information, why are we capturing it? And I don’t think we do enough on information architecture and understanding why we need to do that,” Sandra Cook said.
“We’ve got different health services with different levels of maturity getting different levels of access to the data and presenting it in different ways, and [there’s] lots of duplication in the system, [so we’re] really working out what is it that we need from the enterprise level to provide,” Dr Kelly added.
According to Mr Board, one of the central oversights with data collection in digital health was the lack of data identifying gaps between current care delivery and recommended best-practice care.
“The area we don’t look enough at is the gap between recommended and actual practice … using existing data to just identify how far off cancer, stroke, heart attack patients are from recommended best-practice care and then targeting that,” Mr Board said.
“I think that needs to be not done as a discrete manual data collection, we should just be looking at that and feeding that back quite quickly.”
