Digital health - we have come so far, but still so much to do
I stood down as CEO of the Consumers Health Forum in August after 7 years. During those years CHF has nurtured important collaborative relationships with numerous organisations. Our capacity to ensure the consumer voice is heard and represented in Government health policies has been dependent on our active consumer members and our capacity to deliver credible advice backed up by solid evidence on consumer views and experiences.
One of the complex areas of providing advice to Government is related to the increasing expansion of digital health innovations into our health system. Critical CHF partners in this have been the Australian Digital Health Agency (ADHA).
In 2016 Australia was in the throes of the fraught introduction of My Health Record (MHR). MHR was struggling with low take-up and debates were raging about the benefits of moving to an ‘opt out’ approach, eventually implemented, in which people would be automatically enrolled unless they specifically declined.
Community concern about privacy and protections was being fuelled at the time despite stringent measures being put in place to safeguard personal health information. At the time, these concerns clouded the fact that many people recognised the value of having their records about their health conditions, medications, treatments, scans and tests on one spot, because they know it will improve communication between treating teams and improve health outcomes. For too long, Australians had been traversing a complex, disconnected system, too often repeating their story. MHR was designed to be part of the solution.
The challenge was to build community trust and create a social licence for MHR, as well as to demonstrate to both consumers and clinicians that major benefits could realised. A critical success factor was for MHR to have utility.
Fast forward to 2020 and 2021 the digital health world changed dramatically. It felt like all the angst around the perceived privacy risks and reticence to embrace all things digital health melted away. Convenience, safe, timely access came up trumps as the COVID-19 pandemic struck. Telehealth and other developments like e-prescriptions transformed health care delivery and is now a permanent part of Medicare. We had finally started to shift the health care system, like banking and telecommunications, into the 21st century.
While innovations had been developing at a relatively slow pace over the years, the pandemic has driven the comparatively lightning pace of the introduction of innovations and how we consider the future of digital health in our health system. More importantly for CHF, it is the impact on consumers that is at the forefront of our messages to governments. Emerging consistently from research CHF has undertaken or participated in from early 2020, is that while digital health can break down barriers to access of healthcare it can create new barriers which we now need to address as the health system becomes more digitised.
In that context, an important partnership in these endeavors has been with the Australian Digital Health Agency (ADHA). ADHA’s importance in the context of digital health is that its existence, including through funding, is based on collaboration between the Federal Government and all jurisdictions. Thus, CHFs representation of consumer voices on the issues to ADHA, are heard and can be considered in how State and Territory governments progress digital health. In numerous aspects of digital health, not just the technology, a consistent approach is essential to achieving a truly connected (interoperable) health system.
CHF takes pride in its contributions to both technical and policy aspects of digital health. It has been an active participant and adviser in digital health initiatives, including the development of the original National Digital Health Strategy, the roll out of the opt-out strategy for MHR and more recently the implementation of e-prescriptions and telehealth. CHF has participated in and led extensive research and consultations with consumers as COVID has driven the introduction of digital health innovations.
CHF has provided independent submissions in response to ADHA consultations on a revised National Digital Health Strategic Plan and a National Digital Health Interoperability Plan. We have delivered extensive and authoritative advice on consumer experiences in digital health through specific research commissioned by the Department of Health and ADHA. CHF consistently participates actively in key ADHA roundtables and ongoing and regular fortnightly meetings with ADHA teams working on My Health Record, Electronic Prescribing, Telehealth and Digital Literacy.
Our thought leadership on digital health culminated in a collaborative research project with Curtin University, the Digital Health Collaborative Research Centre (CRC), and Deloitte which produced an independent collaborative White Paper titled Australia’s Health Re-Imagined which was distributed to all Australian Health Ministers, Chief Health Officers and beyond and available using this link Australia's Health Reimagined | Deloitte Australia | Life Sciences & Health Care.
The White Paper revealed that the community is more than ready to embrace digital health. Experiences with telehealth are positive, willingness to use technology to improve access to care is high. Consumers want to control their own health data and their providers to share information to improve their care. The Paper says that over the next ten years the health system must evolve to support all Australians to live their best lives and presents a three-horizon model to summarise the shifts that will occur.
The nirvana is horizon 3 ‘the confident consumer’ where people take an active role in their health and wellbeing and have strong relationships with health care providers. The system benefits from robust data interoperability, digital tools and ecosystem connections to deliver personalised care.
The upsurge in activity and roll out of innovations, such as e-prescribing, telehealth, and additional innovations in My Health Record, are exciting and gives us a taster of what is possible when technological know-how, consumer and clinician voices, and policy come together to create the environment for digital health innovation.