Reimagining healthcare in Australia: the journey from telehealth to 21st century design
CHF has been working with the Digital Health CRC, Deloitte Australia and Curtin University to better understand consumer expectations of virtual care in the 21st century. One of our first activities was hosting a webinar last year that featured the Secretary to the Department of Health, Dr Brendan Murphy, CHF CEO, Leanne Wells, and a number of other thought leaders in the digital health space.
You might be asking what virtual care is, and how it differs from telehealth. Put simply, virtual care is the next revolution in healthcare, where consumers play an active role in managing their care by generating and controlling their data in a fully digital health ecosystem. Today many of us already do this through tools such as wearables (Apple Watch, Fitbit, etc) or perhaps by integrating our weighing scales to apps on our smart phone. Other consumers might use remote monitoring devices to help record and manage their chronic diseases. But very seldom do all of these tools “talk” to each other or integrate with the systems used by medical professionals. The more these tools continue to expand and develop, the more virtual our opportunities for healthcare will become.
This infographic shows a visualisation of the outcomes from the webinar and a follow-up consumer survey. In the first slide, you can see some feedback that participants of the webinar highlighted as key barriers to advancing from telehealth to true virtual care. The second slide shows more consumer context for the barriers identified, and thoughts on how consumers are best placed to take advantage of virtual care evolution.
The following provides some context for the infographic:
Clinician readiness for change
It isn’t just consumers who need to adapt to the reality that virtual care is bringing – providers need to as well. Many providers struggle with understanding and deploying new technology in their practices, and often the cost is quite high. This can lead to scepticism and a slow rollout which negatively impact both practices and consumers.
Virtual care is a powerful tool for transforming healthcare, but it isn’t a solution in itself. Consumers will be empowered by digital transformation, but only if it is co-designed, that is consumers- and their preferences, choices and circumstances - are consistently placed at the centre of service design and delivery. This means rethinking the fundamentals of how we provide service, including embracing home care and community services.
Consumers know that the current healthcare funding system doesn’t reward outcomes. Instead, providers are paid based on time and treatment, rather than prevention. Virtual care has the chance to give consumers a more holistic model of care, but funding will need to be reflective of the opportunities this brings.
Virtual care is driven, and will continue to be driven by consumers. In fact, virtual care has the chance to replace the existing provider-centric healthcare system with something new and empowering for consumers. But before we can get there, consumers need to be made aware of the possibilities on offer and invest in them. This is not just a matter of education, but also about building trust and ensuring that every Australian has the chance to participate. This means access to devices, data and accessible services that have virtual care components.
Inconsistencies between states and territories
Australia is a federated country. States and territories retain a lot of power over the health system and work with the federal government in key areas. Funding for health also differs, alongside privacy and data management legislation. So, a simple ‘one size fits all’ model for virtual care is unlikely to occur.
Now that we know the barriers, how we can start to address them? One way would be to fill the gaps in policy that make these barriers so tricky.
We need to start involving more people in the discussion on health more generally, especially when it comes to prevention rather than treatment. This means activating consumers across the spectrum, from young people, CALD communities, First Nations, and others that traditionally don’t have a place at the table. Understanding the social determinants of health and expanding digital health literacy is the best way to set a solid foundation for future reform.
Equity of access
It doesn’t matter if we have the best virtual care plan in the world, if only parts of the Australian community can access it. Policymakers need to consider how we build up a new digital infrastructure that doesn’t favour urban centres at the cost of rural communities or forgets about those at the bottom of the socioeconomic ladder. Whether it’s the NBN, workforce development, or digital literacy – equity of access is a principle that should be put at the centre of each endeavour.
Technology, integration & interoperability
For as long as digital systems have existed in health, the goal of interoperability has proven elusive. Consumers will know that getting information across the health system can be a challenge at the best of times - a frustration most providers would also share. Addressing the most basic interoperability issues today (between GP and hospital for example), would set the scene for when consumers can start adding data of their own.
Everything is political and getting politicians to take the long view is never easy. We need cross-party consensus to put in place a robust plan for how we can achieve our virtual care future. Other countries have done it, but only when the entire political establishment buys in. That’s why it’s so important consumers take the lead in pushing politicians to understand the lack of leadership that currently exists and the potential for better health outcomes which can be achieved if virtual care is realised.
Leadership and collaboration
Until recently, the idea of consumers and researchers teaming up together wouldn’t have been that normal. But now it is, increasingly so. CHF is engaged in a number of projects seeking to put the consumer voice at the centre of research and policy development. It’s the only way we can hope to break down the conservative tradition of providers not taking consumers seriously, and is a powerful way to change the culture in the healthcare system altogether.