In December 2021 CHF provided a submission in response to a consultation by the Australian Digital Health Agency on the National Digital Healthcare Interoperability Plan. It soon became clear that many were not sure what interoperability meant and why it was important in the context of the health system.
Interoperability has to do with the way computer software systems can connect and communicate with each other. In healthcare, it is the ability of different information technology systems and software applications (programs) to communicate, exchange data and use the relevant health information provided. In basic terms, it means creating a connected health system
In all CHF’s research on consumer experiences with new digital health innovations, a constant theme is dissatisfaction with the lack of sharing of, or ability to access a patient’s relevant health information by providers as they move across the health system, often in different care settings. For those people who have multiple healthcare providers, this causes real frustration, and indeed, concerns around quality and safety of care. Consumers consistently find it perplexing and frustrating that at each encounter with a provider they must repeat their health story repeatedly.
Many of the health care events experienced by consumers occur in a range of different settings; general practice, hospitals, Emergency (EDs), and specialists for example. When we realise that each setting may use different computer software that doesn’t talk to other computer software, the value of ensuring they can talk to each other becomes clear. The benefits of creating a truly connected health system where a patient’s providers have access to all relevant patient health information for decision making and can share information with other providers on relevant history, diagnosis, treatments, pathology and diagnostic imaging tests, are immense.
The key benefits include:
- Improved and safer transitions of care, based on real continuity of care which leads to better health outcomes
- Improved quality and safety in clinical decision making
- Reduction in duplication of tests/diagnostics, which not only contributes to a reduction in unnecessary costs, but reduces the clinical risks to the patient, for example radiation load.
- Reduces the reliance on the patient to retain, understand and share often extensive, complex, and clinically relevant medical information.
- Provides consumers with increased confidence in their care, knowing that key medical information is shared between their providers.
- Delivers improved efficiency by reducing the time it takes to make clinical decisions and to have useful conversations between providers, and between providers and patients.
How do we achieve a connected health system?
A key issue in creating a connected health system relies on bringing software providers along to agree, in basic terms, to develop their systems based on specific national standards. While software companies are very active in ongoing consultations and implementation of current standards for use of their products by the health sector, moving the sector to an agreed set of standards is a challenge for both government and vendors.
Creating a connected health system, however, is not just about technology. Developing a way forward is a vast undertaking, particularly in the context of the Australian health funding model. States and Territories are responsible for funding some parts of the health system, such as hospitals, and the Federal Government is responsible for funding things like general practice, aged care, Medicare, and Pharmaceutical benefits. And each jurisdiction sets some of its own rules that can differ in relation to say, how hospitals manage the privacy, security, storage and sharing of health information for example.
However, the success of a connected health system will be based on consumer trust and confidence. Consumers consistently call for and increasingly are demanding the many benefits that such connectivity or interoperability can deliver. Research, surveys, and consultations illustrate that consumers want their information shared between their health providers and that they clearly see benefits for their own healthcare. At the same time, however, consumers want to retain control of who has access to their health information and, along the path to a national connected health system, will need to be satisfied and feel confident that the privacy and security of their health information is maintained.
The following quotes from consumers from significant CHF consultations undertaken in 2021 reflect, not only a clear awareness of the value of a connected health system but also the frustration with what they often describe as a fragmented system
“We need a far more linked or integrated health system, especially between public and private health systems. The more information my clinicians have about me, the better my health outcomes will be. It also helps me personally, as I can potentially save my energy and effort, which brings its own health benefits.”
“There has been no conferring, and no cooperation of any kind. Now everything is on computer, and doctors have access to your medical records, across the board, you should be able to go to any medical practitioner who should be able to access your medical records. I actually need you guys to work together."
“Our experience is that when systems work well it is because they are well connected and talk to each other. It is when systems are not well connected, that in the end it is the patient that suffers and misses out on good treatment.”
If you would like to read more on the Draft National Health Interoperability Plan, use the following link to the Australian Digital Health Agency’s consultation paper and a briefer Plan on a Page
For CHF’s Submission in response to the Draft National Healthcare Interoperability Plan please go to the following link Draft National Interoperability Plan submission.
For questions, email Julia Nesbitt, Digital Health Policy Officer - J.Nesbitt@chf.org.au