The use of technology in health care is now more important than ever
Australia needs a well-designed digital health system in order to transform health care. Benefits should include better patient experience, quality care and improved health outcomes. The rollout of National Digital Health Strategy initiatives — with the Australian Digital Health Agency at the helm — is realising Australia’s digital health future and COVID-19 is ensuring that it is fast-tracked.
The Australian Digital Health Agency (the Agency) — established in 2016 to lead the development of the strategy and its implementation — has been tasked with evolving digital health to meet the needs of modern Australia and it is now critical to ensure this happens quickly. The Agency is working with healthcare providers, industry peak bodies, government departments and vendors to facilitate digital health integration in the health system and deliver the key initiatives.
The Australian Government’s National Digital Health Strategy was devised to digitise the Australian health system, making it safe, seamless and secure.
The strategy proposes seven priority outcomes to be achieved by 2022:
- Health information is available whenever and wherever it’s needed.
- Health information can be exchanged securely.
- Commonly understood, high-quality data can be used with confidence.
- Availability and access to prescriptions and medicines information.
- Digital models of care that improve accessibility, quality, safety and efficiency.
- Workforce confidence in use of digital health technologies to deliver health and care.
- A thriving digital health industry delivering world-class innovation.
The strategy is the product of detailed consultation and co-production with patients, consumers and carers — and the healthcare professionals, industry, organisations and innovators who serve them.
Delivering digital initiatives
To date, the process of delivering initiatives has been an integrated one, overseen by the Agency’s measured and considered approach: roadmaps designed and adjusted; priorities agreed on; consultation sought from relevant parties on prioritised initiatives, leading to implementation plans in consultation with peak body organisations such as the Australian Medical Association, Australasian College for Emergency Medicine and Australian College of Nursing.
The overall aim is to achieve interoperability, connection and integration between digital systems and sources of information to facilitate fast and user-friendly access to centrally located health information.
My Health Record
According to the Agency, as at the end of February 2020 more than 22 million Australians have a My Health Record — an integrated clinical information platform allowing patients and associated healthcare professionals to access health information securely online. Health professionals can upload, view and share documents via a patient’s My Health Record, which provides a detailed picture with which to make decisions, diagnose and provide treatment. Given the recent crisis events of flood, fire, drought and pandemic, patient access to their health information is more critical than ever.
A whole host of digital initiatives
While My Health Record is a well-recognised digital health initiative — with tens of thousands of healthcare practitioners, public and private hospitals, community pharmacies and other healthcare providers connected to the system — it is just one of several tools that have been launched. There is also a series of test-bed projects underway. A range of systems and technologies are being trialled that, when rolled out, are set to deliver a positive impact when it comes to digital health.
E-prescribing and medicines management
Many Australians will remember the days of handwritten scripts — when pharmacists had to decipher illegible scrawls to determine what medication a patient had been prescribed. Unsurprisingly, this method resulted in a high rate of prescribing errors, with patients receiving incorrect doses or even the wrong medication.
Typed scripts have helped reduce the rate of error; however, electronic prescribing will take us another step forward in patient safety when it comes to medicines management. A transition to e-prescribing will provide an alternative to paper scripts.
In addition to eliminating the problem of lost scripts and repeats, digitally stored prescribing information will create an integrated record of what medications patients are taking, aimed at reducing adverse drug interactions and allowing patients to get the most out of their treatment. This is known as the Pharmacist Shared Medicines List and its aim is to address the 250,000 hospital admissions in Australia each year due to medicine-related problems, half of which are preventable. For example, if a patient is taking ginseng and is prescribed warfarin, the efficacy of the blood-thinning agent may be reduced — increasing the chance of blood clotting. If a pharmacist has access to all the medicines a patient is taking, they are in a position to inform the patient of potential drug interactions and advise on the best course of action to get the most out of treatment.
In the case of e-prescribing, the doctor, pharmacist and patient are all involved. Relevant information is available and accessible, with safety at the heart of the initiative.
Medicines management has been identified as a priority area to be rolled out across all states and territories across the country, incorporating medicines safety, real-time prescription monitoring and a single drug catalogue. Western Australia and Tasmania have already made progress in this area, with Tasmania using real-time reporting and recording of controlled drugs, and the Fiona Stanley Hospital in Western Australia adopting the Automated Pharmacy initiative, which promotes evidence-based use of medicines in a safe, high-quality and cost-effective manner.
In Victoria, an eReferral Program has enabled secure messaging and exchange of clinical information, timelines and roles and responsibilities among health professionals. The initiative has already been implemented in four Victorian health services and will be developed to form a framework for sector-wide use. eReferral and booking capabilities, as well as secure messaging and discharge summary capabilities are all being implemented across Australia. All of these initiatives will work together to improve efficiencies in the health system, allowing delivery of quality health care.
Bringing nurses, midwives and specialists along for the ride
GPs and hospital-based GPs are currently well serviced by My Health Record, and the Agency wants to bring more nurses and midwives onto the digital system, as well as specialists working across all fields of health care.
The newly created Australasian Institute of Digital Health — in collaboration with the Agency as part of the National Digital Health Strategy’s commitment to building health workforce capability in digital health — has conducted a professional development program to identify the digital health skills nurses and midwives need to further improve the quality, safety and efficiency of the care they deliver.
Nurses and midwives across Australia have been consulted on the specific digital health skills they need, what is practical and relevant for them, and how a draft digital health capability framework could be used in hospitals and health services as a professional development guide for nursing and midwifery.
This is part of the National Digital Health Workforce and Education Roadmap, developed by the Agency in collaboration with the Digital Health CRC.
Digital literacy and community engagement
An important part of the Agency’s mandate is building community engagement, ensuring that digital systems are usable and providing community digital health education to maximise uptake.
“Community engagement is vital for digital systems to be successful. Improving health outcomes for all Australians is our key priority and co-designing our solutions with consumers is a vital part of our work,” Agency Acting Chief Operating Officer Rupert Lee said.
The Agency is running a nationwide train-the-trainer program via the Australian Library and Information Association (ALIA) that will train library staff to help users navigate and understand digital health initiatives such as My Health Record.
Many Australians use public libraries as trusted sources of health and wellness information. In addition to information about healthy living, health conditions, treatment plans, therapies and medicines, training will allow library staff to provide support and information on My Health Record and help community members access digital resources.
The Agency has also engaged the Good Things Foundation to provide grants to community organisations to build the understanding and skills that will allow Australians to realise the benefits of our evolving digital health system.
These are just some of the many digital initiatives and new technologies that will be integrated into the digital health landscape over the coming years. It is an exciting time for the health sector and patients and health professionals alike are sure to benefit from the digital transformation.
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