Chief Executive's Officer's review
The Australian Digital Health Agency (the Agency) was established on 30 January 2016 and commenced operations on 1 July 2016, integrating the activities and resources of the National E-Health Transition Authority (NEHTA) and My Health Record system operations of the Department of Health. I was appointed Chief Executive Officer in August 2016.
Since the establishment of the Agency, our purpose has been clear, and is succinctly captured in the National Digital Health Strategy:
“Better health for all Australians enabled by seamless, safe, secure digital health services and technologies that provide a range of innovative, easy to use tools for both patients and providers.”1
Supporting our purpose is our strong commitment to collaboration and co-production in all that we do, driving openness and transparency into the culture of the organisation.
Digital information is the bedrock of high quality healthcare. Healthcare providers need to have instant access to a patient’s medical information – especially in the case of an emergency. Australians want safe access to their personal health information such as their vaccinations and medical tests. Better use of information drives transformation of how services are coordinated and integrated, improving efficiency and delivering better health outcomes for all Australians.
The benefits for patients of digital health are significant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. It can help save and improve lives.
Although much work remains, the Agency has made substantial progress that over the past 12 months. Key achievements include:
- Building momentum in digital health by developing strong relationships and networks across the community and establishing six Board Advisory Committees;
- Building a new organisation including recruitment of a leadership team and establishing policies and processes to operate under a new Rule as a Commonwealth corporate entity;
- Co-producing a National Digital Health Strategy with input from the community, governments, technology industry and the healthcare sector, which was endorsed by the Australian Health Ministers’ Advisory Council (AHMAC) on first presentation. A four year work plan (2018-22) for the Agency was also agreed subject to approval of an Inter-Governmental Agreement in 2018;
- Delivering the 2016-17 work plan2 and co-producing a 2017-18 work program with state and territory health departments that was approved by AHMAC and the COAG Health Council on first presentation;
Garden City Medical Centre, Brisbane QLD
Case study: Secure messaging program
The Agency launched the secure messaging program in October 2016 in response to feedback from healthcare providers and jurisdictions that electronic secure messaging was not usable. The Agency’s 2016-17 work program includes a number of initiatives designed to remove barriers to the use of secure messaging services, so the use of secure messaging is likely to grow across Australia, as more and more clinical practices discover its benefits.
One of the initiatives in this program is a proof of concept study named ‘The HealthLink project’, which was launched in partnership with industry, clinical leaders and jurisdictions.
This project involves secure electronic referrals sent from five different general practices using Medical Director to five specialist groups using Genie and Best Practice software, via the ReferralNet and Argus messaging systems. Once fully implemented, this initiative will enable the sending of referrals from general practices to specialist healthcare providers that could be scaled to a national level.
“Alignment and partnerships between jurisdictions, local health networks, clinicians and patients will be critical to deliver the national digital health agenda and work program. Many jurisdictions already have a significant program of digital health activities already underway, that could support development and implementation of a National Digital Health Strategy.”
- eHealth NSW submission
- Taking on responsibilities for system operation of My Health Record and being charged by the Commonwealth Government to implement the Expansion of My Health Record so that all Australians will have a My Health Record by the end of 2018, unless they choose not to do so; and
- - Reaching 5 million consumers with a My Health Record as at 12 July 2017;3
- - Reaching the Agency's first agreement with a diagnostic services provider to share pathology reports with the My Health Record;
- - Commencing projects with five jurisdictions to upload pathology reports to the My Health Record with 16 labs currently connected and uploading;
- - Commencing projects with five jurisdictions to upload diagnostic imaging (DI) reports to the My Health Record with three DI practices having uploaded 53,000 reports to the My Health Record by end of June 2017;
Spring Hill, Brisbane QLD
Case study – Marjorie Morrison, Brisbane QLD
The Agency’s 2016-17 work program includes a number of initiatives designed to connect more surgeries and hospitals to My Health Record. One of these is Eyetech Day Surgeries Spring Hill, a Brisbane facility that provides cataract surgery and other services.
Marjorie Morrison is the Business Office Manager at Eyetech, and she’s an enthusiastic advocate of the My Health Record, which she sees as providing a great opportunity to deliver better outcomes for her patients.
Many of her patients are elderly “grey nomads” for whom eliciting a useful medical history prior to surgery can be a difficult and error-prone exercise. Despite the relatively early stages of the national rollout, the My Health Record is already proving to be a boon for Marjorie. Many of the patients at her facility already have established My Health Records, which allows Marjorie to check the patient’s history in advance, greatly streamlining pre-operative consultation and improving safety.
The facility has seamlessly integrated the My Health Record with its processes and internal clinical systems, and routinely sends My Health Record information to patients alongside other communications. Marjorie calls this “drip feed communications”.
This strategy is clearly working, and many of her patients are taking the opportunity to sign up. In fact, she was approached a little while ago by a very elderly gentleman and his wife, who asked, “Now, where do we sign up to this My Health Record thingy?”
“Great!” said Marjorie, “Do you have a computer?”
“No, no, don’t you worry about that,” he replied. “My son has got a computer. We just want all the doctors to know what we’re on, because we keep forgetting!”
- - Connecting hospitals and health services to the My Health Record with more than double the number of private hospitals uploading to the My Health Record system in July 2017 than in July 2016;
- - Successfully deploying Release 8 of the My Health Record including a new Medicines View;
- - Laying the groundwork for improved access to health information through a developer program that supports innovators to safely and securely connect to the My Health Record;
- Establishing the Cyber Security Centre to ensure best-in-class protection for Australia’s digital health foundations;
- Initiating projects to implement end-to-end secure messaging solutions so that all healthcare providers will be able to send and receive clinical correspondence without need for paper and a fax machine, making Australian healthcare safer, more effective and reducing the administrative burden on frontline professionals. The program involves ten healthcare providers, two clinical information systems, two messaging vendors and federated directories – where those judging the success of the projects will be the healthcare providers sending and receiving messages;
- Initiating a program to develop a framework for Interoperability that will support clinical information to flow between health providers, patients and carers;
- Reviewing Clinical Terminology Services so that the Agency optimises adoption of SNOMED CT in Australia;
- Driving an evidence-based approach to the delivery of digital health and the establishment of a Benefits Measurement program to ensure all Agency activity monitors and realises defined benefits;
- Supporting the establishment of the National Collaborative Network for Child Health Informatics; and
- Developing international partnerships with a number of countries to support knowledge sharing and innovation in digital health services.
Since I was appointed CEO, I have had the privilege of meeting many people – consumers, citizens and care professionals – who want Australian health services, already among the best in the world, to take full advantage of the opportunities that digital technology offers.
I reflect on what Fiona Panagoulias told me. Fiona cares for her disabled husband in Perth and now co-chairs the Agency Steering Group for Secure Messaging. ‘We have an amazing health system in Australia,’ she said. ‘I’ve seen others in the world. We really must do our best to make it better.’
Chief Executive Officer,
Australian Digital Health Agency
“The National Digital Health Strategy will help facilitate the sharing of high-quality commonly understood information which can be used with confidence by GPs and other health professionals. It will also help ensure this patient information remains confidential and secure and is available whenever and wherever it is needed.”
- Dr Bastian Seidel, President, RACGP
2 See note 1.
3 As at 30 June 2017, there were 4,969,017 consumers registered for a My Health Record.