Creating a connected health service, one step at a time

The National Health Interoperability Roadmap is on its way – which means your chance to get involved is coming soon.

…interoperability between systems is an ongoing issue. Individuals’ health records are placed on varying health facilities systems across the country, and in many instances these are still hard copy or scanned copy records. A consumer does not have ready access to these records, let alone any choice in how their own records are managed and who can access them.

[The Australian Nursing and Midwifery Federation’s submission to Australia’s National Digital Health Strategy – Safe Seamless and Secure.]

Digital health has enormous potential for all Australians, whether we are healthcare providers, consumers, vendors or developers. However, this potential cannot be fully realised while information remains fragmented across providers. We need to work together to ensure that the different parts of Australia’s digital health system can work together. In other words, we need to collaborate to achieve interoperability - the ability to exchange information with a preserved meaning.

Some of the building blocks are already in place. My Health Record provides both a vehicle and a defining framework for the sharing of key information, and enormous strides have been made in sharing information between providers who have a clinical relationship to each other and a shared patient. For example, most pathology laboratories provide information back to referring GPs in highly useful electronic formats.

While these bilateral exchanges of information work extremely well, issues arise when a service provider outside of those arrangements (for example, an emergency department) becomes involved in the care of the patient.

In these situations, what’s needed is a model where emergency care or other providers can access critical information without needing to know the original source in advance. To make this possible, care providers who have critical information about a patient must be able to share that information without knowing in advance who needs it. The draft US Trusted Exchange Framework might serve as a model of this approach.

Collective agreement on two critical issues is essential at this juncture:

  1. What is the information that should be shared?
  2. How do we ensure that what is output by one system can be reliably interpreted and used in another?

To maximise the benefits from the exchange of information, a prioritisation process needs to be undertaken. We need to make sure that we solve the most urgent problems first, in a way that satisfies the needs of both consumers and providers.

What are the key possible approaches that:

  • Directly address an issue with a societal cost (such as patient safety, service navigation or service efficiency)?
  • Advance terminological consistency?
  • Promote “atomic longitudinal data” that tracks individual measurements/status at different points in time?
  • Can be reduced to a series of value-adding steps that can be incrementally implemented?
  • Are feasible and cost-effective to implement?
  • Provide a viable value proposition for all stakeholders?

Furthermore, through all of this, we must ensure that Australian consumers have access to global developments, and that Australian industry is not locked out of global markets by overly localised solutions.

Let’s plan ahead

To lay the foundations for resolving these issues, we’re committed to developing a National Health Interoperability Roadmap by December 2018, and we will soon be calling for stakeholders to get involved. We have undertaken some preliminary engagement with clinical colleges and industry, community and professional groups, using an engagement paper that is available for download.

At the Australian Digital Health Agency we emphasise collaboration, co-development and co-production. The potential benefits of a national digital health system are immense, but to achieve them we will need to work together. A full public and industry consultation process will commence in the new financial year, and we look forward to working with you to further improving our healthcare system.