Collaborating with industry to achieve interoperability

Interoperability. In-ter-op-er-ah-bil-it-tee. Now say it again, faster. It’s a bit of a tongue twister. But saying it is the easy part!

Achieving full interoperability of health information is arguably the distinctive challenge of digital health. The world of finance, for instance, digitised long ago. Numbers and associated concepts are consistent and standardised in a way that health information is not.

This problem of interoperability recurs in multiple guises at every level of implementation. Clinicians of different backgrounds and specialties express clinical concepts in different ways. Large sites such as hospitals frequently employ a number of disparate clinical information systems that do not share information seamlessly. Different jurisdictions and healthcare providers likewise employ disparate, incompatible information systems that may be well suited to the specific purposes of that organisation, but are unable to share information in a safe and predictable manner.

We have been meeting with stakeholders representing industry, clinicians, consumers and jurisdictions to discuss these issues. Here’s what they’ve been telling us:

  • We won’t achieve interoperability by just making information available. Where it actively comes to people as part of their normal work practice, it will be used. People will not go searching for information.
  • In the first instance, we need to focus on just getting the information in front of the people who need it, and letting them interpret it. We can then incrementally improve terminology consistency to achieve machine-level interoperability. This should be prioritised on a risk/clinical outcomes basis.
  • We need to examine some of the fundamentals of the information sharing architecture in Australia, including moving away from an exclusive reliance on a document upload-download paradigm and considering how My Health Record might act as a trust and consent broker, facilitating access and exchange of information between clinical systems, without storing the data within the My Health Record.
  • Some of our core infrastructure needs to be more scalable to meet the expectations and demands that a real-time service supporting clinical software is expected to deliver. More focus needs to placed on transparent performance reporting and quality improvement cycles that actively engage jurisdictional and industry stakeholders.

A consultation and issues paper is currently being prepared with a view to undertaking a second round of consultation to explore these issues further with our stakeholders.