Getting your teeth stuck into digital health

Authors: Professor Meredith Makeham, Chief Medical Adviser, The Australian Digital Health Agency, and Heiko Spallek, Pro Dean, Faculty of Dentistry, The University of Sydney.

Globally, the health sector has been praised for generating and storing data, but characterized as less effective at translating this data into useful information. In general, health data is an underutilised resource that could be saving lives.

Unfortunately, dentistry is arguably one of the least digitally enabled parts of the health system with respect to recording and sharing health information. While physicians, nurses and pharmacists at least share some information via large hospital-based Electronic Medical Record (EMR) systems, dental providers rarely have the opportunity to integrate their Electronic Dental Record (EDR) data into these systems, or are able to extract information from the EMR. Therefore, dentists rely on the patient’s memory to consolidate health data when taking medical and medication histories—a time-consuming exercise that potentially jeopardises patient safety.

Given that Australia is a highly developed country with only 24 million residents who generally value the high quality of healthcare practitioners and workers and enjoy affordable and accessible care, it is well placed globally to take advantage of the increasing datafication of healthcare, serving as a test bed for health innovation and research.

The Australian Productivity Commission recently concluded: “Data is a strategic asset with great potential and should be treated and managed as such”.(1) The Australian Digital Health Agency (a federal government Agency) is responsible for operating the My Health Record system. This is an innovative online health record freely accessible by all Australian citizens. It provides the record owner with clinician and their own consumer entered health information and data on a secure platform, controlled by the individual health consumer.

My Health Record has been able to put the health consumer into the driver’s seat by providing each consumer with this comprehensive access to and control over his or her personal health data. There are currently over 5 million Australians with a My Health Record, and by the end of 2018, the system will move to an opt-out model, meaning that all Australians will have access to the My Health Record platform which has been developed with widespread stakeholder input. It encourages multi-directional data exchange to wide array of health data systems, including dentistry.

All registered Australian clinicians can apply to access the system, and need conformant clinical software and must also comply with a range of security and registration requirements. The privacy of people’s health information in the My Health Record system is also protected by a number of technical safeguards as well as a legislative framework that includes strict penalties for unauthorised access.

My Health Record provides an electronic summary of an individual’s health information that can be shared securely online between the individual and registered healthcare providers involved in their care to support improved decision making and continuity of care. One of the immediate goals for the system is to reduce the 230,000 hospital admissions due to adverse medication events per year that cost up to $1.2 billion annually.(2)

Figure 1: Overview of Australian My Health Record system

As of December 2017, 5.4 million Australians have registered (22% of the population). Over one thousand public hospitals and health services have also started to participate, and private hospitals and providers of radiology and pathology are connecting and contributing health data.

The Australian Digital Health Agency is also funded by the Australian government to develop and implement Australia’s National Digital Health Strategy – Safe Seamless and Secure.(3) Chiefly, it designs and operates national digital health services and data standards that:

  • Give consumers more control of their health and care when they wish it
  • Connect and empower healthcare professionals
  • Promote Australia’s global leadership in digital health and innovation

The My Health Record system is a key pillar of the National Digital Health Strategy, as it ensures health information is available whenever and wherever it is needed. In consultations during the strategy development, it was found that over 65% of respondents stated that the Australian healthcare system is difficult to navigate. People want to know the cost, quality, and availability of services. The top three activities Australians wanted to be able to do on their mobile devices were:

  1. Manage their medications
  2. Track their health
  3. Request refill prescriptions

The My Health Record system provides for potentially lifesaving access to a patient’s key health information such as medications, allergies, health conditions and test results - supporting significant improvements in the safety, quality and efficiency of Australia’s healthcare system.

The Australian Digital Health Agency is also charged in the legislation under which it was formed to “liaise and cooperate with overseas and international bodies on matters relating to digital health”. This opens up new opportunities for learning from international perspectives and for members of the Dental Informatics Section and other leaders in the dental health data space in North America to collaborate with the Australian Digital Health Agency in order to build knowledge and evidence relating to the benefits of applying digital health services to the practice of Dentistry.


Footnotes:

  1. Productivity Commission. Productivity Commission Inquiry Report: Data Availability and Use. Canberra; 2017.
  2. Roughead EE, Semple SJ, Rosenfeld E. The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. Int J Evid Based Healthc. 2016 Sep;14(3):113–22.
  3. Australian Digital Health Agency. Australia’s National Digital Health Strategy.

Source: Contribution to American Dental Education Association’s Section on Dental Informatics Newsletter (PDF distribution)