What is the state of digital health in Australia?
“The digital health and application of healthcare technology in Australia has improved significantly during my career, especially over the past decade. The government has invested significantly in supporting it through the development of the Australian Digital Health Agency.”
“Our health care system is split between federal and state governments, as well as a significant private sector. Some states, such as my home state of New South Wales, have been very active for many years with EHRs in all public hospitals and several iterations of systems during that time. Others were less, but are catching up.”
“We have had widespread automation in general practice for decades. However, this has given us an issue with legacy IT systems as we move to new architectures.”
What is planned for the coming years?
“A number of national initiatives on interoperability using the international standard FHIR – an Australian innovation – are underway. We are also working on more functionality in our national shared file system ‘My Health Record’.”
“The transition from legacy architectures to the cloud is progressing. Recently, approval to integrate the aged care system into the digital world has sparked a wave of activity in that space. COVID-19 has led to an increase in telehealth, but we have yet to see where that leads.”
Some doctors avoid their computers, but you like the IT in medicine. Why?
“It may be a generation issue, but I always saw IT as a tool for improvement and jumped on the IT train as soon as possible with my first personal computer in 1981. I think most doctors view technology positively, but active users and no want to be passive users. If they get the chance to play a bigger role in IT systems, I think they would become a lot more active advocates.”
Already ten years ago, in a TED talk, you mentioned the term “hate e-health.” What’s wrong with this term?
“The problem with e-health, or even digital health, let alone the other manifestations, is that it puts the technology first and the health component second. Our goal is the delivery of healthcare and healthcare technology is one of the many tools we have at our disposal. Using all of our available tools offers us the opportunity to improve our care, but focusing too much on the tools and not on the service model leads to a lot of IT procurement but little care delivery.”
As chair of the IT Council for Elderly Care, can you share what healthcare technology is already offering to an aging population?
“The first thing technology offers an aging population is transparency. Shared information that is available not just to a few providers, but to the entire population. It also opens up new possibilities for intra-sector and inter-sectoral communication. It ensures that the management of their care can be better coordinated, that their family and friends can be involved if necessary, and new tools for monitoring, reporting and alerting can help them better manage the vagaries of aging.”
How can we reach people over 65 with digital services, including those who shy away from computers, for whom the current technological revolution is moving too fast?
“The best way to provide digital services to both over-65s and over-65s is to make them as easy as possible to use and demonstrate the benefits. Easy-to-understand interfaces and integration between systems, so we don’t have to log in to each service separately, and data can be shared.”
“Let the elderly take an active role in designing systems and, most importantly, let them decide what they want help with, don’t make those decisions in isolation.”
Digital health services for seniors are growing at a rapid pace. It is a lucrative market for many companies. How do we separate valuable healthcare technology from gadgets that add no value to healthcare?
“As with any rapidly evolving consumer sector, there will be good and bad uses for the elderly. The market is a vital force, but we also need regulation to ensure safety, and we need to remain vigilant for fraudulent claims.”
During your time at Intel, you worked with the healthcare industry to drive innovative use of information technology. Should healthcare work more closely with big tech companies?
“I have to say that Intel was years, if not decades ahead of the music with its innovations in healthcare. Big tech can play an important role, but these concerns need to understand where it adds value and not see themselves as the healthcare expert.”
“Collaborating with innovative clinicians and engaged consumers is critical, which is difficult for a large company. It is therefore essential to ensure that they make the infrastructure fit for innovative solutions and to support innovators to develop on their platform.”
What should a proper evaluation of new healthcare technology and appropriate adoption look like?
“Legal requirements for quality and safety are essential, but we need to empower clinicians and consumers to innovate new solutions using the available technology. That requires collaboration between clinicians, academia, government and concerned consumer groups to evaluate solutions and report them transparently to the wider community.”
Read the interview with George Margelis on ICT&health International here. Or read this article about a new report from Nictiz to learn from abroad in the field of digital communication.
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