It was certainly a curious decision by the Department of Health and Aged Care to release its Digital Health Blueprint and Action Plan two days before Christmas, thus consigning it to oblivion in publicity terms, but release it they did, and it makes for some interesting reading.
The blueprint itself outlines the vision of the department and as such closely resembles every other vision statement out there by being aspirational with not a lot of real detail, but the action plan is another matter. This is where the meat on the bones can be found.
As DoHAC’s digital health branch assistant secretary Simon Cleverley told us last year, the action plan will be dynamic and updated annually as programs mature. At the moment there’s a lot of detail about the department’s short-term (2023-2025) programs – and a bit of superfluous stuff about some of the digital tools it is co-funding to support population health – but the good news is those most of these programs are well underway.
Some of them a big ones too. There is the commitment the government made in the May 2023 budget to establish the Australian Digital Health Agency as a going concern rather than making it justify its existence every two years.
The intergovernmental agreement (IGA) that DoHAC signed off on with the states and territories provides certainty and substantial money over four years, with much more transparency on exactly what initiatives are being funded and the point behind them. The IGA is going to be incredibly important in the next four years as it is under this agreement that one of the landmark policy priorities is being funded: the design and development of health information exchange (HIE) capabilities that are essential to health information sharing.
The My Health Record modernisation program is in there, as is the sharing by default legislative agenda – backed by actual money – and there is some really important detail on electronic medication management and electronic prescribing. These will also be landmark policies.
But it is the commitment to interoperability and standards in the short and longer term that is the most refreshing. DoHAC has struggled to manage standards development and funding in the past but we’ve been impressed by the collaborative spirit it is keen on promoting with ADHA, HL7 Australia and the CSIRO to properly develop and implement contemporary standards.
If the $9.3 million Sparked program to develop a FHIR AU core is successful, then the long history of missteps may finally be over and proper information sharing can begin. The action plan is one way that we can all keep track of where money is being spent and whether it has been worth it, and we welcome the department’s commitment to transparency. The long hours Pulse+IT has spent poring over budget papers over the last 15 years may finally be over.
There was some other interesting stuff happening over the Christmas break, including an outbreak of opposition to the federal government’s plan to get rid of the seven-day delay when making pathology and diagnostic imaging reports available to patients through My Health Record. Despite their protestations to the contrary, the medical colleges have never been keen on the idea of letting patients see results for anything but the most routine tests when not in the presence of their doctor.
It does seem that the colleges have accepted it is inevitable that the seven-day delay will be done away with but there is a bit of rear-guard action with their recommendation that certain genetic tests and complex reports be exempt. How abnormal results are handled still require some thought.
And this week, there was some surprise activity in the secure messaging market, with HealthLink buying out Telstra Health’s secure messaging and eReferrals portfolio. This includes Argus, which has been a mainstay of the market since it was developed at the Collaborative Centre for eHealth at the University of Ballarat and commercialised as ArgusConnect in 2004.
The plans for what happens to the Argus brand and when and if its users are transferred over to HealthLink are still a bit clouded. Pulse+IT and HealthLink are both owned by the same group so of course we were completely in the dark about this, but we do now hear that approval has been gained from the competition regulator for the acquisition. Along with the rise of cloud-based eReferral solutions like Consultmed, this will shake up the sector quite a bit.
The Christmas break also saw a disturbing hack of St Vincent’s Health Australia that is still clouded in mystery, a bit of a delay for the roll out of the new Acacia EMR at Royal Darwin Hospital, with emergency department clinicians none too happy, and this week news breaking about the hack of a medical practice’s clinical system in Canberra. Know anything more? Drop us a hint.
That brings us to our poll question for the week. The release of DoHAC’s digital health blueprint and action plan are a bit of a breakthrough in transparency, but will the initiatives detailed work? Let us know.
Are the action plan milestones achievable?
Vote here and leave your comments below.
The professions (medical and allied health) are not listed as partners in any of the activities. The document portrays the various projects and programs as purely technical exercises which will be conducted by informatics professionals who are not clinicians.
This is where NeHTA went wrong right at the beginning of developing the then Person-Controlled Electronic Health Record (PCEHR – now My Health Record).
The action plan does not state any milestones – that is, specific outcomes to be achieved by specified dates
Currently the focus on FHIR makes a lot of sense as this is building the fabric for the next 30 years. The challenge is to break away from a focus on legacy systems (of which there are many and some only recently deployed). Instead of multiple programs of work that has the potential to spread the limited skills too far, a focus on the strategic activities makes sense at this time. As the army of people grows, skills and knowledge are shared, then the program can be expanded, building on success. The US has legislated, and this may need to be looked at, as the softly softly approach has inherent weaknesses. The one size fits all approach by several jurisdictions that has been the focus of the last decade has in my view been a decade lost. Learn from these mistakes and disrupt a failed and expensive decade.
It will be interesting to see how the achieve this:
“When I have informed healthcare, I know what’s going on, I know exactly what’s happening, before it happens [7]”
The reference is to EY Sweeney, ‘DoHAC Digital Health Blueprint User Research’. Jun. 2021
It’s a pity there is no trace of this reference or any details how they can deliver this: “I know exactly what’s happening, before it happens”
I think “I know exactly what’s happening, before it happens” is about the patient knowing what is planned to happen before the plan is carried out. This is hard, but possible. Though poorly expressed. One of the alternate readings of the sentence is clearly impossible.