Feedback invited on implementation plan for Australia’s National Digital Health Strategy

In 2017, the Council of Australian Governments (COAG) Health Council approved Australia’s National Digital Health strategy (2018-2022).

The Strategy seeks to put the consumer at the centre of their healthcare, providing choice, control and transparency. The Australian Digital Health Agency (ADHA), in consultation with the states and territories, has drafted a Framework for Action to support the strategy’s implementation. ADHA is running a consultation to gain wider feedback on the draft framework.

The Framework for Action sets out priority activities for co-development for the period 2018-2022 and defines the roles of participants, including healthcare consumers, healthcare providers, the industry and technology sector, peak organisations, ADHA, the Commonwealth Government and the State and territory governments. 

Credit: ADHA

The eight priorities are as discussed below.

Health information that is available whenever and wherever it is needed

Credit: ADHA

By December 2018, the Australian Government will provide a My Health Record for every Australian unless they choose to not have one. For the roll-out of My Health Record, the Australian government allocated AU$374.2 million in its 2017/2018 Budget, over a period of two years from 2017-18 onwards.

The My Health Record will be continuously improved, with scoping, building, testing and executing system releases planned over the life of the Strategy to provide additional functionality and health information.

The My Health Record provides a data platform that will foster and support digital innovation, leading to the development of digital health solutions and support future developments including precision medicine and genomics. To support innovation the capture of available and relevant information in the system, including pathology and diagnostic imaging results, and medicines information, will be increased and the consistency and usability of medical reports will be improved. The usability of clinical information systems will be improved to ensure the My Health Record integrates more intuitively, based on the development of an evidence-based design research framework.

Another priority action in the area is to establish a framework to govern the safe and secure use of My Health Record system data.

Health information that can be exchanged securely

Credit: ADHA

The existence of multiple health service directories and the lack of confidence in completeness and currency of data in these directories and addressing services present challenges to achieving a standardised approach to secure messaging.

A national provider addressing service will be established, building on the design work already undertaken. A key first step is progressing requirements and options analysis, and confirming the scope of this service co-designed with states and territories and industry stakeholders.

The Framework highlights the need for an integrated standards-based secure messaging capability using national infrastructure services.

The set of information in a message, and how it is displayed, is not currently standardised. To address this issue, nationally coordinated programs will continue to develop and refine specifications and national reference architectures, co-produce implementation profiles with vendors and demonstrator health services, and drive national adoption and use for priority usage patterns, including discharge summary, referrals, specialist and allied health reports (e.g. including specialist to specialist and psychologist to GP correspondence).

A roadmap will be produced outlining how national infrastructure services will be further enhanced and leveraged to support potential new usage patterns, such as national protocol for transferring diagnostic images, GP-to-GP record transfer, online consultations supported by smart forms, provider-to-consumer messaging and provider-to-provider instant messaging.

Existing national authentication and identification services will be enhanced, through the co-production of an integrated digital identity framework, aligned to Digital Transformation Agency identity and authentication frameworks and services, for health and care provider individuals and organisations that can be used to access a variety of private sector and government sector digital services.

To ensure the national infrastructure services are being used in the most efficient and sustainable way, a strategic service design, sourcing strategy and procurement review is being undertaken by the ADHA to identify recommendations to enhance national infrastructure services.

High-quality data with a commonly understood meaning that can be used with confidence

Credit: ADHA

To address the risk of uncoordinated investment in technology that does not meet a common set of standards and could exacerbate siloing in the health system, Australian governments, industry and the health sector will co-produce a National Interoperability Strategy (NIS). This will include agreed base level requirements for using digital technology when providing care in Australia with governments and colleges, agreed set of national interoperability specifications and standards, accreditation regimes, and procurement requirements.

Adherence to interoperability standards will be promoted and the widespread implementation of the agreed functionality of standards and specifications will be ensured by coproducing a conformance, compliance and accreditation framework and process, building on existing schemes.

Currently, there are a range of digital health initiatives with discrete governance and management processes, including My Aged Care, Mental Health Gateway, GovPas, MyGov, the NDIS, theNational Cancer Screening Registry and claims and payment processes. To avoid fragmentation and duplication, and ensure that the consumers of these services receive coordinated and efficient care that is simple to navigate, a national technology strategy will be co-produced.

National data services will be continuously improved and enhanced, including the National Clinical Terminology, GS1 standards (including GTIN, GLN, Barcoding) and Supply Chain Solutions, including the National Product Catalogue, Locatenet, Recall Health and eProcurement.

Better availability and access to prescriptions and medicines information

Credit: ADHA

According to the plan, medications management for both healthcare consumers and providers will be improved by co-producing and publishing a national digital medicines management blueprint which will include development of the infrastructure, specifications, policies, legislation and change, adoption and training activities for clinicians.

By 2022 there will be digitally enabled paper-free options for all medication management in Australia. National infrastructure will be leveraged for this, and the specifications and regulatory framework required will be developed.

Healthcare providers and consumers will be able to access a best possible medicines list in a structured data format via the My Health Record system by evolving the Available Medicines View, including pharmacy curated medicines list and consumer-uploaded medicines, to support medicines reconciliation, and enable providers to upload the reconciled medicines profile.

A National Medicines Data Service will be established, building on existing programs (e.g. NSW scoping and pilots) and infrastructure, enabling jurisdictions and health service organisations to maintain their own tailored medicines master data of all medicines suitable for use, or receive a managed service.

In addition, there will be targeted consumer information via the My Health Record system. There are also plans to explore the enhancement of medication safety incident reporting capabilities through digital solutions, including the development of a dedicated national framework.

Real Time Prescription Monitoring will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines, assisting to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines.

Digitally enabled models of care that improve accessibility, quality, safety and efficiency

Credit: ADHA

Test-beds will be established focused on clinical priorities to allow evaluation and refinement of digital health care models, and investigate how to scale innovation nationally. Telehealth models, as well as new and existing models of digital consultations, support and care coordination in End of Life Care, will be harmonised across Australia.

Health Care Homes will be supported for digitally enabled coordinated care. It will be ensured that every child in Australia has access to a comprehensive health record, readily accessible by parents and health and care providers. (Recently,  ADHA entered into a partnership with eHealth NSW and the Sydney Children’s Hospitals Network (SCHN) to establish the National Children’s Digital Health Collaborative to work towards this aim.)

A workforce confidently using digital health technologies to deliver health and care

Credit: ADHA

A network of chief clinical information champions will be promoted to drive cultural change and awareness of digital health across the health sector to help embed digital health into routine clinical practice.

National curricula and training materials will be developed for delivery by universities, health services, peak bodies and training organisations aligned to the requirements of continuing professional development programs for all health care providers.

Plans also include co-production of higher and tertiary education curricula relating to digital health and incorporation of components into existing courses.

Led by the professional associations and workforce accreditation bodies, digital health will be integrated into the national workforce accreditation to ensure healthcare providers have easy access to best practice guidelines, and other supporting resources which increase their understanding of how, when and why to use digital health solutions.

A thriving digital health industry delivering world-class innovation

Credit: ADHA

Innovation and digital inclusion will be promoted through thought leadership, conference presentations and industry engagement. A network of local community partners who run digital literacy programs will be developed to advocate for programs which improve digital literacy and ensure inclusiveness, equity and cultural safety for target populations, including Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse (CALD) populations, people living with a disability, carers, and older Australians.

An Innovation Showcase will be established and coordinated by the ADHA to recognise excellence in digital health innovations through awards and publishing case studies of successful health and care innovations.

ADHA’s Developer Partner Program will be expanded to help simplify, guide and support developers on how to bring new ideas to market, facilitate test environments, provide an open source hub of code sets, and provide support on how digital health national infrastructure services can support what developers are trying to achieve.

A sustainable digital health services endorsement framework will be co-designed to complement existing initiatives by both the public, private and non-government sector to compile a user-friendly list of evidence-based digital health services and content.

A new Health Innovation Exchange will support the establishment of a forum where clinicians, researchers and entrepreneurs, both local and international, can work collaboratively on digital health services.

ADHA plans to partner with organisations who support start-ups to transform their ideas into competitive businesses, providing resources, knowledge, seed funding and access to networks. The objective would be to facilitate regulatory sandpits, joint ventures and strategic partnerships to both support the creation of new digital health solutions and scale up current digital health innovations.

Innovation of mobile, portal and desktop applications will also be supported by enabling connectivity to digital health systems separate to the My Health Record such as electronic prescribing, secure messaging, and other consumer provided sources (for example fitness devices). ADHA will work collaboratively with mobile developers to leverage digital health foundations, the Fast Health Interoperable Resources standard (FHIR), and Application Programming Interfaces (APIs) for exchanging digital information.

The draft Framework for Action and consultation form can be accessed here.  Feedback can be provided until Friday 6 April 2018.

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