Revitalizing Australia’s eHealth Futures

The Australian government made a long-awaited announcement today to reinvest in the country’s previously stalled eHealth reform agenda. The recently appointed Minister for Health has embraced a move to shift the current eHealth system to a national opt-out model – which means all Australians will automatically have a summary electronic health record sensibly and intuitively called “myHealth Record.”

By Lisa Pettigrew, General Manager, Global Healthcare, CSC

Released in anticipation of the federal budget on May 12, the reports suggest the Australian government is making some important and welcome moves toward increasing the innovation and agility of the Australian eHealth model.

Further details include an overdue replacement for the current national governance of eHealth with a new Commission for eHealth. Presumably, further details will be released regarding eHealth reform in coming days and weeks.

The announcement should help restart the eHealth agenda, which stalled after the implementation of the national electronic health system.

It is welcome news that the government is committed to eHealth.

At CSC we believe that eHealth and IT programs must be more connected to healthcare. We believe that new models of care need new models of IT – as we see consumer expectations evolving towards more activist involvement in healthcare, as we experience the rise of wearables, as our population ages and encounters increased chronic disease, and as our clinical workforces evolve.

The move to a national “opt out” model will bring a “critical mass” thinking to the investments around eHealth and will help encourage a pivot towards a more innovative perspective on the variety of means by which consumers should be able to access care in the modern age.

The move to finally retire the National eHealth Transition Authority and replace it with a new Commission for eHealth offers hope for a more agile, innovative framework and governance that reflects the progress that has been made in Australia and globally around how eHealth should be playing a bigger role in improving healthcare outcomes.

But there is still a lot to be done.

As we outlined in an earlier post on this topic, we recommend further areas for focus for the Australian federal government related to eHealth.

Five initial areas for focus include:

  1. Keep it simple. “User-centered design” is not a new concept; eHealth developments must respect the new expectations of consumers and offer simple, convenient means of accessing health records embracing the user experience design standards now common across all online business models. We recommend a “retailer-wholesaler” model whereby the government focuses on ensuring the “wholesale” core of a trusted, authenticated, secure health records system, and consumers can access their records through a variety of appropriate “retail” channels that are convenient, intuitive and user-friendly. For example, why can’t health insurance members access their PCEHR records via the portals of their health insurers? These websites are much more user-friendly than most government websites, and health insurers already have multiple means by which they can authenticate and consent their members.
  2. Embrace a health consumer agenda. Encourage and trial means by which patient-generated data and biometric data can be integrated with patient health records. Consider working with health insurers to trial a variety of models for data integration. Encourage and invite consumer engagement in the design and appropriate means by which consumer generated data can be safely, sensibly and securely incorporated – that is, both qualitative patient-generated data and personal biometric data collected via devices.
  3. Solve the interoperability challenge. Australia has the chance to avoid the interoperability and “data blocking” challenges encountered in the U.S. The restart of Australia’s eHealth reform agenda provides an opportunity for a national commitment to aligning the plumbing of eHealth for connectivity to support the increasing mobility of both consumers and clinicians.
  4. Liberate the data. With appropriate safeguards, unlock the valuable de-identified data associated with eHealth records to encourage innovation in the development of new models of care, new uses of data in identification of healthcare patterns and trends and new healthcare apps to aid healthcare and health services for consumers and clinicians
  5. Get serious about new business models of care. At this time last year, the Australian federal government encountered some political difficulties in considering the concept of a co-pay for GP visits. Aside from potential social equity issues, the real problem with the co-pay concept was a business model problem. The business model of health in Australia needs updating. Australian health consumers need more than the binary options of visiting a GP or an Emergency Department.

What does it mean to change a healthcare business model?

As a comparison, many Australians remember when banks starting charging more for their customers to transact within branches. This was a natural development because customers had already grown accustomed to the convenience of 24×7 access of Automated Teller Machines (ATMs) and phone banking services. Many customers had already stopped visiting banks for routine transactional and information needs.

If the banks had introduced extra charges for branch visits without first implementing ATMs and phone banking there would have been outrage.

In terms of healthcare, this is what it would mean to introduce a GP co-pay in the current Australian healthcare environment. Before we consider modifications to the current fee structures, we need to embrace alternative options and channels for access to healthcare.

The time is now for the Australian government to reform the business models of healthcare to structurally ensure Australians can access the appropriate healthcare in the appropriate way at the appropriate time – that is, it is time for new models of care focused around telehealth and telemedicine, urgent and minor care, and coordinated care for ongoing chronic disease management with access to a range of clinical providers, appropriate to the clinical issue. Many of Australia’s OECD peers are already down this path.

These alternative models of care can encourage self-service and self-sufficiency, can increase health literacy and can offer choice and convenience for Australians.

It is after implementing and encouraging use of alternative models of care that we can sensibly consider embarking upon a community discussion about updated payments and co-payments for healthcare – that is, once there are more options and channels for health consumers to consider other than always having to visit the GP or the Emergency Department.

These are some of the initiatives that can excite health consumers to re-engage and can help deliver upon the promise of eHealth to improve healthcare outcomes.

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