The agency’s chief digital officer, Peter O’Halloran, challenged the findings of an industry survey that claimed hospitals prioritised workflow over data sharing.
Hospitals are no longer choosing clinician workflow over interoperability when procuring electronic medical record (EMR) systems, according to Australian Digital Health Agency chief digital officer Peter O’Halloran, who says interoperability has become a “baseline hygiene factor” that vendors are now simply expected to deliver.
Mr O’Halloran’s comments came in response to the Black Book State of Australian Healthcare IT 2026 report, which found clinical and operational effectiveness was the highest priority for Australian healthcare organisations evaluating EMR vendors (44.1%), ahead of interoperability, data, and innovation (27.1%).
The report concluded that Australia’s EMR market remained “clinically driven, with workflow and medication safety at the core”, with clinician workflow fit and usability and medication safety emerging as the two most important individual procurement criteria.
But Mr O’Halloran rejected the notion that hospitals were choosing between clinician usability and interoperability.
“We don’t see them as being prioritised over and above interoperability in data sharing,” he told The Medical Republic.
“In many ways, we would say that interoperability and conformance with standards and the like is almost like a baseline hygiene factor that shouldn’t be a determining focus on one system or another.
“What we would expect is that clinical usability and safety is front and centre for every hospital when they’re implementing a system.”
Mr O’Halloran said the report should not be interpreted as suggesting clinician workflow and interoperability were competing priorities.
“They are mutually reinforcing, and really should be,” he said.
“There are many things, if you’re putting in an electronic medical record system into a hospital, that are just those core things that a system must do.
“We see that interoperability, compliance with global standards, compliance with the conformance arrangements in Australia is simply the same way.
“It’s a core sort of bar of entry into the system.
“The benefits, and I suppose then the unique selling points individual software can then have, is what functions they have, how usable it is for a consumer or a clinician.
“That’s how we see it. We don’t see it as being one or the other.”
Standards changing the market
The Black Book report, based on responses from 454 validated Australian healthcare stakeholders, found respondents overwhelmingly favoured systems that improved clinical workflows and medication safety.
“Across all roles, nearly half of respondents identified clinical and operational effectiveness as the most critical domain, followed by interoperability and data capabilities,” the report said.
Asked whether the ADHA’s interoperability work had fundamentally changed procurement expectations, Mr O’Halloran said the landscape had shifted significantly over recent years.
“The work across national interoperability across all of Australia … is actually fundamentally changing the landscape for interoperability in Australia,” he said.
He cited initiatives including Sparked, the FHIR Accelerator, national digital health standards, procurement guidelines, and the National Healthcare Interoperability Plan.
“What I hear from many software vendors is that they are now hearing from their customers … that the health services expect that the software vendors will ensure that they are compliant with standards, meet conformance requirements, and are connecting [to] national infrastructure for things such as My Health Record, electronic prescribing, Australian Immunisation Register, and so forth,” he said.
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‘Not luxuries, not add-ons’
Drawing on his previous experience leading ACT Health’s IT strategy, Mr O’Halloran said the first priority in any EMR procurement remained unchanged.
“It needs to be safer than the care that’s being provided on paper,” he said.
“It needs to be accepted by clinicians and consumers. Without that, you can’t achieve anything.”
He said chief executives also needed to ensure prospective systems met a range of non-negotiable national requirements.
“Whether that’s My Health Record, whether that’s electronic prescribing … those are all core things.
“They are not luxuries, they are not add-ons. They’re just a core part of what a system should do today.”
AI depends on better data
Mr O’Halloran also argued that Australia’s adoption of global digital health standards would be critical to the next generation of AI in healthcare.
“One of the biggest barriers to interoperability, but even to the adoption of AI at scale in healthcare, is ensuring that the data is comparable, that you’re comparing apples with apples,” he said.
He pointed to semantic interoperability, including Australia’s adoption of SNOMED CT clinical terminology, as a key enabler.
“When you have a result come in from one health service … that can be consumed directly into another health service IT system, with confidence that it really does mean [the same thing].”
A market still maturing
Despite challenging the report’s implied trade-off between workflow and interoperability, Mr O’Halloran said the Black Book findings reflected a digital health market continuing to mature.
“It really does highlight that the level of digital health maturity in Australia’s hospitals is increasing,” he said.
“We have a diverse range of vendors, which is a good thing. And there is real differentiation between them, but there’s still a long way to go in some areas.”
He said the Black Book report demonstrated “an overwhelming appetite for highly usable clinical systems and seamless data sharing from clinicians, consumers, and administrators”.
“The challenge today … is how is that overwhelming appetite translated from expectations into implementation of the software that underpins Australia’s health system?
“There are many examples of good implementations of clinical usability or consumer-centric services or global standards adoption, but it’s far less common to see those three combined together and at scale across all software in Australia’s health system.
“So, it’s still a journey we have to continue.”
Read the full Black Book report here.
