Speaking at the AFR Healthcare Summit in Sydney, federal health minister Mark Butler highlighted digital health’s ‘quiet revolution’.
Federal health minister Mark Butler has his head around a lot of complex reform in digital health, but is his assertion at the recent Australian Financial Review Healthcare Summit that the My Health Record remains the ongoing centre piece for transforming data sharing in our system on the mark? Decide for yourself.
As Medicare enters its fifth decade, a quiet revolution has been underway in digital health, upgrading the My Health Record, implementing “sharing by default”, developing interoperability standards for health data that are common and have been for years in other countries we compare ourselves to, but have been lacking here in Australia.
The massive potential of these reforms is matched perhaps only by their incredible lack of any news appeal.
When we came to government, My Health Record was unarguably in need of a dire upgrade.
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We were still using the old PDF format we had introduced when I was in the health portfolio back in 2012 [when] it was pretty cutting edge.
It’s not so much cutting edge in the mid-2020s, meaning that too many health professionals and frankly, practices and hospitals, are still relying on paper. The younger members of my staff are still aghast at fax machines, which they’d never heard of until they came to the health portfolio.
For almost 10 years nothing was done to upgrade the technology that underpinned the My Health Record while the broader economy went through an astounding digital revolution that reshaped industries.
The My Health Record sat there gathering dust. Instead of playing a coordinating role to allow patients’ health information to follow them through their health system and their life, the former government just vacated the space without clear leadership.
Clinical information systems were built using licenced frameworks that simply didn’t talk to each other, with many different systems across public hospitals, private hospitals, aged care facilities, general practices and allied health clinics. Patient data became effectively siloed behind a series of walls of proprietary programs.
In 2023 we funded CSIRO to lead a partnership across the digital health sector called the Sparked initiative, to deliver a national set of data and exchange standards. The standards will use that fast healthcare interoperability resources framework (FHIR) that is used widely in the United States, the UK and Europe.
The first goal was to develop standards for core patient health information, covering procedures, allergies, medicines, problems, immunisations and results, and in just 10 months, the goal was achieved in June last year.
Australia’s first ever national information sharing standard was published and can now be built into clinical systems. This represents more progress in just 10 months than we saw in the previous 10 years.
Shared national standards will enable the My Health Record to become the data-rich platform that Australia and Australians need.
Late last year, the Australian Digital Health Agency put out a large tender to do just that.
Instead of a shoe box of PDFs, which is essentially how I’ve described the My Health Record, now we’re going to upgrade the system so that it’s interoperable with the clinical systems used by Australia’s 7000 general practices, 700 public hospitals, nearly 3000 aged care facilities and all of the other healthcare settings.
We want all those different clinical software systems to be able to draw upon data in the My Health Record directly and publish back to it seamlessly without any additional data entry required of the hundreds of 1000s of healthcare practitioners.
The first step is ensuring, obviously, that the data is there in the first place, which is why, late last year, we passed laws in the parliament to ensure that medical test results and scans must be shared to a patient’s My Health Record by default.
Patients should not have to rely on the goodwill or the good management of private providers to be able to access their own health data.
Withhold a patient’s results, and we will withhold the Medicare payment to the company. And let’s be clear about why our government is so committed to this.
Yes, it will make healthcare professionals lives easier by helping them to be more efficient and effective, and yes, there will be flow-on benefits across the system, helping to ensure that every precious dollar in the Medicare system goes to patient care. Those are important things.
But the reason that we are driving so hard for that digital future is not to provide a system benefit, but patient benefit, because patient benefit is and always will be our North Star.
Patients find this so frustrating because every lost test result means another day off work, another waiting room, another procedure and perhaps yet another gap fee.
Studies from the UK’s National Health Service indicate that up to a quarter of all pathology requests may be duplicates or unnecessary.
The Productivity Commission here in Australia says that almost $6 billion a year could be saved through reform in Australia’s digital health infrastructure in the way that we are doing right now.
Every dollar that doesn’t go to a needless or duplicate test or a scan is a dollar that can fund life-saving and life-changing treatments.
Every minute that a GP doesn’t spend searching through the My Health Record for a result that may or may not be there is a minute that they can spend talking to their patient.
You don’t have to be a Rhodes Scholar to recognise that every minute a health professional spends on a task that is well below the level of their skills and training and experience is also a minute wasted.
Unfortunately, this happens too often.
This is an edited version of part of Mark Butler’s presentation at today’s AFR Healthcare Summit in Sydney.
