At Tuesday’s PHN Data and Digital Showcase in Sydney it became clear that DoHDA and the AIHW want to partner with PHNs to develop cohesive primary care data standards and a minimum dataset resource for the country.
On my way to Tuesday’s PHN Data and Digital Showcase in Sydney, the first time PHNs have met as a collective on a national basis to discuss the future of data for the sector, a colleague sent me a piece I wrote a few years ago with a pointed note: “Don’t forget you wrote this…”
The piece, written in April 2022 and titled, The Problem with PHNs As Masters of the Dataverse, was a pretty blunt assessment of how eclectic and inefficient the collection and storage of primary care data was becoming across the national PHN network, and what the government was thinking at the time about these issues given the obvious importance of regional health data to the future of system planning and development.
At Tuesday’s first national get-together of PHNs to discuss the rapidly growing importance of the convergence of data, AI and analytics with fast-improving digital health infrastructure across the country, it was apparent that, while a lot of those issues from a few years ago still persist – core competency in data collection and storage, duplication of resources collecting and storing data across the PHN network, and a lack of standards and governance in the data collection and analysis process – the data expertise and capability of PHNs is growing rapidly. And the government wants to work and partner with the PHNs in developing a much better national primary care data framework, not against it in any way.
At Tuesday’s meeting, the CEO of the Australian Institute of Health and Welfare, Dr Zoran Bolevich made it very clear to his PHN audience that the approach his group and the government would be taking is partnership and collaboration.
“The AIHW is committed to a strong, lasting sustainable partnership with PHNs and the policy leadership of the Department of Health, Disability and Ageing,” he said.
“We have an amazing opportunity to radically improve and enhance the data analytics landscape in primary healthcare in Australia, and make a significant contribution to health outcomes through meaningful use of data,” he told delegates at the Showcase, a few from each of the 31 PHNs around the country.
Dr Bolevich seemed to be flagging a subtle but important change in the government’s approach, at least from DoHDA from a few years ago. He wasn’t at the AIHW back when the Institute, frustrated with the fragmentation, duplication and replication of data collection and analysis by various PHNs across the country, was considering taking over the entire data acquisition, storage and analysis process and running a lot of the work centrally.
That wasn’t an entirely stupid idea.
The government and the AIHW have far more capacity, money and expertise to extract and store data from primary care and to conduct analysis on behalf of the PHNs, than each individual PHN could ever hope to achieve.
Organising all the PHNs in a line to get standardisation, a single governance framework and relatively high levels of expertise, looked very hard back then.
But at Tuesday’s summit Dr Bolevich was clear about bringing the PHNs along on the journey, as the dedicated regional owners and users of local population health data, which, when you think about what PHNs are really supposed to be doing, makes sense.
Related
It would, by the way, be interesting for everyone to get a look at what the Boston Consulting Review on PHNs says about this government-identified core function of PHNs and how it would relate to the stance AIHW and the DoHDA are now taking.
For most of their 10 years of existence the DoHDA has not really allowed PHNs to perform the role that DoHDA has outlined for them – per the DoHDA website, but rather has tended to use them as top-down deployers of tactical initiatives that the department comes up with.
The summary on the website is below:
- Coordinate and integrate local health care services in collaboration with Local Hospital Networks (LHN) to improve quality of care, people’s experience and efficient use of resources.
- Commission primary care and mental health services to address population health needs and gaps in service delivery and to improve access and equity.
- Capacity-build and provide practice support to primary care and mental health providers to support quality care delivery
The second point above is the part which says PHNs should advise on how to collect meaningful local health data, analyse it and use it to deliver better local healthcare services.
But as most people are aware, how the government says PHNs should be working – building intel on local populations through good data and then informing the department on how best to deploy resources into that region tactically based on that data – and how they are actually being used by the government is largely upside down.
Which is why what Dr Bolevich seemed to be hinting at today – that the AIHW and DoHDA really do want to partner strongly with PHNs to build out their data skillsets and expertise, and collaboratively develop a cohesive and standardised approach to primary care data – is potentially an important marker in the evolution and acceptance of PHNs.
PHNs shouldn’t be involved (much) in the actual collection and storage of data, as they are now. As GP patient management systems go to cloud over the next few years it’s easy to imagine that a group like the AIHW could take over a lot of the complexities of getting that data out of GP systems in a cohesive and commercially efficient manner.
It should probably also look after storage.
A lot of PHN storage is done via a data lake project in WA called Primary Health Insights built by WAPHA. A few years ago the government was thinking of going around this facility and building its own centralised data sets.
But in another sign that there really is collaboration and trust building between the government and the PHNs it’s apparent now that the WA facility is going to be run in some sort of joint manner between the PHNs and the government.
This is probably all a good thing because storing and sharing data at that scale is a very complex and expensive game, made especially so by security needs.
Government help should be welcomed by the PHNs.
What the AIHW and perhaps DoDHA may have come to appreciate is that although each of the 31 PHNs will never have the expertise and investment and project management capacity that the AIHW has, they are important regional intelligence and deployment units that we need to upskill.
The also need to stay (or become) agile in their ability to analyse and use their local data.
One thing the AIHW might be able to do is focus the PHNs on how to analyse their data better, rather than extract and store it. Building data analytics skillsets in a cohesive manner across all PHNs will be important, and the AIHW would be a natural ally in helping this process, you’d imagine.
In the past there was a danger that big government would attempt to ride in on some sort of data white charger with its money and expertise and take over a lot of the population health management process.
That likely would have disenfranchised the PHNs and created an environment where PHNs’ superpower, local knowledge, would be lost to the whole process.
It’s not like government has a great track record on running big complex data projects either, so the natural reluctance of PHNs to let go on some obvious areas where government can help, is, well, natural.
Dr Bolevich is happy to take things at a pace that will not frighten off the PHNs from partnering properly with the AIHW.
He told Health Services Daily that the intention of AIHW would be to work on some select projects and prove out to the PHN sector the benefits of working with the Institute so they can build out trust, and create momentum as they go.
He thinks both groups can and should learn from each other.
Dr Bolevich also pointed out that that there’s now an ideal convergence of technology, PHN maturity and government alignment with key digital health infrastructure and standards, which make collaboration on developing great primary data sets across the regions an exciting prospect over the next few years.
Dr Bolevich isn’t a slowly, slowly catchy monkey kind of guy – he thinks big and likes to see progress in what he does. He’s the one that got EPIC over the line against many odds as the new NSW hospital EMR of choice.
He’s ambitious to move as quickly as the technology, especially AI, will allow the AIHW and the network of PHNs to go.
But it’s clear now that both the AIHW and the DoHDA want the PHNs to be immersed in the primary data care journey with them.
They see the PHNs as critical to the plan they have.
Maybe as a part of that plan DoHDA will start to take its own direction on “What PHNs Do” and use PHNs the way their website says – start using them as critical regional population health data intelligence units first, and, using that data, deployment groups after that.
