" To rapidly accelerate the impact of digital health, the strategy should specifically recognise that the role of government is to facilitate private sector development of innovative digital products and services – through establishing the right infrastructure and environment for innovation, rather than attempting to develop new products or services itself."
- BUPA submission
Australia has a track record of innovation and scientific achievement in healthcare. From the invention of the diagnostic ultrasound and the multichannel cochlear implant, to the foundations of Wi-Fi technology, Australian researchers and entrepreneurs have a global reputation for innovation that meets clinical needs and increases quality of life.
New innovative ideas are now under development through collaboration between Australia’s best and brightest entrepreneurs and researchers, turning good ideas into reality, and making new digital health innovations available to healthcare providers and consumers.
In Perth, one hospital’s pharmaceutical ordering system is being operated by robotic systems, allowing the workforce to be reassigned to patient-focused tasks. A mobile app is being trialled that could help diagnose a child with asthma or pneumonia by simply having them cough into a smartphone. A recent pilot program used telecommunications technology to allow patients with serious chronic conditions to be cared for from the comfort of their own homes, monitored remotely by a care team which could respond with appropriate treatment or stage early intervention, helping to keep people well and out of hospital.
In addition to these areas of innovation, there is an opportunity to further drive innovation to contribute to a strong and entrepreneurial economy, and improve our ability to meet the needs of Australians through safer, more efficient and effective healthcare delivery., 
Case study: Western Sydney Diabetes Gateway
The Western Sydney Diabetes Gateway is a mobile application that empowers patients with diabetes to track, manage and improve their health. Developed by Western Sydney Local Health District (WSLHD), Western Sydney Primary Health Network (WSPHN), NSW Diabetes, Telstra, Sanofi and other industry partners, the Gateway app complements clinical care by providing education and support for patients on a daily basis to encourage self-management of their condition. This innovative consumer portal is unique in that it links patients with the core healthcare system and incorporates their data into their care plans, thus improving both self- and clinical management. This is coupled with ongoing two-way communication between patients and their GPs, allowing patients to share data updates and goals, and to receive results and feedback – all from their smartphone or tablet.
There is optimism and enthusiasm among both health consumers and healthcare providers that digital technology will transform healthcare and improve health outcomes. This enthusiasm needs to be harnessed by offering well-designed, evidenced-based digital health technologies and services that are co-designed with users and respect health consumers’ rights to privacy.
Although there is much that is encouraging about Australian innovation in healthcare, there are structural and cultural barriers which prevent Australia from leading the world in digital health innovation. There are lower rates of innovative digital health start-ups in Australia compared to other countries , and a perception of a lack of confidence within the private sector to invest in digital health product development and commercialisation. Potential innovators can be discouraged by a highly regulated and complex healthcare system with strict accountability obligations. More work needs to be done to support the scaling up of successful innovations, based on evaluations of past and current trials.
" The Australian health system needs to be agile and responsive as use of technology becomes more widespread and new tools emerge and change how we manage our health and deliver healthcare."
- eHealth NSW submission
Healthcare researchers and experts are concerned that despite there being over 250 000 mobile health apps available to consumers, few have been evaluated in clinical trials, some have caused privacy concerns, there are no provisions for health system reimbursement, and there are examples of apps making health claims that are unproven or invalid.[166-168]
Many smartphone-based apps, however, have been proven to improve health outcomes , , and there is an opportunity to promote digital tools that legitimately improve and manage consumers’ health, and respect their privacy. Health consumers are looking to government to provide guidance on reliable information and tools to give them confidence in making health decisions for themselves and the people they care for., 
The Agency will work collaboratively with partners, including the Australian Commission on Safety and Quality in Health Care, the Therapeutic Goods Administration and research, clinical and consumer organisations, to design a sustainable digital health services endorsement framework to complement existing initiatives by both the public, private and non-government sectors to compile a list of safe, evidence-based digital health services and content that have beneficial health outcomes and respect peoples’ right to privacy.
While digital innovation is transforming many aspects of our lives, there is not yet equal opportunity for all to participate, particularly those people who make the greatest use of health services. There are three million Australians without internet access, and only 63% of Aboriginal and Torres Strait Islander households have internet access at home.
Case study: Good Things Foundation – digital literacy programs improve access to health services and improve health outcomes
“Widening Digital Participation” was a program established in the UK to support those most likely to experience digital and health inequalities. Between 2013 and 2016 it was found to have achieved:
- a reach of over 387 000 people, raising awareness of digital health resources
- the provision of training to almost 222 000 people in the use of online health resources
- the provision of training to over 8100 volunteers to help deliver the program
- a range of positive impacts on participants, including:
- 41% learnt to access health information online for the first time
- 65% reported feeling more informed about their health
- 52% reported feeling less lonely or isolated
- a total of £6 million was saved in avoided doctor and hospital visits in a 12-month period.
Australia’s digital divide was a key theme highlighted by respondents to the “Your health. Your say” survey, who noted that it must be addressed to ensure that the health benefits achieved in the coming years are shared equally. This view was supported by many submissions, including from Carers Australia, the Good Things Foundation, the Tasmanian Aboriginal Centre, the Consumers Health Forum of Australia, Alzheimer’s Australia, and the Australian College of Rural and Remote Medicine.
" Feedback from older consumers has focused primarily on access and navigation barriers: they either had no access to the internet, did not have the skills necessary to navigate the website effectively, or found it too difficult to find the information that they needed."
- Alzheimer’s Australia submission
"Digital literacy and access is also a significant barrier that needs to be addressed; both in terms of technical ability to access the internet and other digital platforms, but also having the financial means to do so."
- Carers Australia submission
The Agency will convene stakeholders across the community to develop comprehensive approaches to digital inclusion, ensuring that actions to address digital literacy are based on high-quality evidence for how best to support people who are currently experiencing digital disadvantage.
Innovation is about doing things in different ways, whether by using new technology or through collaboration, to create new offerings that meet the needs of health consumers, healthcare providers, industry and the broader community. Accelerating innovation in the health system means:
- facilitating meaningful partnerships between industry, healthcare consumers and the research sector, focusing on addressing the health system’s highest priority challenges
- removing the barriers which prevent the development of new products and processes in the health system
- creating conditions for entrepreneurs to try new things, to engage in rapid prototyping, to learn from patients, carers and healthcare providers, to safely develop products with a “permission to fail”, and applying lessons learnt to make continuous improvements to new innovative solutions
- making investments that drive change
- learning from global best practice
- highlighting and scaling up the innovations that work.
The Agency will work with its partners to evolve the Developer Support Program, focusing on providing a simple gateway to access information, tools, services and support to safely integrate with the My Health Record system and other digital services, as well as providing a space for collaboration and learning. This means providing more transparency on product roadmaps and planned new system improvements, and inviting members of the developer program to partner on co-delivery of new functionality.
The Agency will 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 developers to deliver valued services for patients, carers, clinicians, researchers, administrators and technologists.
All Australian governments have affirmed that Australia’s health system “should focus on the prevention of disease and injury and the maintenance of health, not simply the treatment of illness” and “support an integrated approach to the promotion of healthy lifestyles, prevention of illness and injury, and diagnosis and treatment of illness across the continuum of care”.
The National Digital Health Strategy supports this national commitment through a number of initiatives. Providing a My Health Record to every Australian who wishes to have one will assist patients to understand and communicate with their preferred clinician and other healthcare providers about their health problems, and discuss treatment goals and progress with clinicians. A digital services endorsement framework will give people access to high-quality information about mobile health apps and reliable content that supports and encourages them in taking care of their own health.
“A clear focus (is) needed on meaningful data to be targeted to improve specific health outcomes. Technology should be aligned to areas (e.g. chronic illness such as diabetes or epilepsy) where it can help shift from a reactionary care model to predictive and preventive care.”
- Darling Downs and West Moreton Primary Health Network submission
How will Australia benefit?
- There will be greater availability of well-designed and developed digital health solutions, leading to improved patient and clinician choice and experience.
- There will be increased rates of industry developing and scaling innovative digital health and care services.
- More people will have the opportunity to improve their digital skills and participate in the digital economy.
- Digital health solutions will contribute to building a strong and entrepreneurial economy.
- Australia will be acknowledged globally as a leader in digital health and have an open system that supports industry to develop innovative digital health solutions that deliver improved health outcomes.
Framework for Action - How Australia will deliver the benefits of digitally enabled health and care
Critical Success Factors of Australia's National Digital Health Strategy