In order to realise the benefits of the digital health vision, the National Digital Health Strategy identified six critical success factors that need to be addressed to ensure successful implementation of the strategy’s key priority areas. Below are the details of initiatives underway to address each of these critical success factors.
Trust and security assurance
Consumer and healthcare provider trust in digital health is critical to the successful delivery of the National Digital Health Strategy. Strong privacy, security and risk management frameworks to protect sensitive information while also enabling the safe and efficient sharing of information are vital.
Establishing the Cyber Security Centre
The Digital Health Cyber Security Centre (Digital Health CSC) has been established to support secure operation of national digital health systems and protection for Australian personal health information that is stored and transacted through the Agency. The Digital Health CSC also aims to
raise the security awareness and maturity across the Australian digital healthcare ecosystem. Within the four themes of ‘Partner, Secure, Inform and Respond’, the Digital Health CSC provides a range of cyber-security capabilities to support secure national digital health operations across Australia. This enables the Agency to monitor and assess emerging and evolving cyber threats.
Governing the national data system
In response to the Productivity Commission’s inquiry into Data Availability and Use, the Australian Government has announced they will invest $65 million over the forward estimates to reform the Australian data system and introduce a range of measures to implement the Productivity Commission’s recommendations. The three key features underpinning these reforms are:
- A new Consumer Data Right will give citizens greater transparency and control over their own data.
- A National Data Commissioner will implement and oversee a simpler, more efficient data sharing and release framework. The National Data Commissioner will be the trusted overseer of the public data system.
- New legislative and governance arrangements will enable better use of data across the economy while ensuring appropriate safeguards are in place to protect sensitive information.
The aim of the reforms to the national data system are to improve Australia’s ability to capture the social and economic benefits from existing data, while protecting individual privacy and ensuring people’s data is used ethically.
Commitment, cooperation and collaboration across all governments
Given the significant investment in digital health being made across health services and governments, a national approach must acknowledge, complement and build on these developments and not duplicate existing activity.
Co-development of the National Digital Health Strategy and Framework for Action
The digital health vision and its implementation plan have been co-produced by the Agency with all governments, in partnership with consumer groups, the industry and technology sector and healthcare organisations. The strategy was endorsed by the Australian Health Ministers’ Advisory Council (AHMAC) and subsequently approved by the COAG Health Council on first presentation. The Agency co-designed the Framework for Action with all states and territories, who shared the initiatives that are underway in their jurisdiction that progress the strategy’s outcomes. The Agency also briefed branch heads in the Department of Health to ensure the framework is aligned to Commonwealth Government priorities and supports the broader health reform agenda.
Facilitating national consistency
Mutual interest across all Australian governments is reflected in the Council of Australian Governments (COAG) Intergovernmental Agreement on National Digital Health, with Commonwealth, state and territory health ministers as signatories. The agreement reflects a commitment to the work of the Agency and a recognition of the benefits of a coordinated and collaborative approach across
The Australian Digital Health Agency is governed by a skills-based Board and is supported by several expert advisory committees, including the Jurisdictional Advisory Committee, which is represented by each state and territory in Australia. The committee provides advice to the Board in relation to all matters that are being considered, or are to be considered, by the Board in order to facilitate national consistency in relation to digital health.
States and territory governments working together to improve child health
Australia’s states and territories have joined forces in a unique and transformative partnership that harnesses technology to improve the health and wellbeing of Australian children. The Collaborative is exploring how every child in Australia can have the option of a comprehensive digital health record from the time they are conceived, through those critical first years and adolescence; readily accessible by parents and healthcare providers and ultimately for that individual throughout their life. The Collaborative comprises around 400 clinicians, consumers, IT experts, and researchers from across Australia and is aimed at making a positive impact on children’s health and wellbeing.
Establishment of legislative, regulatory and policy frameworks
The management of personal healthcare information and clinical processes is governed by a complex network of federal, state and territory legislation. Australia’s policy and legislative framework must be able to accommodate changes that will occur from time to time, and for the maturation of implemented solutions.
Regulatory exemptions for innovative solutions
The Agency is leading test bed projects, seeking interest from organisations to provide services to establish geographical or health sector-based test beds. The test beds are intended to be partnerships between industry, government and other organisations using new approaches and demonstrate outcomes (e.g. by creating a new digitally enabled model of care, or by generating robust evidence of the impact of an existing digitally enabled service) that can be scaled nationally, and provide further business opportunities for partners.
The test beds will include the testing of policy, regulatory and governance models through the facilitation of regulatory sandboxes offering regulatory exemptions for innovative solutions.
The Australian Government is investing over $28 million over five years to introduce a national electronic prescribing system for the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) from 10 October 2019. Leading the regulatory work to determine the requirements for electronic prescribing is the Electronic Prescriptions Working Group, established by AHMAC. State and territory chief pharmacists and chief information officers are tasked to develop the legislative framework for electronic prescribing, and help determine the requirements on prescribing operators for the technology used to generate a legal electronic prescription.
Strong consumer and clinician engagement and governance
The ongoing use of collaborative, co-design and co-production principles will be integral to ensuring digital health is usable within the health system. Any initiative requiring a change of practice in the digital health domain will require comprehensive clinical and consumer engagement to be successful.
Co-production is the process of soliciting user contribution into the development and provision of products and services, resulting in outcomes that better meet user needs. Developing and delivering digital products without a complete understanding of the end user’s experience may result in a product that is not usable, is potentially unsafe and ineffective. The Australian Digital Health Agency has embedded co-production into its engagement frameworks, and uses a co-production and user-centred design approach throughout its operations and the product development lifecycle of its products and services. This is demonstrated through the integration of nominated consumer and clinical representatives into the Agency’s project and program teams.
Enhanced clinical leadership to represent their professions
The Australian Digital Health Agency has greatly expanded its group of clinical reference leads to promote greater engagement across healthcare sectors by tripling the number of clinical reference leads – from 15 to 45 members. Each one is an experienced, well-regarded healthcare professional who is able to represent the perspectives of their profession in designing digital health products and services. Collectively, they provide an invaluable conduit between the Agency’s product and service development teams and Australian healthcare professionals.
Leading by learning
The Australian Digital Health Agency hosts regular community and consumer listening forums to initiate important and ongoing conversations with community groups on how digital health will impact the individuals they support and represent, and to provide opportunities for organisations to provide insights into the challenges facing their members, and to identify new ways to deliver more effective and efficient digital health together.
Effective governance and leadership
Strong national leadership will be critical to the success of this strategy. No single organisation can achieve the desired outcomes from digital health alone. A coordinated approach will support governments and industry to deliver on the objectives.
Connecting digital health to national health reform
The Health Services Principal Committee has an ongoing role to advise the Australian Health Ministers’ Advisory Council on health services reform requiring national collaboration. The committee promotes national population health initiatives while collaborating to improve key interfaces between national and state and territories funding and management of services, particularly primary/acute hospital interface, care of older persons and the public/private interface. HSPC also works to improve health system capability (including digital health, performance measures and national health information strategy) as well as advising on workforce planning and reform arising from the work of the National Nursing and Midwifery Education Advisory Network (NNMEAN), the National Medical Training Advisory Network (NMTAN) and the Australian Health Practitioner Regulation Agency (AHPRA).
Achieving the digital health vision together
Achieving the vision of digital transformation will only happen by working in partnership with the healthcare sector and consumers, one of the first decisions the Australian Digital Health Agency Board made was to appoint five Board advisory committees: Clinical and Technical; Consumer; Privacy and Security; Audit and Risk; and Digital Health Safety and Quality Governance. The advisory committees provide strategic thought leadership in their areas of specialist remit, and assist the Agency more broadly in the performance of its functions.
Robust governance arrangements for key national digital health projects
The Australian Digital Health Agency has established robust governance arrangements for key national digital health projects. The My Health Record expansion program includes a steering group which consists of over 30 stakeholder groups, including national clinical peaks, academia and consumer groups. Steering groups representing over 20 peak industry bodies and professional organisations are part of the Agency’s programs.
Learning from others
By developing meaningful partnerships between industry, healthcare consumers, and the research sector, and working with our international partners to share our lessons and insights, there is an opportunity to accelerate our progress in digital health.
A new global network to support best use of digital technology in modern healthcare
International participants from 13 countries, Hong Kong SAR, and the World Health Organization (WHO) have kicked off a new global network to support best use of digital technology in modern healthcare.
The partnership will create a common platform for international experts to share knowledge and experiences, to network, and to forecast emerging trends to support the digital health landscape.
The Global Digital Health Partnership is an opportunity for deep, transformational engagement by governments, digital health agencies, and the WHO so they can learn, share policy and other evidence that supports them to deliver better digital health services. The Global Digital Health Partnership will collaborate on topics including connected and interoperable health care, cyber security, policies that support digital health outcomes, clinician and consumer engagement and evidence and evaluation of digital health.
Industry, government and research partners to transform health delivery
The new Digital Health CRC (Cooperative Research Centre) will invest over $200 million to develop and test digital health solutions that work for real patients in hospitals and health services, while equipping Australians to better manage their own health and wellness. The centre will operate through collaborative R&D programs involving 40 commercial and government organisations operating across the health, aged care and disability sectors, 24 established and start-up technology, advisory and investment companies, and 16 Australian universities. The centre has the support of both the Australian Digital Health Agency and the Medical Technologies and Pharmaceuticals industry growth centre (MTP Connect). By linking industry expertise with world-class research capability, CRCs generate new knowledge, solve problems and offer opportunities to commercialise new ideas.