Progression into digital health
According to the Australian Digital Health Agency, digital health is “electronically connecting up the points of care so that health information can be shared securely”  but is defined to include any aspect of health where emerging technologies are influencing how healthcare is delivered by the World Health Organisation. Examples of technology influencing healthcare range from large-scale projects such as the My Health Record, the development of eHealth or telehealth programs, to products like health smartphone apps or wearable devices such as Apple Watch and FitBit. Dr Steven Hambleton and Dr John Aloizos AM recently wrote an article in The Medical Journal of Australia describing “Australia’s digital health journey” that gives a thorough summary of how digital health has progressed in Australia from the 1990s General Practice Strategy Review Group to the current implementation of My Health Record.
ACHSM President Dr Neale Fong was interviewed by Health Leader TV, an online news-style program created by the ACHSM and ASN Media, last year about innovation and technologies affecting health care leaders today; saying “Innovation and technology is everyday work for healthcare leaders. The digital health revolution is not just on us, it’s all over us. If you want to be a good health care leader, you have to understand what digital health is. Digital is going to be consuming if not 50% of your life, your life is going to be a digital one.” He also discusses where digital innovation will be able to assist in improving work processes and patient outcomes in healthcare. Patient outcomes and workflows appear to be one of the biggest focus’ for all leaders currently working in healthcare at the moment and is the immediate aim of most leaders we speak to regarding future uses of digital health innovations. Nearly every digital health leader has said the greatest achievement as a result of digital health will be the ability to improve the patient experience within the healthcare system.
As technology continues to progress so to does the healthcare industry, as a result, Ccentric has developed a digital health practice to better meet the needs of our clients. We speak with key leaders in the digital health space to bring you insights into where they feel the digital healthcare space will develop in the future, how they got into the digital health and what the biggest benefit of advancing technologies has been to date.
- Dr Amandeep Hansra; Founder, Creative Careers in Medicine, General Practitioner & Director, Evermed Consulting
- Professor James Boyd; Chair of Digital Health, La Trobe University
- Dr Keith McNeil; Assistant Deputy Director General and Chief Clinical Information Officer, Queensland Health
How do you see the digital healthcare space developing in the future?
Dr Amandeep Hansra: I think we’re at a tipping point, when I entered this space nearly a decade ago when I first got involved in telehealth, it really was something that was unheard of. People thought you’re a bit strange if you’re working in telehealth, they often didn’t even know what it meant, we really were unknown. Now every health care organization I speak to, has some sort of digital health strategy, either telehealth strategy or technology strategy utilising emerging technologies. I’ve just seen it explode to be honest, and I think we are at a stage where we’re having the conversation, but we don’t know how to implement it well. We don’t know how we actually bring technology into the healthcare sector in a way that is affordable, efficient and that doesn’t disrupt workflows in a negative way. I think that will be the next step, now we’ve understood that there is huge potential and we’re all talking about it; how do we make it happen? Ten years from now we probably won’t recognise our health system.
Dr Keith McNeil: I think the first thing we will see is that the term digital healthcare will disappear and just become healthcare, which will in the future all be provided on a digital platform.
We talk about digital healthcare in three horizons, the first horizon is getting the technology right and that’s putting in place for example an electronic health record or computer etc. That’s kind of where we are now with digital healthcare.
The next thing is to extract information from that technology and data and turn it into information. We’re scratching the surface of that, but once we’ve bedded that in and it becomes business as usual, healthcare will then become all about how we can maximise the value of that data with complex analytics, bringing in disparate data sets, asking questions that we haven’t been able to answer simply because the size of the datasets involved and the need for complex analytic engines like machine learning and artificial intelligence. That’s where I think it will go but the key to extracting value at any stage is feeding the intelligence back to decision makers, wherever they may be across an organization.
So called digital healthcare will thus become healthcare provided on a digital platform, turning every individual within the health system into a higher performing learning and knowledge-based worker.
Professor James Boyd: To be able to understand health systems better, we need to be able to join up information, to have the complete story about an individual’s journey through the health service. The ability to join together a person visits with their GP and then be able to use that to inform how their journey through the health system progresses, whether there is a trip to hospital or a contact with community services; allows us a better understanding of a person’s journey and how we can improve such services.
If we can achieve a joined-up approach to data, then that’s the starting point for a lot of different types of research. If we can also incorporate the data from new technology like wearable devices to collect information about a person’s exercise, their diet and blood pressure on a routine basis, it will supplement the information we already have.
Why did you decide to move into a digital health role?
Dr Amandeep Hansra: I found that in medicine sometimes we can become a bit of an echo chamber of cynicism and we often sit around focusing on how horrible things are, and all the challenges that we have. This means we don’t spend time brainstorming solutions, thinking about the future and being positive. I found that the technology space allowed me to bring that positivity back into medicine.
Digital health is really about using your imagination, thinking what’s possible and we don’t often get to be creative or use our imagination much in medicine.
In this sector we get to look at emerging technologies and use our creativity to imagine what impact that technology might have on a particular problem in medicine. What impact could it have on clinicians, on patients and health outcomes? Could it improve clinician work experience, and could that solve issues like burnout and sustainability in the long term for clinicians?
I love the digital health space, because of the positivity and the future thinking; everyone’s in it because they’re passionate about it, it really is a choice to go into this particular space. So you are surrounded by such inspiring and enthusiastic colleagues.
What do you think has been the biggest benefit of advancing technologies has been to healthcare to date?
Dr Keith McNeil: As an example, I would probably cite something like the development of PCR (polymerase chain reaction) which has enabled us to do so much in terms of understanding the pathophysiology of disease, and then being able to apply more tailored treatments to that disease. We will move more and more into the precision medicine world, which is really where digital healthcare is enabling us to go. We’ve then got a multiplicative effect of all the technology that comes to bear.
If you think about the huge disruptors in healthcare, you go from big public health initiatives around clean water, vaccinations, food and nutrition, sanitation etc, to treating the big infectious disease challenges with things like penicillin, or streptomycin (for TB). You then move into things like coronary interventions that have stopped people having to have their chest cut open with heart attacks, and really effective treatments of asthma as examples.
The next big leap forward for the 21st century is going to be digital technology underpinning really high-level learning and knowledge-based systems. This will allow us to take what we do now and put it on steroids. Even with all that we know now, and all of the systems that we’ve set up and worked hard to get better and better; we still only provide 60% of our healthcare on an evidence-based platform, 30% of it is still wasteful in terms of the value it adds with duplication or the fact that it doesn’t work, and 10% of its actually harmful.
Until we can address that, and we can’t continue to do it as we have been traditionally been doing it, we wont be able to address the calls of the triple aim of healthcare, and it is the digital space, the data and information space (data and analytics), that gives us the opportunity to address that 30% of waste and 10% of harm, much more effectively than we’ve been able to up until now.
 Australian Digital Health Agency, “What is digital health?”, Australian Digital Health Agency, 2019, www.digitalhealth.gov.au/get-started-with-digital-health/what-is-digital-health.
 World Health Organisation, “WHO Guideline: recommendations on digital interventions for health system strengthening”, World Health Organisation, 2019, www.who.int/reproductivehealth/publications/digital-interventions-health-system-strengthening/en/.
 Hambleton, Steven and Aloizos, John, “Australia’s digital health journey”, The Medical Journal of Australia, 31 March 2019, https://www.mja.com.au/journal/2019/210/6/australias-digital-health-journey.
 Australasian College of Health Service Management, “Innovation and technology”, Australasian College of Health Service Management and ASN Media, 2019, https://www.achsm.org.au/resources/health-leader-tv/episode-2-2019