Interoperability is the answer. What is the question?

29 March 2019: The biggest challenges in improving healthcare interoperability are not technical.

As Australia continues its efforts to connect our health care information systems, we will do well to keep abreast of international developments. During consultation on the National Digital Health Strategy, health sector stakeholders told us they wanted:

  • Australian consumers to have access to global software and digital health services products; and
  • To ensure that Australian industry is optimally positioned to compete for a global market.

The US Office of the Health Co-ordinator for Health Information Technology (ONC) recently released its Annual Report Workgroup Update. The first priority of the ONC over the next few years is improving interoperability through the system, according to the report, but there are a number of gaps and opportunities. While there has been much work done there, there are real questions about whether all of that work has actually led to improved connectedness.

The major learning for us is that improving the interoperability of the healthcare system is a complex undertaking, and technical reasons are not the biggest challenges.

In summary, the big question is:

How do we improve the connectedness of information in a federated health system comprising thousands of service providers funded through multiple channels, in a way that facilitates access to information, while not compromising the security of that information, at the same time responding to expanding consumer expectations of controlling their own information while understanding what informed consent actually means in a digital context, without marginalising any members of society who have less access to or skill with technology?

The system-wide issues must be agreed, understood and addressed to develop a forward plan, which is what the Agency proposes to do with Australia’s National Health Interoperability Roadmap.

The Agency is preparing to launch its consultation process on the Interoperability Roadmap, which will draw in stakeholders from private and public health institutions, academics and consumer representatives, to ponder a few questions:

  • What are Australia’s Digital Health aspirations? How can health learn from innovation in other industries?
  • Priority areas – what are the problems we are seeking to solve by making information more accessible? What’s important to you?
  • What does it mean for consumers to be in control of their own information?
  • What features would be important in maintain trust in systems that share people’s information between providers?
  • How do we ensure that no one is left behind, while at the same time allowing early adopters to exercise greater control?

It’s going to be a fascinating conversation, and one where the views and needs of multiple stakeholder groups will provide synergies and contrasts. The investigation is both complex and critical, and is a vital step along the road to true connectedness of Australia’s digital health systems.