What technological innovations have made the biggest impact in the health sector over the last 10 years?
In the last 10 years there have been some good steps forward in the health sector, but the majority of the innovation has occurred in Medical Technology rather than in Information Technology.
Many health departments and hospitals have done a reasonable job of deploying IT in back-office and administrative processes, but are only in the last few years starting to properly look at how eHealth systems can be used to make a difference in a clinical context.
Standardised approaches to system interoperability such as HL7 have made a difference, as have (more recently) clinical coding schemes such as ICD-10, AMT and SNOMED CT-AU. Â These coding schemes (also known as clinical terminologies) allow us to have standardised ways of referring to medical terminology and medications, which drives semantic as well as syntactic interoperability.
When you consult with organisations, what common issues have you uncovered?Â
As I consult with various Healthcare organisations, I'm continually surprised by the lack of a deep understanding and vision for the role that eHealth / Digital Health can play in driving a modern, accessible, sustainable, safe and efficient health system. Â It's constantly seen as an optional extra, and the fact that many public health systems spend less than 1.5% of their budget on Information Technology shows that it isn't yet seen as the lever for change that it should be.
The major challenge of my work is first to excite people about what might be possible, and then build a pragmatic and implementable plan in the face of many constraints, such as funding and the complexity of large-scale change.
What do you see are the main challenge/s leaders in the sector currently face? Is it the technology or the people?
Healthcare is an industry that is easy to be passionate about, but tough to work in. Â Governance structures are complicated, there are a huge number of stakeholders involved in every problem that you try to solve, and there are some pretty entrenched behavioural patterns.
As a result, leaders need both clarity of vision and resilience as they try to move towards a better future. Â As we work together to try and improve the health system there are constant complications and setbacks, and it can be emotionally difficult work.
Empowering a new generation of IT and eHealth leaders to have the appropriate set of skills for these challenges is vital to driving positive change.
The landscape is changing all the time, what emerging technologies or trends should leaders be aware of?
There are so many interesting things going on in the eHealth / digital health space at the moment...
In terms of the available benefits, I think medications management has to be one of the most exciting technologies that is starting to be implemented across Australia.
It may surprise you that this is still the case in 2014, but in hospitals, the majority of doctors still prescribe using pen and paper. Â Whilst this makes it really quick and easy, it's not particularly safe. It doesn't allow us to double check that this is the right medication, the right dose, or that the patient isn't allergic to it. Â This unfortunately can lead to 'Adverse Drug Events', where the wrong drug can be given, or to the wrong patient, or at the wrong time, or in the wrong dose, or that drug can interact badly with another medication already being taken.
Some studies indicate that an estimated 18,000 Australians die each year and 138,000 are admitted to hospital as a result of Adverse Drug Events. Â If true, that would make ADEs the second leading cause of death for Australians after heart disease.
By implementing medications management systems we can code medications data using schemes like MIMS and the Australian Medications Terminology (AMT). Â This then allows us to perform Clinical Decision Support (i.e. automated checking) of all of the things I referred to above during the prescribing, dispensing and administration of medications.
These are complex projects to implement, but critical in driving improved patient safety within the Health system.
What does the future look like for the health industry?
There is a lot of doom and gloom about the fact that the cost of the Health system is growing at an unsustainable rate.Â This view is actually debatable, and also underestimatesÂ the extent to which the Health system is about to be positively impacted through digital disruption.
The ability of eHealth to drive more consistent clinical practice (and hence drive improved quality and safety for patients), the growth of consumer health devices and the rise of online health communities (and the engaged patient) are all starting to disrupt Healthcare in really interesting ways.
Obviously we need to navigate our way through these movements carefully, but we finally have some real game changers in terms of affecting the demand for health services. Â I'm excited about that, and spending a lot of my time working with clients who are starting to recognise and adapt to digital change.
Which country is leading the way with innovations in the sector and how does Australia measure up?
The world's leading digital hospitals are arguably found in the US and South East Asia. Â This isn't particularly surprising given that these health systems are largely private sector models and have a lot more funding for digital health / eHealth.
A more mature digital health system (i.e. one that makes much better use of mobile devices at the point of care, is paper-lite or paperless, captures and codes clinical information, etc) doesn't necessarily mean a better health system. Â The US might be advanced in many respects, but they spend nearly 18% of GDP on Health. Â Australia currently spends around 9.6% of GDP on Health, and arguably achieves similar health outcomes - but these outcomes are much better per dollar spent.
If Australia can learn lessons from the US and successfully marry the adoption of digital healthcare with our relatively effective Health system, I believe that we can develop a health system that will be the envy of the world.
However, the challenge we face is in convincing people that digital health / eHealth is not optional. Â If we want a modern, accessible, sustainable, safe and efficient health system then it must be built on the foundations of Information Technology.
Where is your favourite place to travel?
I'm very fortunate that I get to travel all around Australia with work, and some of my most interesting recent destinations include Cairns, Alice Springs and Broken Hill. Â My favourite, however, has to be Hobart.
After spending a few days a week in Hobart for the last couple of years, I think I'm now an 'honorary Tasmanian'! Â I just love the natural beauty of Tasmania, the friendliness of the people and the trendy, big-town feel of Hobart.