Digital transformation has been slow to arrive to the healthcare sector because the sector is inordinately complex, fraught with risk and regulation and the economics of supply and demand, especially around the services of doctors, has retarded the normal rapid equalisation of informational power that  digital brings to the consumer, in this case, the patient.

But things are starting to change and quite quickly as businesses outside of the sector start to chase opportunities.

 Take Equinix as a case in point. 

In the terminology of the economics bestseller Freakonomics, Equinix is  ‘a connector organisation’.  Connectors are the facilitators of mass markets. They arrive and work at the beginnings of big changes to markets.

Equinix connects companies and institutions to the internet on the one side at scale and with high efficiency, and to vast amounts of cloud based services including data storage, such as those provided by Amazon and Microsoft, on the other. The march and growth of businesses like  Equinix has followed the rise of the digital revolution. They started with the major service supplies to the internet such as Google, and then moved through finance, marketing and media, travel and retail. Now they see opportunity in health.

Local managing director Jeremy Deutsch believes the Australian health ecosystem is showing all the signs of needing the sort of services Equinix provides. “We have some early health clients and many elements of the sector suggest that the timing is right”, he told Which-50.

The impact of digital on health will feature prominently in the Wild Health is being held on October 16 at the Belvoir St Theatre in Sydney. Which-50 is a media partner.

The other major factor pushing the sector are consumers – patients. Specifically, digitally connected and empowered patients, who as consumers, are starting vote with their iphones and laptops.

The power isn’t significantly evident yet, because healthcare is stubbornly regulated and controlled by governments, and the culture of medicine and doctors is that they control things, but the signs are there. Early next year, for instance, Medibank Private, which currently has more than one million users of its app, will upgrade the app to include live mobile payments of all sorts of medical services, including bulk billing, gap payments and the like for both doctors and allied health. No more messing with credit cards, Medicare cards and all sorts of gaps to chase up. They will also add a booking system for all doctors and allied health professionals.

As we know from the controversy over specialist gap directories, the private health insurers are very keen on “compare the market” type applications. They want transparency of medical services to increase efficiency so they can lower their premiums. The power is starting to shift to the consumer. Doctors will need to adapt. So will hospitals and other health organisations. Patients are going to get more leverage and soon.

But as ready as things seem for Australia, and as good as our healthcare system is today – we remain the envy of many OECD countries despite the many complaints – the arrival of the digital revolution in healthcare in this country is asking some very demanding questions of us a community. Questions which if we fail to respond to properly, we may find ourselves rapidly falling behind other OECD countries which are embracing digital in healthcare.

Central among those questions are the ideas of healthcare interoperability, a centralised medical record for everyone in the country, and perhaps, the rise of AI and how we are going to treat the opportunities and threats that it presents to our healthcare system.

Interoperability, is how all our health systems talk to each other. A simple example in finance is how one bank’s ATM talks to another seamlessly. In travel it’s how one airline system will easily talk to another to get you somewhere. In health, virtually no systems talk to each other and it’s a big issue for the progress of digital efficiency.

Critics would say that we’ve done an awful job so far on interoperability in health. They would point to things like the fact that most GPs and specialists still rely heavily on the fax to talk to other providers and say, “what if the banks were still using faxes to move money around”.

It is true that the various software and secure messaging vendors, along with the major healthcare data players, like the large pathology providers, have failed largely in Australia to organise well enough to make communication of vital healthcare data efficient and secure. Much of the problem has been a lack of co-operation between competing parties. Pathology providers for instance want to hold in place their downstream channels to resell their services through GPs. So making the system highly efficient and open, hasn’t been a particularly high priority for them.

There have been a lot of efforts and a lot of failure so far. But the march of digital technology, patient connectivity, consumer demand and cloud based services means the time is now for these groups to come together and work for the greater good. It appears that some organisations are moving this way today, but many people think Australia suffers culturally in that we don’t work well together for the long term betterment of the community. That we are short sighted about the profitability of our organisations and selfish.

Some question whether market forces alone are going to get us there in time to bring much needed efficiencies to the whole system. The potential is huge. The government may have to play a deft hand in helping.

A related question to interoperability is how we treat patient data and central to that is the federal government led My Health Record project. The MyHR currently aims to provide every Australian who doesn’t actively choose to ‘opt out’ of their record, a personal centralised patient record, that can be shared across the health system, with the aim of significantly increasing patient safety, and system efficiency. The target is to get this working properly within the next 15 months.

But like interoperability, the MyHR program, today run by The Australian Digital Health Agency, has been mired in past controversy. To date, the program has cost around $1.5 billion, and no one so far is really using it. Doctors have been incentivised with money to use it, but don’t like spending time loading information, and patients, largely still don’t know much about it. The project also has a lot of technologists and experts questioning how it will achieve it’s goals, given the technology and formats that have been chosen for the MyHR.

The money spent for little progress in this field isn’t all that unusual. Getting such a program up in other countries has seen far more waste and much less progress. The issues with MyHR aren’t so much how much we are spending, but whether the approach is right. Will a centralised EMR for all Australians actually produce the benefits being promised?

Are there serious security issues with honeypotting all this data in one place and trusting the government to look after it? And is technology providing better ground up mobile solutions to the same problem for a lot less money – there is technology now that will live update your mobile phone with a highly secure personal health record from you local GPs electronic patient management system. Your phone will soon be able to talk to your health insurer, Medicare for payments live at your doctor, your pharmacist, and other connected allied health professionals. Is this sort of technology going to see the MyHR never really used?

The key issues of Interoperability, the MyHR, the real impact of AI in medicine in the mid term, security of health data, and the rapid rise of the connected patient, are all sessions at a unique event being held next week in Sydney called The Wild Health Summit.

The aim, says Wild Health organisers, is to start getting everyone on the same page in these most critical digital health transformation issues.

The Summit has managed to attract an A list of movers and shakers in all of the above issues, and is putting them on stage in a series of Q&A sessions with the audience, each session dealing with each issue, and each session featuring thought leaders in that topic.

As an example, for the ‘MyHR or bust’ Q&A session, panellists who will be answering audience and moderator questions include: Tim Kelsey, The CEO of Australian Digital Health Agency, Dr John Lambert the CCIO of eHealth NSW, Dr Louise Schaper, the CEO of the Health Informatics Society of Australia and Dr Tony Sara from South Eastern Sydney Local Health District.

The Interoperability session includes Dr Zoran Bolevich, the CEO of eHealth NSW and Tom Bowden, the CEO of secure messaging company Healthlink. Professor Enrico Coiera will headline the AI Q&A session, along with Callum Bir, immediate past head of Microsoft Health Asia Pacific, and the connected patient panellists will include Dr Marcus Tan, CEO of our most successful health startup, Health Engine.

Wild Health is being held on October 16 at the Belvoir St Theatre in Sydney. Tickets are limited but available at www.wildhealth.net.au/tickets. If you use our promotion code WILDWHICH50 you will receive a 15% discounts.

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