Picture someone who needs their blood pressure monitored regularly. They take the readings at home using a monitoring device which automatically uploads the readings so their GP can view them. The patient spends less time travelling and the GP has a more frequent view of the patient’s blood pressure.
Opportunities like this to improve the patient experience are one of many reasons for Australia’s healthcare sector to change the way it deals with data.
Overburdened workforces, privacy and security risks are also driving the need for digital transformation at hospitals and medical practices.
Investment in digital health initiatives is growing significantly. "If you actually focus on digital health, which is the area that we operate in," said Matthew Galetto, CEO of health record and patient management platform MediRecords, "the spend I think last year was $2.5 billion dollars, which is about one per cent of global digital health spend."
"That's growing to I think about $11 billion, so it's about [a] 20 per cent compounded annual growth rate over the next five years through to 2027."
Among the challenges is the need to securely integrate healthcare data. CRN Australia spoke to several technology providers about this.
Patient expectations
"Offerings that are most in demand [are] really around the healthcare providers taking a digital-first approach to support; taking a patient-led approach," said Lisa Fortey, national sales director at Logicalis Australia.
"Because patients are becoming more digital savvy and are taking more control of their health outcomes, they want to be able to access healthcare services...[like] virtual care."
"Better patient experiences through modernisation and through efficiency gains, in particular data lies at the heart of this, especially being able to track patient healthcare journeys."
Healthcare providers vary in their digital maturity.
"Across the healthcare sector in Australia we have a broad range of foundational level of digital maturity," said Sharon Hakkennes, VP analyst for healthcare at Gartner.
"Some organisations are really focused on building those foundational capabilities and those foundational systems; so those core clinical records, electronic health records and some of those base level technologies."
"Others are well down the track and have those foundational systems in place and are really now starting to think about 'how do we get the most value out of these investments that we've made, how do we use our data and the information that we're collecting to drive new insights, to drive actions to improve care, improve outcomes and improve efficiency?'"
Breaking down digital silos
Consolidating siloed data is an opportunity for IT partners, noted Simon Poulton, CEO of Google cloud consultancy Kasna.
"There's a very long list of both new and legacy systems which often in a healthcare setting hold data in separate repositories," he said.
"Probably the biggest opportunity we've seen or step one opportunity is really to start to bring some of those data sources together, get correlation between those types of data and then make some key insights into how that particular [healthcare] provider is going about health care."
Companies like Brisbane’s Opus 5K are helping healthcare providers tackle this. Its cloud solution MARS uses Azure Open AI to help frontline workers document patient information in clinical or community settings.
NSW Health is also tacking the problem. Earlier this year, NSW Health sought suppliers for a solution to help centralise and digitise electronic and paper-based systems.
Galetto said legislative changes to improve fragmented systems are expected.
"There's a new standard that's emerging, it's called Fast Healthcare Interoperability Resources (FHIR)...these are the standards that the US implemented several years ago to mandate information sharing across electronic medical records vendors," he said.
"The [Australian] government will likely legislate that, in fact they certainly will, in the next couple of years, and so we're just lacking the skillset in country."
"But there's a tremendous emerging demand for that knowledge [of FHIR] to help with breaking down those silos and that fragmentation that we're seeing in the market."
"So definitely a role there for systems integrators, resellers, IT companies."
Also helping healthcare organisations with cloud is the likes of AWS and Ingram Micro partner Stoic IT, who’s work includes providing image content services and helping clients move applications to the cloud.
Private cloud providers such as Macquarie Cloud Services and Virtual IT Group also partner to service the sector.
“Tracing the journey of patient data”
The expected removal of exemptions in privacy law for small businesses is factoring into health IT spending.
"When we see a tender that's coming through to us from, it might be a local health district or government or even a large corporate, we're starting to see those privacy amendments come into the system," Galetto said.
"But we know, for example, that patient provided information; that data set is expanding. We know that small businesses...their exemption for breaches and the privacy policy are going to be lifted."
"Even those small practices that we all go to down the road, say our local medical clinic, will be subject to some of the new changes."
"What we're seeing is a shift more towards the US-based or European-based GDPR or HIPAA compliance."
SaaS has advantages.
"We've seen SaaS services offer very significant benefits here as they are generally highly available by nature and more able to rapidly respond to vulnerabilities," Fortey said.
But cloud has its own set of risks.
"Understanding the security risks inherent in that environment and making sure you've applied the right security controls is critical, and that's part of pretty much every project we've got in the healthcare space," Poulton said.
"The second part of it, and this is one where I haven't seen as much demand, but I've probably seen more need if I'm honest, is collaboration."
"The way people collaborate around data has often in healthcare systems been built around the processes that a healthcare provider might use."
"This might be a clinical setting, it might be things like a safety huddle which doctors and nurses might have after a safety incident occurs; the typical ways that people have shared data is not really ideal and it's not really necessarily designed for a cloud native environment."
Many healthcare providers are unclear on cybersecurity legislative requirements.
"There's still surprisingly a lot of really conflicting information and unknowns when it comes to legislative requirements as well," Fortey said.
"Things like informational data management requirements and even items related to the [Security of] Critical Infrastructure Act."
"Some of these require a monumental transformation in the way IT functions and how they deal with the business and external parties and partners."
"What makes it really difficult to decipher is that larger organisations in the space tend to each have their own interpretations of the requirements, and so there's no single framework accepted when it comes to tackling security for the most part."
"On top of that you see cybersecurity implementations in the smaller end of the market tend to be an afterthought, because it's either deemed too hard or the cost of entry is just too high."
"When you trace the journey of patient data, you will likely find that it passes hands through varying organisations and varying sizes of organisations, [with] varying data security policies and safeguards in place, which obviously leaves an opportunity for cyber uplift across the board."
"...if you can bring the leading organisations together to tackle the issue as a group, rather than individually, I think this could be an opportunity for the market."
These issues will also be a factor in the use of AI in the health sector.
Microsoft and the Tech Council of Australia have talked up the potential for AI to help automating nursing tasks and discovering new drugs.
Poulton described one way AI could be put to greater use.
"There's a lot of handwriting and physical records from the past in...healthcare scenarios, so bringing some of that data back into the fold so it can be digitised, it can be indexed, it can be searched, it can be correlated," he said.
Long term vision
Despite huge challenges in the health sector, some IT providers see an opportunity to do more than optimise systems, but shake up the way healthcare works in Australia.
"We're going to shift from an encounter-based method where we all go to the doctor and...we're out within15 minutes...to more of an coordinated care model, which is more of a holistic approach to your healthcare," Galetto said.
"We'll go from a fragmented system, that's the current system, [where] all of our information is siloed and sitting in databases scattered around the country, to more connected care."
"The underlying theme of all of this is to move to the cloud and break down some of those silos."
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