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17 Mar 2017

The proposed national digital health strategy should be a simple, straightforward list of proposed projects and their benefits, rather than a high-level strategy document, Australia’s peak doctors’ body says.

In its submission to the Australian Digital Health Agency (ADHA), the AMA says it has long advocated for a strategic plan for digital health.

But it warns that clinicians must be involved in both the development of the proposed National Digital Health Strategy (NDHS) and its implementation, saying too many e-health projects around the world have failed because they were developed without consultation with the people who had to use them.

“The AMA is aware of the long track record, both locally and internationally, of e-health projects falling over for failing to consider the social aspects of development and implementation,” the AMA says.

“If no other lessons have been learnt from Australia’s approach to e-health, clearly a ‘build it and they will come’ approach, without coalface clinical involvement, will fail.”

Clinician involvement must not stop at the ‘strategy’ level.

“There is a need for co-produced development and operational plans so providers can see where critical services are heading, over what time frame, and what this means for them,” the AMA said.

“Many doctors and other healthcare providers have a level of scepticism about high level strategy documents, preferring instead to have access to a simple, clear, prioritised and costed list of projects, with tangible products and benefits able to be understood by the non-technocrat.”

The AMA also said that the strategy should have a more balanced and complete coverage of all health practitioners’ needs, compared to the historic over-emphasis on patient-controlled health records – the My Health Record (MyHR) - and support for e-health in general practice.

“This must include specific support for medical specialists other than GPs to take up digital health, including but not limited to the MyHR,” it said.

“The NDHS should also clearly acknowledge that digital health has important and direct implications for the way health care is organised, for health financing and funding, and for existing payment models.

“It should explicitly identify the need to carefully identify implications for payment models for clinicians of coming digital health initiatives.

“For example, under some initiatives, clinicians will be doing much if not most of the work of the inputting of data – work which is for the benefit of patients.

“In addition, digital health will likely involve clinicians doing a lot of work in communicating with a patient who is not present in the consulting room – eg communicating with the patient by secure messaging.

“Funding models – which currently don’t even fund phone calls – will need to support this new clinical activity, including by dealing with and responding to new expectations, such as patients who may have an unreasonable expectation that they will be able to contact the doctor without having to see them, and without having to pay for their time and skills.”

Submissions to the consultation closed on 31 January, 2017, with more than 1,050 online submissions received, and 3,100 people attending meetings, forums, workshops, webcasts and town halls.

More than 80 per cent of respondents agreed that digital technologies would transform and improve healthcare outcomes in Australia, and four times as many people want to access their personal health information on their smartphone than those who actually do.

Maria Hawthorne

 


Published: 17 Mar 2017