A recent review into Western Australia’s healthcare sector is expected to drive a more strategic approach to eHealth initiatives in the state, such as improving ICT systems across the WA health ecosystem and accelerating the adoption of digital solutions.
The findings in the interim Sustainable Health Review commissioned by WA’s health minister suggest that although sporadic instances of innovation and technology achievements are happening, such as the expansion of telehealth capabilities, these successes "do not seem to spread effectively across the system".
The state’s enthusiasm for eHealth investments has also been tempered by high-value IT projects that have “not necessarily supported the system or improved health outcomes more generally”, according to the interim report.
“It is timely for the WA health system to look towards value – to understand what is being spent and being achieved, and measuring the health benefits to patients and the wider community,” states the review.
The drive for core digital transformation in WA’s health sector comprises part of the state’s extensive public sector reforms, with the McGowan Government set to implement a number of recommendations from the Service Priority Review to facilitate a more effective public sector. Suggested focus areas in the review include ICT governance, digital service delivery, cyber security, and data sharing.
Further, a Special Inquiry into Government Programs and Projects, submitted to the Public Sector Commission by Special Inquirer John Langoulant earlier this month, also highlighted “the lack of a common purpose” across the jurisdiction, and identified the need for greater collaboration to reduce agency silos and improve outcomes for citizens.
Bringing WA eHealth strategy in line with the rest of Australia
Among the recommendations put forward by the review is a greater focus on core capabilities and infrastructure, like electronic health records and data sharing.
The state is a “pioneer in data linkage, with ‘one of the most comprehensive data linkage systems in the word’” according to the review, and yet WA Health does not allow for the sharing of patient information, including diagnostic testing, across digital platforms. The review recommends “immediate action” on the development and implementation of “innovative approaches to sharing of patient-level data across public/private providers”.
Further, the review noted that the state is “well advanced compared to other jurisdictions with a unique patient identifier system in place. This should facilitate the implementation of a state-wide electronic health record system.”
A shift in ICT investment decisions as suggested in the report will put WA’s eHealth priorities in line with most other Australian states and territories.
Late last year, Intermedium revealed that over $1.1 billion worth of new health-related ICT initiatives were introduced across Australia in the 2017-18 budgets – this was more than double the amount of the previous financial year. This substantial growth reflected the increased focus on digital health across Australia in recent years, with several governments releasing health-specific digital strategies.
Queensland Health is on its way to implementing its integrated electronic Medical Records (ieMR), as per their Digital Health Strategic Vision 2026 released in 2017. The department has expressed a need for a scalable and interoperable information sharing platform to meet data-sharing requirements.
NSW Health, too, committed to focus on improving their data exchange/brokerage solutions, as per their eHealth Strategy 2016-2026. The strategy detailed the need for NSW Health to “work on high-impact and innovative data linkage, collaborate with the NSW Government DAC and to work with health and government stakeholders … to support increased data mobilisation”.
The development of a health-specific digital strategy in WA was one of areas identified in the interim report that required further work.
“This work will involve exploring how digitisation can empower consumers, support clinicians and integrate services (with particular focus on regional and remote areas), with a focus on prioritising and optimising investment for digitisation," the review states.
Along with addressing the review’s recommendations, WA Health is grappling with complications associated with transitioning its ICT environment into the GovNext-ICT platform.
Under its GovNext-ICT transition project, dubbed ‘HealthNext’, WA Health will replace the existing centralised computing services arrangement with Fujitsu with GovNext-ICT services, as well as four other managed IT arrangements: telecommunications carrier services, server computing and storage environments, local area network and wide area network infrastructure, and gateway services.
However, the department has estimated that approximately 50 per cent of the managed services that it requires will not be covered by the GovNext-ICT Common Use Arrangement. With its contract with Fujitsu approaching expiry in November 2018, WA Health has less than 12 months to complete up to five work packages with GovNext-ICT suppliers, or make other arrangements to ensure its services are not interrupted by the expiration of the existing contracts.
WA Health is currently seeking a permanent chief information officer, who will be responsible for enhancing the health sector’s digital capabilities.