This provocative question occurred to me as I was reviewing content for this week and I spotted this which was a sponsored article from Telstra Health.
How digital health has responded to COVID-19
Sponsored
Australia’s health and aged care sectors have been fragmentally digitised for a number of years and, as a partner to some of the largest health and care providers, at Telstra Health we have seen a multitude of early adopters of digital systems.
In some states, the health and care systems have been digitised for many years; however, these systems do not always work in sync with one another, and thus do not operate as efficiently as they could for the states they support.
For example, some components of the aged care sector adopted digital systems more than a decade ago. In addition, some medical practitioners were trailblazers in adopting to digital solutions, whereas others tested out telehealth for the first time in recent months as a result of state-wide restrictions due to the COVID-19 pandemic.
At the height of the first wave of the pandemic, approximately 36 per cent of GP consultations were delivered by telehealth which amounted to around 4 million consultations per month. Furthermore, approximately 37 per cent of specialist consultations were delivered virtually during this time.
The pandemic has rapidly accelerated the adoption of digital solutions as a whole, and not just virtual health consultations. The global virus has significantly raised the recognition and value of digital health solutions and has highlighted the necessity of these by expediting regulatory processes and requirements.
Where Telstra Health’s digital health solutions are concerned, the pandemic has accelerated our launch of paperless scripts, resulted in the roll-out of clinical task management systems and enabled us to more quickly support hospital providers improve patient flow. In addition, our solutions have also continued supporting aged care providers through improved communication infrastructure, and COVID-19 surveillance and monitoring resources.
Acceleration of paperless scripts implementation
Impacts from the COVID-19 virus raised as assortment of concerns and
difficulties in accessing relevant medicines. As health prescriptions
increasing by up to 46 per cent following lockdown regulations, we launched
Australia’s first fully electronic prescription which was prescribed and dispensed
by a doctor and pharmacist in May of this year. This successful alternative to
paper scripts was developed by our joint venture group Fred IT Group, the
largest provider of software to the Australian pharmacy sector.
Working alongside the Australian Government, Fred IT Group fast-tracked the implementation of electronic prescribing, making it easier for patients to access their medicine, helping to reduce medication errors, and enabling information to be shared between healthcare professionals in real-time.
Streamlining hospital communication and task management
The COVID-19 virus created an acceleration in demand and implementation of
communication and task management systems such as Telstra Health’s Patient Flow Manager and Medtasker solutions.
Patient Flow Manager provides clinicians with consolidated operational and clinical information and supports hospitals in managing patient journeys from admission to discharge. The solution is implemented at 125 hospitals across Australia and New Zealand, and the pandemic highlighted a necessity to upgrade Patient Flow Manager to identify COVID-19 positive patients or those classified as high-risk or suspected as having the virus. The upgraded solution has enabled hospitals to allocate resources accordingly and better manage the flow of COVID-19 positive patients.
The urgency of ensuring hospital providers were fully prepared for an anticipated influx in COVID-19 positive patients led to an acceleration and expansion in the roll-out of Medtasker, a Telstra Health enterprise grade, secure clinical and multidisciplinary task management and communication solution, at Royal Hobart Hospital’s Emergency Department. The implementation was successfully completed one month ahead of schedule and was extended to other teams within the hospital provider.
Keeping our most vulnerable connected
Amid the myriad of problems the COVID-19 virus has presented for the most
vulnerable in our communities, digital health has enabled residential aged care
providers to meet increased demand, and to maintain connection with the
families, carers and loved ones of residents.
Our Message Manager software enables all elements of communication to be captured and easily reported on from a singular system by combining SMS and email functionality, list management and historical communication records. This has enabled providers to share clear and frequent communication about visiting restrictions, health protocols, government changes, and the social and physical wellbeing of residents directly with the family, friends and loved ones of residents. The solution has supported providers, residents and those who care about them at a time when streamlined communication has never been more vital.
Digital health industry inflection
The pandemic has proven to be a true inflection for the digital health industry, from uptake and perception, to acceptance and acceleration. Both public and private providers are seeing the benefits and efficiencies digital health can support with, and as attitudes towards digital health evolve so too does behaviour among patients and providers.
The pandemic is likely to result in an increase in the overall level of digitisation in health and aged care providers. Once our systems have a basic level of digitisation, we can introduce additional digital health measures to further support healthcare providers in directing and administering care. In turn, this will lead to improved system efficiency and productivity among health and care providers for driving better health outcomes through more timely, cost-effective and efficient care, and in ensuring the best allocation of resources to patients who need it most.
Here is the link:
https://medicalrepublic.com.au/how-digital-health-has-responded-to-covid-19/36683
It seems to me that Telstra Health
has managed to gradually put together a pretty useful portfolio of Digital Health
solutions that are actually in use around the country. (Accepting that you need to apply a powerful level of scepticism to sponsored articles.) They also seem to be gradually learning how to work with the health sector and is foibles.
On the assumption we can put in place the appropriate anti-monopoly and competition regulations would not this entity be a better home, with the other private sector entities (e.g. ANDHealth, Digital Health CRC and the various other system providers) to provide a more considered and more appropriate guidance and direction to Australian Digital Health possibly via some co-ordinating entity.
The key point to be is that within the private sector I sense we have all the expertise needed to move Digital Health forward and that largely the ADHA is a pretty much useless $200M bureaucracy!
I am sure there are a range of views possible on all this but it really seems to me the ADHA is well past its use by date at this point.
What do others think and how should the future be organized?
David.
23 comments:
Sounds great, while we are at it let’s outsource standards to KPMG
How is the life saving critical project involving Telstra and registeries going? How many thousands of lives would have been saved?
David Telstra like the other entities you list are packed with the same idiots that keep failing us. A new t-shirt and cap does nothing change anything.
Guys and gals...
This was meant as a post to foster debate re the actual role of the ADHA. I am not convinced producing Reconciliation plans is their core mission as important as that is?
Don't be to serious about all this - critical though it is!
David.
Decent article David and nice to see Telstra have managed to compile a half decent product range. They are a good competitive force and that can only be good for the purchaser. Should they take on aspects of ADHA? I don’t believe so and do not see it to anyone ones advantage. What the answer to the current digital equivalent of the doldrums I am not sure, what is happen seems to be a fragmentation of effort with lots of unconnected thing happening but no one to orchestrate.
Anyway for some amusement google this: Chief Technology Officer - Digital Health
@T.28, if you mean the CTO role for the ADHA, then yes that it certainly a true reflection of the ADHA state of mind.
David it is clear that ADHA has not lived up to the expectations of many. Now so wedded to the My Health Record they are in fact no different to other large EHR vendors (albeit with some important advantages). The challenge of standards, compliance and research for emerging digital health needs. The world is fast changing and the specifications and standards developed through NEHTA and reply blushed by ADHA reflects implied times. ADHA should remain but only as a system operator, we need a proper digital health capability, an innovator in in design and conformance to feed the exploiters ( market vendors) or simply step aside and let the market drive things in a policy free world.
A debate that is much needed
From Telstra's Annual General Meeting Today.
"Meanwhile he said Telstra's previously under-performing Telstra Health division was performing well, with the COVID-era boost in virtual GP consultations an obvious driver.
He said the division hit break even in May and that he now expected it to make a positive EBITDA contribution in 2021, with revenue growth in excess of 25 per cent.
"We know that not all the investments Telstra has made in the past have gone well but we have learned from the experience. Our measured approach now means Telstra Health is incredibly well positioned and performing well," Mr Penn said.
"I believe it will be a very strong contributor to the value of Telstra in the coming years."
via AFR
David.
Telstra is a communications company and most of its business is as a common carrier.
For decades, they have wanted to move into value added services, e.g supplying equipment such as mobile phones. However, most of their value added services are tightly bound to telecommunications, rather than business outcomes. Telehealth is an example.
It is not clear if Telstra Health is supplying common carrier services to a market segment, of if they are delivering true health provider services over and above data management/delivery. AFAIK, it is the former.
ADHA doesn't deliver health provider services either. They have delivered a system that sits on top of existing health record systems but which does not seem to solve any particular or common problem. The give-away is the answer to the question: "what would happen if My Health Record were to suddenly disappear?". The answer is "very few people would notice."
As has been stated elsewhere, the exchange of health information is not a technical problem, it is a problem that clinicians would like to see solved so that it improves their effectiveness and efficiency. It is not a problem that a common carrier like Telstra and/or ADHA have the ability to solve. Unfortunately, clinicians don't have the skill either.
AFAIK, nobody actually owns the problem of the exchange of health information - other than as a technology problem.
This is a long winded answer to the question "Would Digital Health Be Better Served With Telstra Health Rather Than The ADHA?"
My answer is that it doesn't matter, neither are attacking the real problem.
Meaningful and effective health reform pivots around "the exchange of health information".
I agree - it "is not a technical problem".
I also agree - "it is a problem that clinicians would like to see solved so that it improves their effectiveness and efficiency".
This is discussed at length in the excellent comments in the blog Thur 5 Nov commencing here:
https://aushealthit.blogspot.com/2020/11/it-seems-further-you-are-away-from-adha.html?showComment=1604631025839#c4147678234739460434
Relying on pandemic driven uptake of services might not be a winning hoarse. On the back of a vaccine announcement specific tech companies valuation drop considerably.
Need to shift from exchanging to sharing
IMHO, the problem is not "the exchange of health information", but defining what information should be exchanged, or more precisely, made available.
When a patient presents for a consultation, what information does the doctor need? The doctor will not know until they talk to the patient and after that it is an iterative process. Neither the data requirements nor the processes can be predetermined. Which makes automation rather difficult.
Talking about Telstra...
Telstra has revealed dramatic plans to split itself into three legal entities, amid widespread speculation it is positioning to buy the National Broadband Network in coming years.
https://www.abc.net.au/news/2020-11-12/telstra-plans-biggest-restructure-since-privatisation/12876638
"Under the proposal, Telstra would split into three separate legal entities which would operate under an umbrella Telstra Group:
* InfraCo Fixed — to own and operate Telstra's physical infrastructure assets (ducts, fibre, data centres, subsea cables and exchanges)
* InfraCo Towers — to own and operate Telstra's physical mobile tower assets
* ServeCo — to own and operate Telstra's retail business"
Where do you suppose a value added, health business would fit into that structure?
Health most certainly doesn't fit into either of the first two and according to the Australian, the "third business ServeCo will own the active parts of Telstra’s mobile phone business, which also includes its radio access network and spectrum assets that maintain the network’s coverage."
https://www.theaustralian.com.au/news/latest-news/telstra-to-split-into-three-separate-businesses/news-story/625a9f3711c80b1d8175e633de01af5b
Not to dissimilar to the British Telecom model from 20 years ago. That said talking Telstra Health up as a success is always useful if one was looking to sell all of part of it.
The optics seem to indicate the Telstra is moving away from the software solutions and consulting business. Recall the hyped-up days of Sausage Software and other Telstra acquisitions under Ted Pretty's leadership; the wheel turns once more.
Will Tim Kelsey, CEO of PKS Holdings, try and buy Telstra Health?
@10:35 AM What a good idea. With $2.8M in current liabilities against $4.2 M in Cash Assets (Net Positive $1.4M) Tim could make a compelling story to Telstra to hand over Telstra Health to PKS with an offer to share in future profits when he has turned Telstra Health around like he did with the ADHA. CAN he do it? Yes he CAN. (Apologies to CBA).
Riveting presentation by Tim at the PKS AGM
https://cdn-api.markitdigital.com/apiman-gateway/CommSec/commsec-node-api/1.0/event/document/1410-02303422-0ML9BAGKOF7PQEM4M68HJCUA23/pdf?access_token=fSQ5y6caxolHD67265Alfi7gvrtS
Long Live T.38November 11, 2020 10:12 PM. Regarding the CTO role. Would not bother applying, the under visual has already be tapped. Just a common law appointment via a panel. Basically required to prop up our chief digital officer chap. Show how little respect is extended to Ronan and how little they understand that role.
@ ADHA.Staffer. That should but does not surprise me. I looked at the description and thought it was someone to run the internal IT operations. What an odd and flippant way to require an important national role. You start seeing why this new CEO has fallen so far so fast.
You start seeing why this new CEO has fallen so far so fast.
what do you expect from a lawyer? Whatever you expect, you get hubris. Same as the previous CEO. All confidence, no competence. Like a marketing guru running government.
From a SES level public servant overseeing highly sensitive data I would expect quite a bit. It is the same with the CTO role. Very disappointing and raises numerous red flags. Something very wrong is going to happen.
Internal appointment - how very ADHA.
Internal appointment? That is only hearsay. All the acting roles are ex-COO appointees, not convinced a politically savvy new CEO would not seek to plant fresh faces in her team.
As David stated - This was meant as a post to foster debate re the actual role of the ADHA.
The announcement of a ten year set of goals to deliver against the remaining three years of the national strategy suggests the ADHA is going nowhere. The role of ADHA is still a difficult one to define. Even the wording around the re-platforming suggests it seeks to dominate and control the healthcare technology infrastructure. I find it difficult to see how the government can do that and remain independent enough to allow open standards to be community driven and vendors to have a level playing field.
My hope is that government returns to funding standards, developing open specifications and coaxing everyone into meeting agreed conformance and compliance obligations.
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