AusHealthIT Poll Number 736 – Results – 3 March, 2024.

Here are the results of the recent poll.

Do You Believe Gene Therapy Will Make Significant Strides Forward In The Next Few Years?

Yes                                                                         22 (76%)

No                                                                            5 (17%)

I Have No Idea                                                        2 (7%)

Total No. Of Votes: 29

A split vote with a large majority being pretty optimistic for improvement!

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. But also a very clear outcome! 

2 of 29 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

This Is A Fascinating Look Back At An Era That Has Now Passed But Was Really Formative.

This appeared last week and bought some memories back of the time I actually  worked – briefly – for “Big Blue”!

IBM changed history, and then couldn’t keep up with it

A new book, co-authored by the grandson of IBM’s mid-century CEO, sheds light on the unusual family dynamics that shaped the iconice corporation.

Deborah Cohen

Feb 22, 2024 – 9.55amBM is one of the oldest technology companies in the world, with a raft of innovations to its credit, including mainframe computing, computer-programming languages, and AI-powered tools.

But ask an ordinary person under the age of 40 what exactly IBM does (or did), and the responses will be vague at best. “Something to do with computers, right?” was the best the Gen Zers I queried could come up with. The history of IBM offers much more than an object lesson about complacent Goliaths. Michael Nagle In the chronicles of garage entrepreneurship, IBM retains a legendary place: as a flat-footed behemoth.

In 1980, bruised by nearly 13 years of antitrust litigation, its executives made the colossal error of permitting the then 25-year-old Bill Gates, a co-founder of a company with several dozen employees, to retain the rights to the operating system that IBM had subcontracted with him to develop for its then-secret personal-computer project.

That mistake was the making of Microsoft. By January 1993, Gates’ company was valued at $US27 billion, briefly taking the lead over IBM, which that year posted some of the largest losses in American corporate history.

But The Greatest Capitalist Who Ever Lived, a briskly told biography of Thomas J. Watson jnr, IBM’s mid-20th-century CEO, makes clear that the history of the company offers much more than an object lesson about complacent Goliaths.

As the book’s co-authors – Watson’s grandson Ralph Watson McElvenny and Marc Wortman – emphasise, IBM was remarkably prescient in making the leap from mechanical to electronic technologies, helping usher in the digital age.

Among large corporations, it was unusually entrepreneurial, focused on new frontiers. Its anachronisms were striking too. Decades after most big American firms had embraced control by professional, salaried managers, IBM remained a family-run company, fuelled by loyalty as well as plenty of tension (what family isn’t?), with its bosses frequently at odds.

Meanwhile, it served its customers with fanatical attentiveness, and, starting in the Depression, promised its workers lifetime employment. “Have respect for the individual” was IBM’s creed. Today, as we hurtle toward a future in which AI threatens to obliterate the individual both as employee and creator, much of the IBM story reads like a tale from a faraway world.

The company’s technological accomplishments are still recognisable as the forerunners of the digital era, yet its culture of social responsibility – a focus on employees rather than shareholders, restraint in executive compensation, and investment in anti-poverty programs – proved a dead end.

A mashup of progressivism and paternalism, communalism and cutthroat competition, the once ballyhooed “IBM Way” was, for better and worse, inextricably intertwined with the family at the top. 

The business of efficiency

For most of its history, and especially from World War I through the 1970s, IBM’s business was making business run more efficiently. During the late 19th century, the development of railways, the telegraph, and electricity created the conditions for a significant expansion in the scale and scope of American firms.

As companies produced and distributed goods to middlemen and consumers, they had to deal with ever more complex logistics. Firms required new ways of tabulating, storing, and recalling information. Enter the typewriter (patented in 1868), the cash register (1883), and the adding machine (1888).

At the apex of this information-machine ecosystem was the firm National Cash Register, which was where Thomas J. Watson snr, born in 1874 and raised on a farm near Painted Post, New York, served a 17-year apprenticeship.

At NCR, Watson found his calling as a salesman. At the behest of NCR’s dictatorial boss, he also ran a shady scheme to undersell secondhand-cash-register vendors to drive them out of the market. He was indicted for restraint of trade and then, deepening the humiliation, forced out at NCR.

By the time Watson landed on his feet as the new general manager of the New York-based Computing-Tabulating-Recording Company in 1914, he was 40 years old and newly married with an infant son, Tom jnr.

Watson soon renamed the company International Business Machines Corporation, a much more fitting description of his global ambitions. IBM’s embrace of punch-card technology, the state-of-the-art method for aggregating information, was his doing.

So was the creation of an evangelical company culture, equal parts moral uplift, corporate paternalism, and personality cult. Inscribed on the company’s walls were Watson’s favourite slogans: “A company is known by the men it keeps.” “Spend a lot of time making customers happy.” And “Think,” a dictum that to Watson (as the business historian Richard S. Tedlow has observed) likely meant “Think like me”.

If these injunctions call to mind “Don’t be evil” (Google’s former mantra) or “Do the right thing” (the current Alphabet slogan), those are the hollow echoes of what was at IBM an all-encompassing credo, anchored by the promise of a permanent job.

Attached to IBM plants were IBM country clubs, which served dinner three nights a week. When Watson and his wife travelled to visit IBM offices in other cities, they attended meticulously planned employee “family dinners”. IBM men were clean-shaven and wore the regimental attire: dark suits, starched white shirts, and ties. Alcohol was forbidden at company events.

With the optimism of a true believer, Watson snr boldly expanded the business during the Great Depression, stockpiling tabulators, adding to the sales force, introducing the lifetime-employment guarantee.

A Democrat and (unusual for a corporate executive) a supporter of US president Franklin D. Roosevelt, he was perfectly placed to furnish the machines necessary to implement the Social Security Act when it passed in 1935.
‘A predetermined failure’

By the late 1930s, IBM was the dominant player in data processing. Young Tom had a front-row seat to both his father’s formidable ambitions and his vanities, including his 20,000-plus-square-foot mansion in Manhattan and the appreciative letters from FDR he carried in his pocket.

But even by the free-and-easy standards applied to well-heeled young men of the time, he was an underachiever. He got into mischief and flunked his classes; he spent weeks in bed suffering from bouts of depression. Despite his father’s money, Princeton refused to admit him: the director of admissions told Watson snr that his son was “a predetermined failure.”

Indeed, without World War II, what would Tom Watson jnr have been? A flying enthusiast, in May 1940 he joined the Army National Guard. Major General Follett Bradley, the commander of the First Air Force, made him his personal pilot.

During the war, Watson kept a diary for the first time, as if – at age 28 – his life was just beginning. After the war, he returned to IBM at Bradley’s suggestion.

His father was pleased. As Watson snr liked to say, nepotism was “good for business”: In a company run like a family, he encouraged the employment of fathers and sons, and expected that his own sons, Tom and his younger brother, Dick, would one day head IBM.

But Tom was stifled by his father’s rule, disgusted by the sycophants he thought his style of management encouraged. Their fights were frequent, titanic, and brazen – and often conducted in plain view of IBM employees: “God damn you, old man! Can’t you ever leave me alone?”

They agreed on IBM’s guaranteed lifetime employment, the importance of customer service, the need for a CEO to have an open-door policy, and the danger of complacency. Like his father, Tom Watson jnr was a political liberal; he refused to permit racial segregation in IBM’s southern plants and opposed Senator Joseph McCarthy’s witch hunts.

No computers

But they disagreed about nearly everything else, not least the direction of IBM’s core business. Watson snr forbade the term computer, worrying that it would antagonise people who feared that these novel machines would replace workers.

Curious as he was about the new “thinking machines,” he didn’t see the point of electronic speed, figuring that few companies would need it. They certainly weren’t business equipment.

Watson jnr, by contrast, was beginning to grasp their significance. By the early 1950s, the father, now in his 70s, started to withdraw from day-to-day management, naming his older son as president of IBM in 1952.

Watson snr had cultivated a patriarchal style, with 38 managers reporting directly to him. His son introduced an IBM organisation chart, and the company’s managers started to take down the photographs of Watson snr that had once decorated every sales branch’s showroom.

More important, he moved IBM decisively into computers; in 1952, the company opened a campus in San Jose, Silicon Valley’s first computer factory and corporate-research facility.

The company’s growth was extraordinary, and so was Watson jnr’s risk-taking. In the early 1960s, he made a bet-the-company gamble on the decision to produce a fully compatible line of computers, the System/360.

At that point, IBM was producing seven entirely separate systems with different levels of computing power. Each had a distinct internal architecture, so migrating data from one computer line to another was often impossible. Clients that wanted to upgrade their computers would effectively have to start from scratch. And IBM itself was saddled with inefficiencies in production, including 2500 distinct types of circuit boards.

The System/360 has been described as one of the greatest product innovations in 20th-century American history, next to the Ford Model T. Achieving compatibility across a wide array of processors was an engineering nightmare, requiring millions and millions of lines of code.

IBM’s investment was equivalent to $US50 billion today, more than twice the cost of the atomic bomb’s Manhattan Project. The new computer made every one of the company’s other lines obsolete, meaning that if the System/360 didn’t work as anticipated, IBM stood to lose its clientele to other firms.

When the System/360 line finally shipped after many reversals, including problems in both the engineering and manufacture, it proved an instant success. From 1964 to 1970, IBM added almost 120,000 new employees (for a total workforce of 269,000), and its revenues more than doubled, from $US3.2 billion to $US7.5 billion – unprecedented growth for a major corporation. Saying “let’s not be piggish,” Watson jnr had stopped taking his stock options, worth five times his annual salary, in 1958.

As the economist Theodore Levitt famously argued in 1960, businesses that bank on particular products, even very successful ones, are courting obsolescence. Hollywood’s moguls failed to see that their business wasn’t movies but entertainment; they let television, the greatest opportunity of the era, slip from their grasp.

Watson snr thought he was in the tabulator-and-punch-card business. Watson jnr understood that IBM’s actual business was information.

Why IBM made the shift from mechanical to electronic modes of data processing has presented something of a puzzle for scholars. The leap into the unknown, as James W. Cortada deftly explains in his recent history of the company, IBM: The Rise and Fall and Reinvention of a Global Icon, owed much to the ways in which the Cold War with the Soviet Union, and especially the Korean War, supercharged the federal funding available to private R&D efforts.

The company’s engineers, too, played a key role, initially in pressuring management to see the promise of the new technology, then in transforming complex computing systems into commercially viable products.

IBM’s customers began to demand the new machines. Still, it could easily have been otherwise. Despite a technological head start in computers, Remington Rand, IBM’s major competitor in the tabulator industry, chose to focus on electric razors, typewriters and office furniture. 

Family dynamics

The Greatest Capitalist Who Ever Lived, as is inevitably the case with biographies, puts the emphasis on individuals – Thomas Watson jnr, specifically, as well as the IBM executives who at various points served as his consiglieri, soothsayers and foes.

As Watson jnr’s grandson, McElvenny offers an insider’s assessment of familial dynamics, drawn from interviews and private papers.

Most notable, the authors go further than most scholars have in portraying the son’s embrace of computers as a repudiation of his father. The resentment, they explain, was mutual: When Watson jnr appeared on the cover of Time magazine in 1955, a marketing triumph for the company, the old man didn’t say a word.

The rivalry between them continued to spur Watson jnr on, even after his father died the next year. In a sense, Watson jnr was founding a new company when he took over IBM, and the need to prove himself meant that he ran the firm like an entrepreneur rather than an heir.

Instead of surrounding himself with yes-men, he preferred, he wrote, “sharp, scratchy, harsh, almost unpleasant guys who could see and tell me about things as they really were”.

He established a system of “contention management” that required executives and their subordinates to fight out disagreements in front of the corporate management committee. The guarantee of lifetime employment was supposed to encourage responsible risk-taking and make the inherent friction within the hierarchy productive for the company.

As Richard Tedlow has observed, Watson jnr wanted the dynamic he had with his father to “metastasise” throughout IBM. As profitable as this Oedipal conflict may have been for IBM’s bottom line, it was near disastrous for the Watsons.

In McElvenny and Wortman’s apt description, they were “the Kennedys of the corporate world,” complete with yacht racing, extramarital affairs, ski weekends with the actual Kennedys, and psychological breakdowns.

The story of the System/360 was also the undoing of Dick, Tom Watson jnr’s younger brother. Dick Watson was a much less rebellious character than Tom; he’d even permitted his father to accompany him and his bride on their honeymoon.

As young men, the brothers had been close, and Dick was able to cajole a depressed Tom out of bed when no one else could. Dick had been running IBM’s worldwide operations very successfully; Tom wanted his brother to follow him as CEO.

But Tom’s decision to put Dick in charge of the manufacturing and engineering of the System/360, and to task his rival for the CEO position, T. Vincent Learson, with selling the line, backfired badly.

As production delays mounted, Dick stopped coming to work; rumour had it that he was drinking too much. The brothers barely talked to each other, and after Tom effectively fired Dick, the estrangement was complete.

In 1970, at age 56, Tom had a major heart attack and soon resigned as CEO; he formally retired from IBM in 1974. Later that year, Dick died at 55 from a fall down the stairs at home.

Tom Watson jnr was in the Soviet Union, serving as President Jimmy Carter’s ambassador there, when IBM’s executives made the disastrous deal with Bill Gates. Watson went on to write an unusually frank memoir, Father, Son & Co., which in 1990 spent 14 weeks on the New York Times bestseller list.

By that time, “IBM – my company”, he still called it – was a wounded giant. Overinvested in the mainframe business during the 1980s, Watson’s successors failed to capitalise on the PC and its software, forfeiting a huge consumer market.

Much more here:

https://www.afr.com/work-and-careers/management/ibm-changed-history-and-then-couldn-t-keep-up-with-it-20240219-p5f5xc

Really a great article!

You would have to say letting Bill Gates wander out the door with MS-DOS was really a mistake but would have been so easy to do at the time.

Today IBM is the 72nd biggest company on the planet (Market Cap. Of $US 170 Billion) so it is hardly a tiddler!) (It is still bigger than BHP, but rather smaller than Microsoft!)

I came into computer awareness around the time of the introduction of the IBM=PC (August 12, 1981) and my first e-mail experience was with IBM PROFS! (At about the same time I was running a computer BBS which ran on IBM Clones – networked with Artisoft Lantastic – running e-mail using a client called Binkley!) Really takes you back!

When you think of where we are now with AI, Cloud Computing and so on things have sure moved on!

Do you have some ancient computer memories?

David.

I Really Do Wonder About These Services That Seem To Be Popping Up All Over!

I noticed this last week:

Hola Health

Health Info | Telehealth

Healthcare When You Can’t Leave Home – Australia’s Telehealth Landscape

Written by Sai Pragna Chagarla, Staff Writer – Hola Health

Digitally connected, the term we commonly use in a range of industries across Australia be it travel, banking, education, government services, food and beverage, ecommerce and more. But, what about healthcare? Can the available technology ease the wait times, bring in consultation services to the remote parts of Australia with a click of a button? Can the health care industry sustain the burden of disease with the growing population? Is telehealth in Australia the answer to contain the spread of various illnesses? 
 
As we ring in the new year of 2024, it is important to understand how telehealth is shaping Australia’s health care system and why it has become a necessity in our daily lives.  

Connect with our doctor within 15 mins

See Dr Now

Usage of digital technology in Australia

As per a report from Australian Communications and Media Authority, 99% Australian adults have internet access post 2022 for work, study, leisure, shopping, and daily activities. Since the outbreak of Covid-19 in 2020, Telehealth has seen a consistent increase in usage due to the restrictions imposed on movement and to mitigate the risk of spreading the disease. Especially the restrictions led people of all ages to get online for tele consults.  

Australia’s healthcare landscape is undergoing a revolutionary transformation, driven by advancements in technology and a growing emphasis on digital solutions. The National Digital Health Strategy is at the forefront of this change, with telehealth emerging as a pivotal component in delivering accessible, efficient, and patient-centric care. 

As per some statistics from Australia’s National Digital Health Strategy, 1 of 20 Australian google searches are health related, 84% of users first go online for health information and 69% of older Australians used Internet to look up health information which shows how digital technology is already a part of our life.

What do Aussies want from Telehealth in Australia?

As per the Australian Digital Health Agency led consultation process in forming the National Digital Health Strategy, it was found that

• 65% of the respondents think that it is difficult to navigate Australia’s healthcare system.
• 45% of the respondents had difficulty in accessing healthcare when they needed it due to location, cost, or wait times.

Here are some key aspects that Australians typically want from telehealth:

• Reduced Travel: Reducing the need for extensive travel, particularly for routine check-ups, follow-up appointments, or minor health concerns is a boon especially for patients who are in older age. 
• 24/7 Access: Many Australians desire round-the-clock access to telehealth services, allowing them to seek medical advice at any time, especially when it comes to urgent situations or child health. 
• Reduced Waiting Times: Australians want telehealth to address the issue of long waiting times for in-person appointments, providing a more efficient and time-sensitive healthcare experience. 
• Professional Expertise: Patients want assurance that telehealth consultations will involve qualified healthcare professionals who can provide the same level of expertise and care as in-person visits. 
• Cost-Effective Services: Australians look for telehealth options that are cost-effective, providing a more affordable alternative to certain types of healthcare services compared to traditional in-person consultations. 
• Remote Monitoring and Follow-Up: Patients with chronic conditions, new mothers, patients with illnesses that could spread appreciate telehealth for remote monitoring and ongoing management, enabling them to receive continuous care without frequent travel. 
• Post-Operative Care: Australians expect telehealth to play a role in post-operative care, offering convenient follow-up consultations and reducing the need for unnecessary hospital visits. 
• Culturally Competent Care: Australians from diverse cultural backgrounds appreciate telehealth services that are culturally sensitive and respectful of their individual needs and beliefs. 

How are Telehealth services such as Hola Health come into the picture?

Telehealth services are the need of the hour, especially with diseases such as Coronavirus and other easily spreadable viruses, we understand the importance of virtual healthcare in our life. Hola Health, one of the best telehealth platforms in Australia, reduced the burden on the Australian Healthcare system by utilizing technology. Many Australians benefit from these services namely:

• People living in remote or rural areas. 
• new mothers 

• older people  
• people who need post-op follow-up 
• People who require a repeat script 
• people who need a medical certificate for a single day or multiple day leaves 
• People who require medicines, test kits, OTC products delivered to home. 
• People who would like to speak to a mental health specialist in anonymity. 
• People who can’t take off work or cannot travel long distances to reach a hospital. 
• People who need a specialist, pathology, radiology referrals quickly so they can have the reports ready for the next appointment. 
• People who require after hours or weekend consultation.  
• People who cannot get an appointment due to long wait times. 
• People who are travelling  
• People who want cost effective health care and who wants to save on travel costs to a hospital. 

Hola health offers a plethora of services including:

• Online General Practitioner (GP) consultation: Hola Health’s telehealth doctors are AHPRA (Australian Health Practitioner Regulation Agency) accredited GPs and can provide a broad range of medical advice including sick children, coughs, cold and flu, heavy congestion, earaches, sore throats, tooth aches, temperatures, and sexual health. Speak to a GP within 15 minutes, 24 hours a day, 7 days a week from anywhere in Australia. 
• Get a Medical Certificate: Whether you need a doctor’s certificate for work, school, or as a carer, Hola Health puts you in control of your medical certificate needs with simple, quick, online certificate requests.  
• Get an online prescription: Cannot get in to see your regular doctor and need a prescription? Select your medication from the provided list and have a short consult with an AHPRA registered medical practitioner within 15 mins 24 hours a day. Approved scripts are sent to your mobile device as an eScript.  
• Get a Mental Health Treatment Plan: If you think you may be experiencing a mental health disorder, and it is not an emergency, you can make an appointment with an AHPRA registered doctor who is trained in mental health assessment. During this appointment, our doctor will assess whether you have a mental health disorder and would benefit from a Mental Health Treatment Plan (formerly known as a Mental Health Care Plan). Appointments are 100% Medicare bulk billed. 
• Get your medicines delivered at home: Getting to the pharmacy to collect your medicines can be time consuming and take you away from the things you should be doing. There is an easier way. Hola Health medicine delivery provides a fast and convenient way to get the medicines you need, now. 

Telehealth is a cornerstone of Australia’s National Digital Health Strategy, representing a transformative shift towards a more accessible, patient-centric, and digitally driven healthcare system. As technology continues to evolve, the integration of telehealth in Australia will play an increasingly crucial role in shaping the future of healthcare, contributing to improved health outcomes for all. 

See a GP within 15 minutes anytime, day or night

See a doctor

Request a script

Reference

1. Australian Communications and Media Authority – How we use the internet – Key Summary findings: Reference Link

2. Australia National Digital Health Strategy: Reference Link

3. Internet Activity Australia – Australian Bureau of Statistics: Reference Link

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This link shows you the services offered:

https://hola.health/

Having read the sales pitch I would love to hear from people about whether they would use this or a similar service and how useful they would find it to use such services.

I also wonder just how ethical the advertising is. It does seem pretty commercially orientated and you wonder how patients are screened as suitable for on-line care?

All comments can be anonymous and I am sure we would all learn a lot from other people’s experiences!

David.

Some Views On Digital Health Interoperability From One Of Our Experts

This appeared in New Zealand and I felt it needed some OZ exposure:

My View: Interoperability is a team sport

Monday, 19 February 2024  

VIEW - Grahame Grieve, FHIR product director

I started working on FHIR (Fast Healthcare Interoperability Resources) because I believe in better health outcomes and that healthcare has broken processes. As well as being a technical standard, FHIR is a name for a community of people dedicated to solving the challenge of sharing healthcare information, and who participate in an open fashion.

Together we have produced a technical specification that describes how to exchange healthcare information. That API has become transformative and is taking over the world of healthcare.

Open Solutions
Interoperability is not a technical problem, it is about building community knowledge and building community answers at every level.

FHIR is an open community, anybody can join. You do not have to pay or register, you can just be part of the community by spending your time on FHIR. This frees up the community to focus on solving problems.

One of my mantras is that interoperability is a the team sport: people contribute to open knowledge to drive change, and it’s why FHIR being an open community is so important. One outcome of that is that open knowledge lifts the baseline, forcing everybody to get better.

The ultimate goal of FHIR is to make the platform public property, so that commercial organisations make money by providing services, not by owning the platform.

If we can solve community problems in an open way, we share the technical base at multiple levels. This solves another key problem with healthcare, which is scale.

Making interoperability worthwhile
The accepted definition of interoperability is the ability of two or more systems to exchange data and make use of the data, so it is a very data centric view of the world. But what if we automate our existing processes, and they are not very good?

You can easily create worse processes with digital, so the real challenge with interoperability is to make it worthwhile.

I prefer to use this definition of clinical interoperability; ‘the ability of two or more clinical teams to transfer patients and provide seamless care’.

The idea is not to automate existing bad practices, but to build new ones that allow us to transform healthcare outcomes.

Institutions tend to keep records and share them for institutional purposes, rather than to serve the patients their families. This means the systems serve our institutions, they do not serve us – where us is either the individuals providing care, the individuals receiving care, or their families.

Our call in the FHIR community is to refocus not on interoperability that automates our existing walls and features, but on processes that break down the walls and allow us to create new kinds of workflows, as it is through those new kinds of workflows that change happens.

For example, using FHIR to provide access to fluid patient summaries that are widely available to create virtual workflows. Virtual Emergency Departments and early discharge services that keep people connected through FHIR and interoperability to hospital systems are truly transformative.

Join the community
In my experience, interoperability happens slowly and gradually and then suddenly you realise that you now totally depend on it.

We set out to disrupt healthcare by significantly reducing the cost of data exchange, principally through making it scalable, easy and natural to use. But of all the things we did, it is the open community that truly changed the game.

I encourage you to join our community and build interoperability that serves clinical health outcomes and helps to build a public treasure that we all benefit from.

This View is a summary of Grieve's presentation at Digital Health Week 2023, if you attended the conference you can access his and all other presentations online.  

If you want to contact eHealthNews.nz regarding this View, please contact the editor Rebecca McBeth.

More here:

https://www.hinz.org.nz/news/665386/My-View-Interoperability-is-a-team-sport-.htm

Some good thoughts here. Interesting to see how widely FHIR is now adopted and used. Suggests it has a lot right!

I hope at least a few might give thought to joining the FHIR community to add to its progress and success.

David.

The ADHA Has Released A New Digital Health Strategy – Oh Whoopdy Do!

I noticed this press release last week announcing a new Digital Health strategy:

Digital health: focus on interoperability, collaboration bolstered with national strategy

Friday, 23 February, 2024

The Australian Digital Health Agency has launched the National Digital Health Strategy 2023–2028 and the accompanying Strategy Delivery Roadmap that set out a vision and pathway for the country’s digital health future.

The five-year strategy plan is aimed at achieving four key outcomes for digital health: digitally enabled — health services are connected, safe, secure and sustainable; person-centred — Australians are empowered to look after their health and wellbeing, with the right information and tools; inclusive — equitable access to health services, when and where they are needed; data-driven — readily available data informs decision-making at the individual, community and national level, contributing to a sustainable health system.

Australian Digital Health Agency CEO Amanda Cattermole PSM said the Strategy and Delivery Roadmap were the result of a productive collaboration between federal, state and territory governments and shaped through extensive consultations with consumers, carers, healthcare providers, research organisations and technology innovators.

“In an age of precision medicine, characterised by healthcare innovations like wearable technology and AI-driven genomic research, we are witnessing a paradigm shift towards personalised and preventative health care. The National Digital Health Strategy is essential to support this shift while fostering a connected, secure, inclusive and ethical healthcare system, backed by robust legislation,” Cattermole said.

“The Strategy captures areas of reform that require a nationally co-coordinated effort across all jurisdictions to drive transformation in digital health. The powerful partnerships behind this Strategy and Roadmap will ensure that no matter what corner of the country they call home, Australians can reap the benefits of digital health care that is tailored to their unique circumstances.”

Agency Chief Clinical Advisor Dr Steve Hambleton said advances in technology are already improving health outcomes and reducing waste. Clinical benefit and consumer engagement can only get better as programs such as sharing diagnostic tests to My Health Record by default roll out.

“Immediate access to critical diagnostic information wherever requested is a quantum leap forward in supporting clinicians to make the best decisions for the patient.

“Digital tools will never replace doctors but doctors who use digital tools will likely replace doctors who don’t,” Hambleton said. 

The roadmap initiatives are based on some key principles to guide partners and collaboration:

• Digital health solutions support a person-centred health and wellbeing system.
• Digital health is integral to care delivery and complements in-person care.
• Solutions are co-designed to reduce rather than create access barriers and to be fit for purpose and accessible.
• Solutions are developed to make information discoverable and accessible.
• Digital solutions are interoperable, reusable, coordinated, efficient and supported by the use of national healthcare identifiers.
• Governance, use and management of data is respectful, culturally responsive, meaningful and appropriate.
• Data and information are shared in accordance with jurisdiction and partnership actions under the National Agreement on Closing the Gap.
• Initiatives are developed and implemented with respect to consumer rights on access, safety, respect, partnership, information, privacy and feedback.

Here is the link:

https://www.hospitalhealth.com.au/content/technology/news/digital-health-focus-on-interoperability-collaboration-bolstered-with-national-strategy-828235392

Here is the official link:

National Digital Health Strategy

About the strategy and roadmap

Australia's National Digital Health Strategy is a 5-year plan that sets the vision and pathway for our digital health future.

It builds on the achievements of the previous National Digital Health Strategy released in 2017 and acknowledges the efforts, planning and investment to date towards digital enablement and the uplift in digital health maturity.

The strategy places people at the centre of a connected and digitally enabled healthcare system. It seeks to achieve 4 key health system outcomes that will improve the wider Australian health system by creating a more connected, person-centred digital health system and by realising the benefits digital technology offers consumers and carers, health care providers, the wider community, governments, industry and providers.

The strategy is supported by a Strategy Delivery Roadmap which sets out the implementation pathway over the 5 years.

"This next phase of digital transformation will drive information sharing and advance real time data exchange to make information available when and where it’s needed, in line with consumer consent and strong privacy and cyber security standards."

National Digital Health Strategy

The strategy and roadmap have been collaboratively produced and agreed by the Australian, state and territory governments and informed through detailed consultations with patients, consumers, carers, healthcare providers, industry, organisations and innovators.

The Australian Digital Health Agency is the custodian of the strategy, with its role being to evolve national digital health capability by innovating, collaborating and leading.

Download the strategy and roadmap

The strategy and roadmap have been produced collaboratively and agreed by the Commonwealth, state and territory governments.

The documents have been informed through detailed consultations with patients, consumers, carers, healthcare providers, industry, organisations and innovators.

Here is the link:

https://www.digitalhealth.gov.au/national-digital-health-strategy

It is worth scanning these documents, if only to be amazed at how much is to happen and just how busy the ADHA will be delivering all the various components – if they actually do!

I have seen many plans like this over the years and I am not sure just how much has actually been delivered. Change is hard and I suspect the real purpose of all this documentation is to paint a set of objectives that can be approached as the resources and skills are available.

There is no doubt that progress can happen in the directions laid out but I sense it takes a good deal longer than suggested above. It is sensible to have stretch targets and as I read, while awed by the scope, the broad directions seem sensible.

You only have to think of things like secure messaging and electronic prescribing to understand that they are happening, just not at the pace originally suggested. For how long have we been talking about electronic prescribing? How fully adopted is it now?

Still some progress is better than none – so it’s sensible to just sit back and watch as it happens, with the odd comment if things are too slow or go off the rails!

It is a worry just how slow progress seems to be and I really wonder how much of what is happening is actually due to the ADHA. They cost a fair bit each year so it would be good to see them really moving things along!

Have you noticed progress in your city or town with new services becoming available?

The other point to make is that as far as I can recall the 2017 ADHA Digital Health Strategy really was not that much different from the 2024 one. Not much strikes me as very new or very unexpected, That probably says something!

David.

It Seems There Are Some Encouraging Signs Coming From The Gene Therapy Arena.

This appeared a few days ago

‘Years my kids didn’t have’: Boost to Australian gene therapy development

February 24, 2024 — 10.00pm

 

When Megan Maack’s two children were diagnosed with a rare genetic condition causing childhood dementia in 2013, research teams overseas had a drug that could dramatically slow the disease’s progress.

But it took years for the drug to be developed to a clinical grade, and it is extremely difficult to enrol in trials of such drugs when they are held abroad.

“They were years my kids didn’t have,” said Maack, who is now CEO of the Childhood Dementia Initiative, a group advocating for the 2800 children born with conditions causing childhood dementia in Australia each year, including her children Isla, 14, and Jude, 12, who have Sanflippo syndrome.

“We need to get these drugs to kids when they are young. Once they hit a point of decline, the drug is just not effective,” she said.

“Unfortunately, at the moment, there’s just not the capability in Australia to develop clinical trials locally. It is more about developing small batches to test on mice.”

But Maack is optimistic about the future of treatment in Australia, with major investment in gene therapy in NSW that could see life-changing drugs for rare childhood diseases being produced and trialled in Sydney as early as 2025.

A $134.5 million world-leading “viral vector” manufacturing facility in western Sydney is expected to be fully operational by the end of this year.

Viral vectors – microscopic tools which deliver genetic material into cells – are providing hope in the treatment of rare genetic diseases and cancers through gene therapy, an area of medicine which has progressed rapidly in the past five years.

“It’s just unbelievable what’s evolving: the way we can fix genes is now more precise,” said Professor Ian Alexander, head of the gene therapy research unit at Sydney Children’s Hospital.

“Instead of putting an extra copy of a healthy gene in, we can go in and fix ‘spelling errors’ in existing genes.”

A recent success story has been the treatment of spinal muscular atrophy (SMA), a rare condition causing muscle wastage which is the leading cause of infant death.

An international trial of gene therapy for the condition, which involved babies treated at Sydney Children’s Hospital, was so successful that since 2022 NSW has funded free screening for the disorder in a baby’s first three days of life, to ensure early access to treatment.

Maack said this would be an ideal outcome for therapies developed for conditions causing childhood dementia. Like SMA, she said, parents are unlikely to know if their child is at risk, and early genetic treatment, before a child’s decline, is critical.

“Both parents need to have a mutation in the same gene, so you can’t look at your family history,” she said.

“The majority of families will be completely blindsided by the diagnosis.”

The state government announced today it had created a new company, registered as Viral Vector Manufacturing Facility Pty Ltd, to manage operation of the Westmead plant as it manufactures the therapies on a commercial scale, managing relationships between research teams, universities, hospitals, pharmaceutical companies and other stakeholders.

“My priority as health minister has been to embrace innovative initiatives in improving health outcomes for our community,” Ryan Park said.

“These therapies are expanding rapidly, targeting more and more genetic diseases, cancer and infections, significantly increasing the number of patients who can and will benefit from viral vectors.

More here:

https://www.smh.com.au/national/nsw/years-my-kids-didn-t-have-boost-to-australian-gene-therapy-development-20240223-p5f7dg.html

It really must be one of the worst outcomes people can have to find their nipper(s) have a genetic flaw that will lead to disability, suffering or worse.

What is proposed here is clearly complex and expensive work with no guarantee of success and all most of us can do is watch and wait as the experts do their work and progressively more young lives can be saved / improved!

It’s good to see funding and effort are going to these endeavours. It is hard to see the rewards won’t be pretty large over time! I sure hope so….

David.