Dan McInerney has a deep passion for healthcare and health system management. A partner at EY, he is currently working with State and Federal Governments to develop and realise their digital health and wellness strategies.
I come from a family with a rich history of chronic disease. My mother’s illness meant that my childhood and teenage years were spent navigating both general practitioners, hospital wards and the health system at large. Constant trips in and out, a check-up here, a specialist visit there, another uncomfortable sleep in a bedside chair.
I knew early on that I wanted to be part of the Australian Healthcare System that was keeping my mum as healthy as she could be; to help it does the same for families just like ours; I’ve never been good around blood, so the hands-on work of doctors and nurses wasn’t a realistic option. I studied hospital administration instead. Beginning in 1998, I worked in state hospitals, in federal government healthcare, and now I’m consulting across this sector as a partner with EY.
Today I find myself in a unique position. I am revisiting the reason, my purpose on why I first started in healthcare. I’m a father to a three-year-old daughter who has recently been diagnosed with juvenile arthritis. Another chronic condition, but one that we’re learning to manage. I grew up experiencing the health system as a user, I’ve since built a career as a passionate enthusiast wanting to improve it, and now, need to navigate it all again as a parent, I’m wearing both hats at once.
There’s a big difference between the system that helped my mum and the one that’s helping my daughter. And there’ll be just as big a difference if my daughter needs its help, for herself or children of her own, when she’s my age. And that difference can be summed up in one word: digital.
Digital healthcare brings a different ability to engage, access and participate
We’re right in the middle of one of the most ambitious clinical agendas that the Australian healthcare system has ever undertaken. The idea is to make navigating the health system as seamless as possible for those every day Australians choosing this experience; one that provides new options to access services, better experiences and improvements to patient safety and outcomes. This is no easy feat.
The current state of play has been laid bare for me since my daughter’s diagnosis. We’re navigating a health system of GPs, hospitals, specialists and therapists that’s part-way there but has a long road ahead of it. We don’t yet have the benefit of a complete and comprehensive digital record – instead, we are required to carry around hard copies of referrals, scripts and specialist reports, which serve as golden tickets at key points in the journey. Having to keep such important documents safe, organised and constantly available in hard copy can be daunting, particularly if you’re doing so for a vulnerable child so reliant on them.
I see digital as a big part of the future. It’s a future in which a referral is sent directly from GP to specialist. No mess, and no fuss. Where I’m no longer required to carry around the golden tickets that ensure my daughter’s needs are met. Where a health professional can quickly and securely see all relevant information concerning my daughter, allowing them to offer the most efficient and effective care possible. So there is no more need to constantly repeat her clinical history.
Improving patient outcomes through digital health initiatives
The main question we are trying to answer is this: how do we transition, in the right way, to using digital better?
When the term ‘digital’ is uttered, the first thought that pops into most people’s heads is technology. Apps, artificial intelligence, blockchain, whatever other new development is making headlines this week. But the evolution of our health system isn’t all about flashy tech. Technology is simply one of many means to the end.
For me at least, digital health is about connecting my daughter’s care community to better understand her disability. Digital healthcare allows us, irrespective of your socioeconomic status, to be connected and to have all relevant information in the right hands at the right times. It will allow care communities to proactively monitor care plans including medication adherence and required real-time changes to treatments. How in the near term via innovations such as precision medicine and genomics it will allow us to understand the exact cause of a symptom and to treat it with medications tailored to a specific person. It’s a community enabled by technology.
We’re only at the foundation stage. It’s no mean feat to have all of our health systems working seamlessly together; national and state, public and private. But we’re getting there. We have the recent release of My Health Record. We have every state moving from paper-based to electronic records. We are strengthening other necessary infrastructure such as e-referrals, where your GP sends your information to a specialist electronically, removing the need for a hard copy.
Data privacy and security of digital health records
New ideas are inevitably met with resistance. There are a number of big questions being asked about digital health, from everyday Australians and the medical community. They’re questions that inevitably centre on consent, access, control and security.
Those steering the ship are well aware of the importance of these questions. If digital health is to be successful, we need to ensure that:
- Health professionals – doctors, nurses and others – feel comfortable that new, digital models of care make their care advice better and their job easier, not worse and more difficult.
- Patients – everyday Australians – feel they have provided informed consent on the secure release of their health information and are comfortable that their health information is secure.
- Government – provides the legislative framework to protect the rights of our its citizens that gives comfort and a sense of ease their personal health information is protected and can only be used for its primary purpose or approved secondary purposes.
The question of security is paramount. Thankfully health isn’t the first to navigate this particular maze – it’s one that’s already been traversed by the finance and retail sectors. We’re now largely comfortable with online banking and shopping, the challenge is to bring the same levels of comfort to the most personal of personal information – that of consumers’ health. It’s up to the sector to set standards in this regard, and educate citizens that they hold the power via consent protocols on what and how information is secured and controlled. This will require continual educational campaigns and engagement. We need to invest in making sure people feel comfortable with how their data is handled.
We’ve still got a long way to go, and in reality, I don’t expect this process to ever end. Technology won’t stop evolving, so neither can our health system. Advances need to be considered, put through rigorous processes, and carefully introduced if they meet the required standards.
Thankfully, there are a lot of passionate and enthusiastic stakeholders in and around the Australian healthcare system. Some are excited by what digital health might provide, others are rightly mindful about the risks of progressing too quickly. But all stakeholders share one thing in common: a desire to create and maintain the best healthcare system possible.
Digital health as a supplement, not a replacement
Despite the continual evolution that our healthcare system is experiencing, the treatment that my daughter is getting from the full spectrum of health and care providers is fantastic. My daughter is getting the best care she possibly can, in what is consistently ranked as one of the best healthcare systems in the world.
From my perspective, digital isn’t the future of our health, it’s just part of the future of our health. We need to accept that everyone will have a different pace at which they become comfortable with digitally-enabled healthcare. Each individual’s perspectives and opinions need to be appreciated. Some people may never want to switch to digital, preferring the tried and true models they have now. Due to the makeup of our amazing country, some Australians may not get the opportunity due to remoteness, connectivity barriers, and cultural beliefs. If this is the case, then we must improve our traditional models so these individuals have the same level and quality of healthcare service access and experience.
So, digital health is about complementing our already rich healthcare system. It’s about providing consumers with the choice of how they would like to interact with that system. If they’d like face-to-face care, we want to be able to provide that. If they want or need a tele-medicine consult, we want to be able to provide that too. We want a system that grows with the needs of its users; one that offers every user, be they patient or provider, the best way of doing things, whatever ‘best’ may mean to them.
We want a system that works for the people who need it most: people like my mum and my daughter.