In 2017, the Council of Australian Governments (COAG) Health Council approved Australia’s
National Digital Health strategy (2018-2022).

The Strategy seeks to put the consumer at the centre of
their healthcare, providing choice, control and transparency. The Australian
Digital Health Agency (ADHA), in consultation with the states and territories,
has drafted a Framework
for Action to support the strategy’s implementation. ADHA is running a
consultation to gain wider feedback on the draft framework.

The Framework for Action sets out priority activities for
co-development for the period 2018-2022 and defines the roles of participants,
including healthcare consumers, healthcare providers, the industry and
technology sector, peak organisations, ADHA, the Commonwealth Government and
the State and territory governments. 

The eight priorities are as discussed below.

Health information
that is available whenever and wherever it is needed

By December 2018, the Australian Government will provide a
My Health Record for every Australian unless they choose to not have one. For
the roll-out of My Health Record, the Australian government allocated AU$374.2
million in its 2017/2018 Budget, over a period of two years from 2017-18
onwards.

The My Health Record will be continuously improved, with
scoping, building, testing and executing system releases planned over the life
of the Strategy to provide additional functionality and health information.

The My Health Record provides a data platform that will
foster and support digital innovation, leading to the development of digital
health solutions and support future developments including precision medicine
and genomics. To support innovation the capture of available and relevant
information in the system, including pathology and diagnostic imaging results,
and medicines information, will be increased and the consistency and usability
of medical reports will be improved. The usability of clinical information
systems will be improved to ensure the My Health Record integrates more
intuitively, based on the development of an evidence-based design research
framework.

Another priority action in the area is to establish a framework
to govern the safe and secure use of My Health Record system data.

Health information
that can be exchanged securely

The existence of multiple health service directories and the
lack of confidence in completeness and currency of data in these directories
and addressing services present challenges to achieving a standardised approach
to secure messaging.

A national provider addressing service will be established,
building on the design
work already undertaken. A key first step is progressing requirements and
options analysis, and confirming the scope of this service co-designed with
states and territories and industry stakeholders.

The Framework highlights the need for an integrated
standards-based secure messaging capability using national infrastructure
services.

The set of information in a message, and how it is
displayed, is not currently standardised. To address this issue, nationally coordinated
programs will continue to develop and refine specifications and national
reference architectures, co-produce implementation profiles with vendors and
demonstrator health services, and drive national adoption and use for priority
usage patterns, including discharge summary, referrals, specialist and allied
health reports (e.g. including specialist to specialist and psychologist to GP
correspondence).

A roadmap will be produced outlining how national
infrastructure services will be further enhanced and leveraged to support
potential new usage patterns, such as national protocol for transferring
diagnostic images, GP-to-GP record transfer, online consultations supported by
smart forms, provider-to-consumer messaging and provider-to-provider instant
messaging.

Existing national authentication and identification services
will be enhanced, through the co-production of an integrated digital identity
framework, aligned to Digital Transformation Agency identity and authentication
frameworks and services, for health and care provider individuals and
organisations that can be used to access a variety of private sector and
government sector digital services.

To ensure the national infrastructure services are being
used in the most efficient and sustainable way, a strategic service design,
sourcing strategy and procurement review is being undertaken by the ADHA to
identify recommendations to enhance national infrastructure services.

High-quality data
with a commonly understood meaning that can be used with confidence

To address the risk of uncoordinated investment in
technology that does not meet a common set of standards and could exacerbate
siloing in the health system, Australian governments, industry and the health
sector will co-produce a National Interoperability Strategy (NIS). This will
include agreed base level requirements for using digital technology when
providing care in Australia with governments and colleges, agreed set of
national interoperability specifications and standards, accreditation regimes,
and procurement requirements.

Adherence to interoperability standards will be promoted and
the widespread implementation of the agreed functionality of standards and
specifications will be ensured by coproducing a conformance, compliance and
accreditation framework and process, building on existing schemes.

Currently, there are a range of digital health initiatives
with discrete governance and management processes, including My Aged Care,
Mental Health Gateway, GovPas, MyGov, the NDIS, theNational Cancer Screening
Registry and claims and payment processes. To avoid fragmentation and
duplication, and ensure that the consumers of these services receive coordinated
and efficient care that is simple to navigate, a national technology strategy
will be co-produced.

National data services will be continuously improved and
enhanced, including the National Clinical Terminology, GS1 standards (including
GTIN, GLN, Barcoding) and Supply Chain Solutions, including the National
Product Catalogue, Locatenet, Recall Health and eProcurement.

Better availability
and access to prescriptions and medicines information

According to the plan, medications management for both
healthcare consumers and providers will be improved by co-producing and
publishing a national digital medicines management blueprint which will include
development of the infrastructure, specifications, policies, legislation and
change, adoption and training activities for clinicians.

By 2022 there will be digitally enabled paper-free options
for all medication management in Australia. National infrastructure will be
leveraged for this, and the specifications and regulatory framework required
will be developed.

Healthcare providers and consumers will be able to access a
best possible medicines list in a structured data format via the My Health
Record system by evolving the Available Medicines View, including pharmacy
curated medicines list and consumer-uploaded medicines, to support medicines
reconciliation, and enable providers to upload the reconciled medicines
profile.

A National Medicines Data Service will be established,
building on existing programs (e.g. NSW scoping and pilots) and infrastructure,
enabling jurisdictions and health service organisations to maintain their own
tailored medicines master data of all medicines suitable for use, or receive a
managed service.

In addition, there will be targeted consumer information via
the My Health Record system. There are also plans to explore the enhancement of
medication safety incident reporting capabilities through digital solutions,
including the development of a dedicated national framework.

Real Time Prescription Monitoring will provide an instant
alert to pharmacists and doctors if patients received multiple supplies of
prescription-only medicines, assisting to identify patients who are at risk of
harm due to dependency, misuse or abuse of controlled medicines.

Digitally enabled
models of care that improve accessibility, quality, safety and efficiency

Test-beds will be established focused on clinical priorities
to allow evaluation and refinement of digital health care models, and
investigate how to scale innovation nationally. Telehealth models, as well as
new and existing models of digital consultations, support and care coordination
in End of Life Care, will be harmonised across Australia.

Health Care Homes will be supported for digitally enabled
coordinated care. It will be ensured that every child in Australia has access
to a comprehensive health record, readily accessible by parents and health and
care providers. (Recently,  ADHA entered into
a partnership with eHealth NSW
and the Sydney Children’s Hospitals Network (SCHN) to establish the National
Children’s Digital Health Collaborative to work towards this aim.)

A workforce
confidently using digital health technologies to deliver health and care

A network of chief clinical information champions will be promoted
to drive cultural change and awareness of digital health across the health
sector to help embed digital health into routine clinical practice.

National curricula and training materials will be developed
for delivery by universities, health services, peak bodies and training
organisations aligned to the requirements of continuing professional
development programs for all health care providers.

Plans also include co-production of higher and tertiary
education curricula relating to digital health and incorporation of components
into existing courses.

Led by the professional associations and workforce
accreditation bodies, digital health will be integrated into the national
workforce accreditation to ensure healthcare providers have easy access to best
practice guidelines, and other supporting resources which increase their
understanding of how, when and why to use digital health solutions.

A thriving digital
health industry delivering world-class innovation

Innovation and digital inclusion will be promoted through
thought leadership, conference presentations and industry engagement. A network
of local community partners who run digital literacy programs will be developed
to advocate for programs which improve digital literacy and ensure
inclusiveness, equity and cultural safety for target populations, including
Aboriginal and Torres Strait Islander peoples, culturally and linguistically
diverse (CALD) populations, people living with a disability, carers, and older
Australians.

An Innovation Showcase will be established and coordinated
by the ADHA to recognise excellence in digital health innovations through
awards and publishing case studies of successful health and care innovations.

ADHA’s Developer Partner Program will be expanded to help simplify,
guide and support developers on how to bring new ideas to market, facilitate
test environments, provide an open source hub of code sets, and provide support
on how digital health national infrastructure services can support what
developers are trying to achieve.

A sustainable digital health services endorsement framework
will be co-designed to complement existing initiatives by both the public,
private and non-government sector to compile a user-friendly list of
evidence-based digital health services and content.

A new Health Innovation Exchange will support the
establishment of a forum where clinicians, researchers and entrepreneurs, both
local and international, can work collaboratively on digital health services.

ADHA plans to partner with organisations who support
start-ups to transform their ideas into competitive businesses, providing
resources, knowledge, seed funding and access to networks. The objective would
be to facilitate regulatory sandpits, joint ventures and strategic partnerships
to both support the creation of new digital health solutions and scale up
current digital health innovations.

Innovation of mobile, portal and desktop applications will
also be supported by enabling connectivity to digital health systems separate
to the My Health Record such as electronic prescribing, secure messaging, and
other consumer provided sources (for example fitness devices). ADHA will work
collaboratively with mobile developers to leverage digital health foundations,
the Fast Health Interoperable Resources standard (FHIR), and Application
Programming Interfaces (APIs) for exchanging digital information.

The draft Framework for Action and consultation form can be accessed here.  Feedback can be provided until Friday 6 April
2018.