The Australian Government has published their national interoperability plan for 2023 – 2028, highlighting five priority areas with actions including researching UK practice around national minimum standards for health technologies, and developing a national digital health standards catalogue.
The plan begins by noting the “fundamental building blocks” required to establish a connected healthcare system – accurate healthcare recipient and healthcare provider identities, standardised digital record keeping, and clear consumer rights regarding personal information and privacy.
Interoperability principles
The document sets out 10 principles designed to “accelerate the shift towards a more interoperable national healthcare system”, adding that “implementing digital health initiatives that align with these principles will significantly increase the digital health maturity of the sector and enable contemporary, innovative models of care.”
The principles are for health information to be discoverable and accessible; for use of health information to support individual privacy, choice and safe access to information; to use national healthcare identifiers across the healthcare sector; for national digital health standards and specifications to be agreed and adopted; and for the value and quality of care to be multiplied in a digitally connected health system. In addition, the principles include measured digital health maturity informing interoperability system design; for investment to support interoperability and an efficient health technology sector; for collaboration and stakeholder engagement to underpin interoperability; and for high-quality data to be used for safe and meaningful interoperability.
Priority area: identity
Here, the plan stresses the need to leverage existing functionalities in Australia, primarily the Healthcare Identifiers Service and the National Health Services Directory. “Adopting healthcare identifiers will ensure that individuals, healthcare providers and healthcare provider organisations are uniquely and correctly identified when exchanging health information,” it states.
Along with the overall push to adopt and use identifiers, the plan shares a number of national actions in this area. An immediate action is to develop a Healthcare Identifiers Roadmap that will coordinate a response to recommendations regarding identifiers. The roadmap will also review legislative barriers to the wider uptake of healthcare identifiers, and report on healthcare identifier adoption.
In the short-term, plans include developing and implementing a programme of improvements in healthcare identifier matching, including a focus on data quality and user interfaces; reviewing conformance requirements for using identifiers when managing uploads to the My Health Record system; and developing deeper organisation identifier network structures to support enhancing online network registration. This last action will include working with vendors to address software limitations.
There are also national actions planned around The National Health Services Directory, which the plan states “should be managed as core national infrastructure.” An immediate plan is to roll out and support the implementation of Provider Connect Australia, described as “a single place to update your business information that reduces duplication and streamlines notifications.” In the short-term, Australia aims to assess the feasibility of integrating the National Health Services Directory and the Healthcare Provider Directory, in the hopes of reducing duplication and rationalising the national directory infrastructure.
Priority area: standards
The priority here is to “drive digital transformation through effective leadership and a sustainable approach to standards governance. This will ensure that digital health standards, specifications and terminology are developed consistently and collaboratively, and are fit for purpose, widely adopted and implemented using relevant conformity assessment schemes.”
In terms of ongoing actions, the Australian government is engaging with the health technology sector and health departments to integrate national terminologies and classifications natively, and developing specifications and standards through further engagement. Australian participation in international standards development is also being supported.
Immediate priorities include developing and implementing a national digital health standards catalogue; implementing the National Digital health Standards Programme to develop a “dynamic, comprehensive and collaborative digital health standards environment”; publishing a set of national guiding principles for those developing or implementing digital health standards in Australia; completing a gap analysis to prioritise the digital health standards that are most urgently required to accelerate interoperability; and developing stakeholder relationships.
In the short term, the plan shares plans to coordinate discussions on expanding minimum datasets; develop a national library of resources to provide translation mapping from national terminologies to other popular terminologies; engaging with the sector for API information exchange; developing a conformance framework and rules; and establishing a standards development cooperative.
Priority area: information sharing
Next, the plan sets out a need to “increase information exchange between healthcare providers and individuals by making information discoverable and accessible. This includes consideration of an individual’s safety, consent, privacy and data quality.”
The document highlights how ongoing actions include promoting the use of the API Gateway to support interoperable information exchange, and the government and health services specifying interoperability requirements in procurement requests.
In terms of immediate priorities, Australia will establish an intergovernmental working group to “harmonise procurement and use of standards” based on best practice approaches; develop and maintain an online interoperability toolkit; and assess the current interoperability between GP and residential aged care facility systems.
Looking to the short term, the document shares plans to engage with consumers to investigate options for consent management; research international practice, with noted focus on the UK national minimum standards for digital health technologies; and build capability to identify and manage individuals through a care management network.
Priority area: innovation
In this section, the plan highlights how interoperability should be driven through “future innovations that apply the interoperability principles to new digital health initiatives and functional enhancements.”
Giving examples of current activities, the document notes that in the 2021/22 budget, $7.2 million was announced to develop an integrated electronic diagnostic imaging referral system. In addition, an electronic prescription initiative has been undertaken with the Department of Health.
“During consultation with stakeholders on interoperability and on the 2023-28 National Digital Health Strategy, many potential use cases and digital technologies have been identified showing how digital health can transform the way healthcare is delivered, and how individuals can manage their health,” it states. This strategy and accompanying roadmap will highlight priority focus areas and innovative initiatives. The document adds that many of these initiatives “will rely on the principles and actions in the Interoperability Plan, and at the same time build the capacity for a more interoperable health system”.
Some of the key initiatives to be set out in the digital strategy include a project looking at key pain points between primary care and acute settings and enhancing exchange of and access to near-real-time data sharing; and a multi-year programme of re-platforming the My Health Record System, with delivery of infrastructure that can be used across the digital health ecosystem. Another initiative is the development of the pregnancy and child digital health record programme, and a programme of work focusing on building digital capability in aged care residential facilities.
The immediate priority is to develop educational content in partnership with users, to increase awareness of interoperability.
Priority area: benefits
Finally, the document notes the four categories that interoperability benefits generally fall into – patient experience, safety, productivity and reduced costs, and improved data for practice and research – and emphasises how digital health maturity should be measured in order to identify areas for investment.
The plan shares a number of current and ongoing activities in this area; Queensland has piloted the HIMSS Digital Health Indicator, for example, and the government is participating in the development of a Global Interoperability Measurement Model – “a tool for a country or territory to assess its interoperability progress by measuring foundational, structural, semantic and organisational interoperability”. In addition, the University of Queensland has developed an assessment methodology for maturity models, which will be used to assess “the best digital health maturity model options for wider use”.
Australia is also undertaking a survey of hospital, pharmacy, general practice, allied health, specialist practice and aged care organisations in order to provide an interoperability benchmark to track future progress.
The plan goes on to share policy tools to support interoperability, including examples of national arrangements that encourage adoption.
To access the document in full, please click here.
