Harnessing the Power of Digital to Improve Population Health
The current primary healthcare crisis in Australia provides a clear justification for an urgent overhaul of our ailing Medicare system. The current review is an exciting opportunity to stop the ‘band-aid’, fragmented approach to healthcare, to create a prevention-first rather than a treatment-first approach, to improve population health and reduce healthcare costs. To achieve this, digital health must be seen as a crucial part of the solution.
As a GP and clinical entrepreneur with a passion for prevention, I was relieved to hear Prime Minister Albanese's statement on Friday that health will be a key priority for federal, state and territory leaders in 2023. His acknowledgement that early intervention is cheaper, informed by the Strengthening Medicare Taskforce report highlights the increasing burden of chronic diseases on the healthcare system and the need for an effective and timely prevention first approach. Equitable prevention that incorporates early detection and management of chronic diseases is absolutely crucial.
Augmenting Primary Preventive Care
GPs play an essential role in our health system as do nurses, allied, mental health clinicians, non-GP specialists and support staff. There is overwhelming evidence that strong primary care is the most effective foundation for a robust health system and improved population health. Sadly, the impacts of chronic underfunding on workforce shortages with consequent care fragmentation has contributed to increasing health inequities in our communities and pressure on our public hospitals. These issues have been developing for many decades. There are no quick fixes. Solutions that rely solely on improved funding for primary care and expectations that an already perilously stretched GP workforce will have capacity to staff additional services (such as the planned urgent care centres), will not be sufficient.
The proposed overhaul provides a valuable opportunity for us to be truly innovative. As identified in the Taskforce report, digital health is a key enabler in the delivery of preventive care in Australia. Currently available digital health technologies have the potential to revolutionise preventive care, by facilitating and augmenting the care that our hard working health professionals provide. Many of these can improve individual health outcomes, communication between care providers and support the evolution of a more efficient and effective healthcare system.
Available early intervention capabilities for both physical and mental health chronic conditions include digital risk assessment, triage, personalised management plans, biometric wearable and other health data analysis, tracking and linking individuals in with care and excellent online health resources, that are broadly recognised to be under-utilised.
Person-Centred Digital Health: an Equity Focus
Alongside conversations about Medicare funding we must continue to urgently prioritise strategies to integrate digital solutions that are person-centred and that can augment primary and allied health care by automating processes that make sense. This approach has the potential to empower individuals and to reduce the economic and workload burden on our struggling health system.
To be effective, digital health solutions must minimise fragmentation of care and address inequity. Through consideration of health literacy and diversity, digital health can be optimised to ensure access by the people with the highest need. Individuals with complex chronic conditions must be supported to access the information and care that they require but in parallel we should also sustain a long-term primary prevention vision.
Integration of Digital Health Tech into a Holistic Solution
Integrating digital health capabilities is an important part of a holistic solution for healthcare. I fully support the drive to improve the current funding model for long consultations for GPs, where doctors are currently financially disadvantaged for providing comprehensive care to individuals with more complex care needs. Holistic care should be rewarded not punished. Provision of structures that enable all health practitioners to work collaboratively and to the scope of their practice are also essential. Our funding structure needs to respect that allied health and nurse practitioners, like GP-specialists, should be able to identify when they need to refer to colleagues.
Frictionless sharing of meaningful health data between patients, health systems, and providers is also crucial for driving better health outcomes. The current model where the myriad of layers of public and private, primary and tertiary services across the country use different medical software systems that are not interoperable is highly problematic. This contributes to significant inefficiency and carries risk.
The My Health Record continues to be an important investment that was developed to address this. The National Digital Health Agency and partners are working hard to achieve interoperability, but due to the complexity of our health system and foundation of locally driven approaches to electronic records, this is yet to provide clinically meaningful and useful health information for the majority of Australians.
Conclusion
The current review of the Medicare system provides a unique opportunity to address the increasing burden of chronic diseases, improve population health and reduce healthcare costs. The Medicare taskforce and prime minister's recognition of the need for prevention-first care and digital health's potential as a key enabler, highlights the opportunity for a more efficient and effective healthcare system. Let’s ensure that the conversations that we’re having about a system overhaul also fully embrace the capabilities of digital health to focus on solutions that remove barriers for our population to access the care they need and even better, not get sick in the first place.