DoH secretary signals move to integrated, mobile healthcare data
Opening up the My Health Record to mobile devices and apps will raise “a world of great opportunities” through new technologies and analytical services that are now reaching an exciting maturity, the secretary of the federal Department of Health (DoH) says.
DoH secretary Martin Bowles told the New York eHealth Collaborative Forum at the New York Academy of Sciences last week that there was a significant role for information technology in the government’s health reform plans, from opening up the My Health Record (MyHR, formerly PCEHR) to interact securely with mobile devices to allowing healthcare data collected by the government to be shared through a user friendly portal with technology developers and systems designers.
Mr Bowles said he saw the role of the department as helping to evolve and enable national infrastructure in a way that “allows innovative healthcare service providers and software companies to pick up the ball”.
“We need to be open to these new approaches and understand what might be possible as the company who may come up with the next great innovation may not even exist today,” Mr Bowles said.
“The creation of permission cultures is important. Permission to try different things and sometimes fail is critical to success.”
The department announced last month that it planned to make the MyHR mobile-compatible next year, allowing app developers access to the platform through a set of conformant APIs.
Mr Bowles said the functions of the system are also being steadily expanded although he acknowledged consumers had been slow to take up the system and providers even slower.
“[We] have a long way to go to get national coverage of doctors and patients actively using the system,” Mr Bowles said. “We can do better. We need to better understand how consumers want to interact with the healthcare system.
“We have seen big shifts in this in the banking and services sectors and enablers in the app market so by mid-2016 the My Health Record system will be able to interact securely with mobile devices.
“Having the My Health Record system accessible by mobile devices and apps raises a world of great opportunities from new technology and analytical health services which are reaching an exciting maturity right now.”
He also said consumers were increasingly using wearable technologies to help them manage their own health and wellbeing, and he believed there were opportunities for consumers to choose to connect their wearable and other personal health technology to their My Health Record to send information to it, or provide access to information in it.
“Consumers will be able to choose to use their health information to personalise health services to their individual needs, including how the information might be integrated with the data from their mobile and wearable devices,” he said.
“The power of this integrated data, combined with the computational and analytical capacity of third party vendors, will improve capacity to predict health outcomes and provide proactive personalised advice to the consumer and their carers.”
Mr Bowles also signalled opening up data that the department already collects to third parties through a web portal was on the cards.
“Our Medicare system and Pharmaceutical Benefits Scheme provide excellent data on use of healthcare services … [but] we do not use it to its full potential,” he said.
“This is partly because of the complexity. But it is also because different parts of the system own and protect the Pharmaceutical Benefits Schedule, Medicare benefits, private, and public hospital data and have tended to block, rather than clear the way for, data sharing.”
He said that when he was first appointed he asked whether he could provide PBS and MBS data to the states and territories and was given “100 pages of legal advice around privacy explaining why this was impossible”.
“When I then said – I want to do this. How could we make it happen? I received just four pages of advice. They now have the data. You need to ask the right question.”
While the department’s main thinking on data has been focused on privacy, he believes there is a great deal of data that is not really private, data that is in aggregate and de-identified, that should just be openly available to researchers and others and become a foundation for policy discussions.
The Atlas of Healthcare Variation released by Australian Commission on Safety and Quality in Health Care last week was one example in which data could be analysed to reduce waste or outdated or unnecessary treatments such as the overuse of antimicrobials and psychotropic medicines, he said.
“In the immediate future, this atlas will be very helpful to the 31 new Primary Health Networks that have been set up in every part of Australia. These networks are commissioners of service for their defined population. They are a major step forward to creating a single, coordinated health system from the complex array of stovepiped health systems that we now have.”
To do their jobs properly, data needs to be at the centre of the PHNs’ business operations, but this data is not only useful for policy makers, he said.
“[We] are moving to make this data easily available beyond traditional government partners. I have asked that data is accessible through a user friendly website/portal that can be used by innovators, both in technology development, but in systems design that Primary Health Networks could use to commission more efficient and effective health services.
“Better information leads to better understanding of our system and therefore to better health care at every level.
“Instead of focusing on health services data on payments or as a way of catching out doctors, we can now use it for insights into doctor and consumer behaviours to better understand what is affecting health outcomes.
“We have a way to go but we will continue to push the boundaries because it is one of the important issues for us to conquer.”