Australian digital health continues to reinvent the wheel

We know we keep banging on about it but another week in Australian pandemic news has again brought home how weak and disjointed our collective IT response has been, despite the considerable arsenal of top-notch systems that have already been developed for our health authorities and governments to use.

And yet we continue to try to reinvent the wheel. Nowhere was this more apparent than the announcement of a new Australian Digital Health Agency-led (ADHA) project for an assessment framework for mobile health apps. ADHA held a webinar on the topic this week that in our opinion was so badly staged we are not even deigning to report on it.

In summary, regulators are proposing to set up a new assessment framework that will take several years to put into action, has no discernible legislative weight and for which app developers will still have to pay. Meanwhile, there is an existing guide to assessing digital health apps in Australia that is up and running at the moment, is freely available and is peer reviewed, and has already been paid for.

It is called the Digital Health Guide, developed by the private sector and funded by the public. And yet both ADHA and the Medical Software Industry Association (MSIA) are insisting on going through the whole process again, meanwhile charging app developers for the privilege of being assessed. It doesn’t make sense, but it also calls to mind the absolutely torturous process through the Therapeutic Goods Administration (TGA) of the Software-as-a-Medical-Device (SaaMD) regulation, which require a PhD to understand.

And despite calls from Australia’s leading health informatics groups, this week made it clear that each state and territory in Australia is on its own when it comes to app development and standards for vaccination passports, with political considerations and “customer service” taking precedence over security and authenticity.

NSW has already announced it is moving down this track with its trials adding a direct Australian Immunisation Register (AIR) link to its Service NSW app to display vaccination status. And just yesterday, Services Australia’s deputy CEO of transformation projects Charles McHardie told a Senate COVID response hearing in Canberra that it was working with the states and territories on adding functionality to each jurisdictional app, including the check-in apps pioneered by ACT Health and also in use by Queensland, Tasmania and the NT. (There’s a good round-up of where the states are at here.)

Asked by Senator Kimberley Kitching if this meant travellers would have to download eight different apps to travel around Australia, Mr McHardie said the four jurisdictions using the Check-In CBR app were interoperable (the ACT, NT, Tasmania and Queensland), but the others would need to download individual apps. While this would be in near real-time, it still isn’t optimal when a single, national solution is possible.

Services Australia argues that the need for different state solutions comes down to the fact that public health orders are state-based, but it does makes us look a little ridiculous, a wealthy country of just 25 million that can’t organise itself on a national scale.

There is a solution that could be very quickly instituted, based on internationally agreed standards, which will be discussed in an HL7 webinar next week. The Australasian Institute of Digital Health has thrown its support behind it, but unfortunately we doubt if anyone in our state or federal health departments are listening. COVID-19 seems to have broken Australia’s federation, and each state and territory is going it alone now.

It’s a sad state of affairs. Our poll from last week asked whether you thought we needed a national solution for domestic vaccine passports. You voted in the affirmative by 87 per cent to 13 per cent. It is obvious, however, that several of our commenters were adamantly in the negative.

This week, we ask:

Should medical apps be regulated?

Vote here and leave your comments below.

Comments  

0 # Kate McDonald 2021-10-08 11:51
Should medical apps be regulated? Yes, most of our readers said, with 82 per cent voting in favour. Our optional questions were how, and by whom?

Any health technology that has potential to do harm or stop people wasting money on infective health apps should be regulated by government.

Regulated by adherence to standards and not like TGA

MTAA

Use the existing mechanisms such as App Stores and Ratings to weed out poor quality and bad security.

National standards

In the UK it's the MHRA

Regulation medical software already exists. Too much Regulations will strangle innovation

No because the government is incapable of regulating them in a timely and acceptable manner. The Federal government has demonstrated its incompetence when it comes to the development of any IT harder than a simple spreadsheet and even then, if it is a budget or project plan, they still get it cringingly wrong. The trouble is, their incompetence prevents them from seeing their own incompetence.

One National government body

It depends on what the App does. If it is providing medical interventions (eg dosage calculation) then it needs relevant medical oversight. If merely lifestyle advice or monitoring then not needed.

TGA

TGA

TGA approves all medications and medical devices - an app is just another medical device.

Commonwealth

By a federal body instead of a state based one

Not adha

Will Pulse IT check its facts next time? The "free, publicly funded" Digital Health Guide option costs $110 per year and was developed with funding from Tasmania PHN which is a non-government, not-for-profit organisation.

See:
https://digitalhealthguide.com.au/Subscription
https://www.primaryhealthtas.com.au/who-we-are/about-us/

Apps survive on the userness. Bad designed apps disappear quickly. If there is choice you choose the most featured and simplest to use.

Independent regulator NOT govt!

Ministry of health

A number of country government health depts in the NHS in the UK, Estonia, Holland and I believe Germany are using a Single App Library through ORCHA - https://orchahealth.com/

A national council with digital health and safety as a mandate

The hospitals or organisations in control of them or allowing use within facilities

there are many applications that do not respect patient confidentiality and are poorly written.
- medical applications should be more than "profiteering" by developers .
why wouldn't there be guidelines and regulations .

Government for safety, security and privacy

At the Federal Level to be consistent across all states, which governing body is a good questions, I expect the a branch of the TGA should be setup.

Data needs to be safe and secure, TGA is best placed as ADHA doesn't have the right skilss set

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