Are we heading in the right direction on integrated, person-centred healthcare? A debate across government leaders and HCPs

MedTech News: The need for integrated, team-based models of care has been promoted for decades, yet the Australian healthcare system is still facing challenges in operationalising such models.

A panel of leaders across government, primary and secondary care came together at the Australian Healthcare Week to debate whether the nation is heading in the right direction on Enabling Integrated, Person-Centred Healthcare in Australia.

Daniel McCabe, First Assistant Secretary, Benefits Integrity and Digital Health, Australian Government Department of Health & Aged Care, was on the affirmative side of the debate with several points that undoubtedly assisted the opposing panellists in their argument.

Mr McCabe said “We learned a lot through the pandemic. We have consumers and healthcare providers demanding more power and use of digital which has demonstrated a lot of benefits. But despite all this, Australia’s health system is still struggling mainly due to different information systems across all care settings. So they are still very siloed.

In February, Mark Butler MP, Minister for Health and Aged Care, announced the Strengthening Medicare Taskforce report. Mr McCabe said that digital health is a critical enabler for “what we’re trying to do in improving primary care and linking it into acute care. This includes requiring all healthcare providers to share by default, including potentially mandating My Health Record uploads across all sectors and starting with diagnostic investigations so all recent tests are available for their caregivers.

“We must agree on nationally consistent standards that underpins the healthcare system. This is going to be fundamental if we’re going to really achieve interoperability across our environment.”

Mark Simpson, Chief Clinical Information Officer, eHealth NSW said that this is a pivotal moment where we have the opportunity to harmonise digital health, especially from the state’s perspective.

“We need to engage and support the expectations of the citizen and not only when they’re a patient, but actually in their environment of wellbeing. In the last few years, there’s been a significant shift in the expectation for delivery of connected health from wellbeing through to primary and into secondary care,” he said.

“A challenge for the coming years is to actually have an overarching strategy not only for state health, but also with our colleagues from Commonwealth and dare I say with our interstate colleagues. A large number of citizens move frequently between state boundaries and the idea that their digital health cannot seamlessly follow them should not be impeded by technology or policy,” Dr Simpson added.

Michael Brydon, Board Director, AHHA and former Chief Executive Officer of The Sydney Children’s Health Network shared his perspectives on why the nation is not heading in the right direction on enabling integrated, person-centred healthcare.

“10 years ago, there were 175 definitions of ‘integrated care’ used in the literature. So, we start off with a problem because we’re not sure what we’re really talking about. Also, we all agree that the technology is available to [enable integrated, person-centred healthcare]. What holds it back from being shared is the legal situation and the privacy situation for good reasons. But in reality, it’s impeding the benefits of these systems operating effectively,” argued Mr Brydon.

Mr McCabe stated that the government is considering regulatory and legislative levers to enable the sharing and use of standards across the healthcare systems.

He said “We know that we need to do this. We can’t just keep incentivising and hoping that everyone will come together on this.”

Dr Amandeep Hansra, Expert Committee Member of Practice Technology & Management (eHealth), Royal Australian College of General Practitioners (RACGP) said while the pandemic has helped, Australia is still a long way off from having an integrated, person-centred healthcare model and infrastructure funding.

She read out the NSW Health definition for integrated care and said “As a GP, I don’t feel like we’ve achieved any of that so far.

“We have to be open to disruption in healthcare. How do we work more collaboratively with startups that are coming into the industry to really change the way we deliver healthcare? How are we open to new models of care when we’re still operating in silos and on different sides of that fence?”

Dr Hansra added “We’re such a small country yet have a large number of pilots and projects in healthcare. Yes, innovation has to start somewhere, but it’s how we change that initial planning stage to say what I’m building here is going to be applicable and have an impact for everyone in this country.”

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