Advances in digital technology have transformed almost every facet of our world in a very short period. Whether or not these changes have all been positive is debatable, but tech’s positive influence on healthcare is undeniable.
Australia’s healthcare system is one of the most cost-effective in the world, in terms of health outcomes achieved per dollar spent. Technology plays a huge role in how health services are provided here today, from the basics such as eScripts and telehealth appointments to groundbreaking new treatments using the latest in artificial intelligence (AI).
But as much as we have integrated technology into our healthcare system, the government thinks we could be using it more even more efficiently.
A fascinating research paper from the Australian government’s Productivity Commission (PC) has revealed just how much the network of hospitals, doctors and other healthcare professionals is underpinned by technology, and how can leverage it even further.
The report acknowledged that as good as our healthcare system is, quality has declined in recent years for a number of reasons.
“The lingering effects of COVID-19 and workforce constraints are contributing to longer wait times for care,” the report’s introduction reads.
“In hospital emergency departments, the share of high-priority patients seen on time has fallen. And a growing number of Australians say that wait times for general practitioners (GPs) and specialists are unacceptably long.”
The PC says we need to find ways to ease pressure on the system and contain spending without sacrificing the quality of care. And believes better use of digital technology in several key areas is the answer.
Electronic health and medical records
The report highlighted the already widespread adoption of electronic health and medical records, and the improvements they have brought.
Around nine out of 10 GPs now practise entirely digitally, maintaining no paper records. This has allowed patients to move more easily between doctors and GP clinics.
Use of digital records in hospitals is becoming more common, but the report notes adoption has been slower and more fragmented than in general practice, and is an area that needs improvement.
The investment in, and quality of, digital record keeping varies greatly across Australia’s network of hospitals, specialists, diagnostic imaging and pathology labs and pharmacies.
This is because, for the most part, individual facilities have been left to acquire and set up their own systems, each with their own structure and terminology, with very little integration between them. The report identifies this as an area where we could improve.
The PC notes the My Health Record (MHR) was meant to address this lack of integration, but that so far it has not succeeded.
They blame MHR’s patchy uptake and ‘disconnected’ way of storing patient information, saying it doesn’t allow doctors to capture all of a patient’s health information. The PC says MHR needs to be “better integrated with workflows in busy clinical settings such as GPs and specialist clinics, hospitals and aged care”, and suggests providing incentives for software companies to develop the tools needed to do so.
Telehealth and remote care
Since the pandemic, telehealth appointments for GPs have exploded in popularity and have greatly increased the number of patients who can be seen in a day.
They’re also much more convenient for patients, allowing them to receive care from the comfort of their own homes, avoiding travel costs and time.
A knock-on effect of telehealth’s increased popularity has been the development of digital therapeutics (DTx) and remote patient monitoring (RPM).
Through a combination of online appointments and apps, patients can now complete stroke rehabilitation or undergo cognitive behavioural therapy, while doctors can track patients with diabetes and chronic respiratory and cardiovascular conditions in real time.
The problem here, the PC says, is not with the tech or how it’s being used, but rather that it doesn’t seem to fit neatly into existing health funding models, and as such is not getting the money it needs.
“While there are instances of case-by-case funding, pathways for funding RPM are limited and the rationale behind what can and cannot be reimbursed is not always apparent,” the report says.
“Gaps in funding RPM and DTx mean that practitioners and patients alike may instead opt for subsidised in-person care or forego care, even if that is more costly for the system as a whole in the long run.”
The PC says funding for these technologies needs to be reworked, especially as they can be highly cost effective. The ease with which these technologies can be rolled out means that relying on traditional in-person funding risks “a costly expansion of low value services”.
Artificial Intelligence
The report also looked at the role AI can play in improving the healthcare experience. The sheer amount of health information available to clinicians in a digital format is more than any human brain can process – which makes it perfect for AI.
“AI can help to unlock this data’s potential, by enabling it to be accessed, shared, analysed and interpreted at an unprecedented pace,” the report reads.
“This information can be used by service providers to help make decisions and workflows quicker and reduce the time patients spend waiting for care.
“The automation of low-complexity tasks in particular could free up as much as 30 per cent of clinicians’ precious time to care for patients.”
But the PC acknowledges that while AI can provide substantial benefits, its use comes with significant and genuine risks, which understandably leads to lower public trust. The research showed 60 per cent of Australians surveyed supported the development of AI in general, but that dropped to between 27 and 43 per cent for health uses.
They suggest mitigating risks and building trust by bolstering existing regulatory guard rails. At the moment, AI used in healthcare is only regulated where it provides treatment or replaces the judgement of a doctor.
The problem here is that AI used to guide decision-making – but not actually make the decision – falls largely outside regulatory control, leaving it up to the doctor to assess the quality of the data they are receiving. They may be medical experts, but they are not data scientists or computer programmers.
The PA recommends introducing stricter controls around the use of AI in any healthcare setting, drawn up with the help of both the healthcare and IT industries.
What are some other ways we could use technology in healthcare? Would you trust a diagnosis from an AI doctor? Let us know in the comments section below.
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