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Overview of the Agency

Role

The Agency is the accountable organisation for progressing digital health in Australia through the leadership, coordination and delivery of a collaborative and innovative approach.

The Agency’s functions, as defined in Section 9 of the Agency Rule, are:

  1. to coordinate, and provide input into, the ongoing development of the National Digital Health Strategy;
  2. to implement those aspects of the National Digital Health Strategy that are directed by the Ministerial Council;
  3. to develop, implement, manage, operate and continuously innovate and improve specifications, standards, systems and services in relation to digital health, consistently with the national digital health work program;
  4. to develop, implement and operate comprehensive and effective clinical governance, using a whole of system approach, to ensure clinical safety in the delivery of the national digital health work program;
  5. to develop, monitor and manage specifications and standards to maximise effective interoperability of public and private sector digital health systems;
  6. to develop and implement compliance approaches in relation to the adoption of agreed specifications and standards relating to digital health;
  7. to liaise and cooperate with overseas and international bodies on matters relating to digital health;
  8. such other functions as are conferred on the Agency by the Agency Rule or by any other law of the Commonwealth; and
  9. to do anything incidental to or conducive to the performance of any of the above functions.

The Agency’s responsibility includes the role of the My Health Record System Operator (the System Operator), which transitioned from the Department of Health to the Agency on 1 July 2016.

The System Operator works with a range of agencies and organisations to deliver the My Health Record system. Many of the System Operator’s functions are delivered by Accenture, contracted by the System Operator as the My Health Record system’s National Infrastructure Operator, and the Chief Executive Medicare, Services Australia.

Principles

The following guiding principles support the ongoing operation of the Agency and underpin the National Digital Health Strategy.

  • Putting users at the centre – User needs and their context of use are placed at the centre of decision making, supporting improved prioritisation and user experience.
  • Ensuring privacy and security – Australians expect strong safeguards to ensure their health information is safe and secure, respected, and their rights protected. They expect that their health data is only used when necessary and with their consent. The strategic priorities described in the National Digital Health Strategy take into consideration security, privacy and the protection of sensitive personal information, balanced with safe information sharing and maintaining consumer and clinician trust.
  • Fostering agile collaboration – Appropriate co-design and co-production methodologies are important for ensuring that digital health solutions developed for use in Australia meet the evolving needs of users and stakeholders.
  • Driving a culture of safety and quality – The safety and quality of digital health solutions and services are of critical importance. The National Digital Health Strategy will embed a systems approach to safety, quality and risk management throughout the design, development, implementation and use of digital health solutions and services.
  • Improving equity of access – Digital health solutions and services have the potential to empower consumers and to address longstanding barriers to equity of access in healthcare. All Australians deserve to benefit from the opportunities presented by digital health, and the strategic priorities are aimed at improving health system accessibility across the socio-economic spectrum.
  • Leveraging existing assets and capabilities – Australia is making significant advances in the delivery of digitally enabled health and care across Australia, through the development and operation of national digital health foundations.
  • Judicious use of taxpayer money – Development of strategic activities is based on sound investment of funds to eliminate waste, deliver value for taxpayers, and to ensure that investments are assessed on the basis of delivering the best health and care outcomes for all Australians. Whether it be through increasing our proportion of public transport versus use of taxis for official purposes, a policy of economy fares for all domestic travel and high compliance with best fare of the day flights – we are building a culture to “think like a patient, act like a taxpayer”.

Values

The values and culture of the Agency, reflected in conduct, interactions, and how decisions are made, are an integral part of living out the Agency’s purpose and strategy.

As a new Commonwealth public sector organisation, the Agency embraces the Australian Public Service (APS) ICARE values found in section 10 of the Public Service Act 1999: Impartial, Committed to service, Accountable, Respectful and Ethical.

To strengthen our values-based culture, the Agency has its own set of complementary values that it works to embed in both policies and practice. These are:

  • Working together: We get our best results working collaboratively – this is how we excel.
  • Respect and trust: We care about each other and we treat everyone in a way that we would want to be treated. We know with conviction that we can rely on each other because it is only together that we can achieve greatness.
  • Transparent: We share our knowledge and our skills because, when we work in an open and frank way, we demonstrate that we trust and respect each other.
  • Accountable: We are all accountable for living our values and taking responsibility for our actions. When we think this way, we will always be focusing on doing things that are right and good.
  • Innovative: We seek to understand new and different ways to improve delivery and performance for digital health.

Structure

The Agency is structured to support its purpose, strategy, principles and values by providing clear lines of reporting and responsibility, aligning resources to core priorities, and supporting stakeholder engagement activities.

Management team
The Acting CEO of the Agency, Bettina McMahon is responsible for the overall management of the Agency. She is assisted by an Executive Leadership Team (ELT) as depicted in the following figure.

 Steven Issa Chief Digital Officer Prof Meredith Makeham Chief Medical Adviser Bettina McMahon Chief Operating Officer until 16 February 2020 Rupert Lee Acting Chief Operating Officer from 17 February 2020 Steven Momcilovic Chief Financial Officer Ronan O’Connor National Health Chief Information Officer

The ELT lead the following divisions:

Architecture, Design and Strategy Division

Core functions

  • Digital strategy and planning
  • Architecture and user experience
  • Policy and privacy
  • Benefits and research
  • Data catalogue and governance
  • Terminology and tooling

Clinical Advisory, Safety and Quality Division

Core functions

  • Clinical governance
  • Research advisory
  • Clinician and consumer safety and quality
  • International relations and horizon scanning

Office of the Chief Operating Officer

Core functions

  • Programs and work plan development
  • Promoting use in clinical practice
  • Communications and Community Engagement
  • Developer program

Finance Division

Core functions

  • Statutory Chief Financial Officer duties
  • Financial transaction and reporting services
  • Budget and planning including workplan

Infrastructure Operations Division

Core functions

  • Strategic Service Design and Delivery
  • Technology Delivery and Projects
  • Operations
  • Information Technology and Cyber Security
  • People and Capability

These divisions are supported by the Office of the CEO, which encompasses corporate and legal services.

Products and services

Upon its establishment, the Agency inherited a range of products and services from those entities who previously performed some of the Agency’s functions, which have been added to and enhanced through a range of new initiatives.

These products and services are referred to collectively as the national infrastructure and constitute Australia’s digital health foundations. Operating and maintaining this infrastructure is a core activity for the Agency.

In 2019–20, the national infrastructure consisted of the following initiatives.

My Health Record

My Health Record is a secure digital summary of an individual’s health information, stored in one place. It’s available when and where it’s needed and can be accessed by individuals and their healthcare providers, offering seamless sharing of information.

The secure sharing of digital health information has many benefits, including reducing hospital admissions and the duplication of pathology tests. It can also improve overall medicine safety and even save lives.

 Improvements in patient outcomes

Healthcare Identifiers Service

The Healthcare Identifiers Service (HI Service) is a national service for uniquely identifying healthcare providers and individuals, ensuring that the right health information is associated with the right individual as patients move through the health system. A healthcare identifier is a unique 16-digit number that identifies an individual, healthcare provider or healthcare organisation.

Secure messaging

Reliable, secure provider-to-provider communication is a key component of digitally enabled integrated and coordinated care across the Australian health sector. Secure messaging is a foundational capability enabling interoperability and safe, seamless and secure information sharing between healthcare providers.

While there are significant pockets of secure messaging already in use, there has historically been an inconsistent approach to secure messaging and information exchange across Australian healthcare. This has exacerbated information sharing challenges across the sector.

The Agency’s Secure Messaging program is working collaboratively with industry, suppliers of secure messaging solutions and clinical software vendors to reduce existing barriers to adoption and provide pragmatic and implementable solutions.

National Authentication Service for Health

The NASH is a service to support healthcare providers and organisations in securely accessing and sharing health information. The NASH builds on the HI Service to provide healthcare providers and organisations with authentication credentials that assert their healthcare identifier, which means that the parties they transact with will be able to have trust in their identity.

Australian Medicines Terminology and SNOMED CT-AU

The Agency manages and contributes to the ongoing refinement of clinical terminologies via the NCTS, Australia’s National Release Centre for SNOMED CT®.

The NCTS publishes monthly updates of SNOMED CT-AU (the Australian extension of SNOMED CT), which incorporates the AMT. These updates ensure that medicines content remains current with the Therapeutic Goods Administration and the Pharmaceutical Benefits Schedule, as well as continually enhancing clinical content such as diagnoses, allergies, adverse reactions, procedures and results, supporting a shared meaning among the creators and users of health data.

The NCTS now also hosts FHIR code systems and FHIR value sets on the National Terminology Server to support the Agency clinical information specifications and FHIR profiles developed in the community.

Clinical document specifications

The Clinical Informatics Specifications program produces specifications with consistent underlying data models, enabling common and consistent structures for information exchange and supporting appropriate use of clinical terminologies.

Clinical terminologies for clinical concepts and medicines are a key part of national infrastructure, supporting the sharing of high-quality data with a commonly understood meaning that can be used with confidence, driving greater safety, quality and efficiency. The Clinical Terminology program supports the ability to use a standard mechanism for describing data shared between healthcare providers.

Outlook for 2020–21 and beyond

We will continue to deliver on our work program priorities over the next two years, with a particular focus on:

  • designing and calling for tenders for the next generation of Australia’s national health infrastructure managed or operated by the Agency;
  • advancing the interoperability of clinical systems across multiple fronts;
  • supporting the widespread implementation of electronic prescribing across general practices and community pharmacies;
  • establishing multiple Communities of Excellence that showcase practical implementations of community-wide integrated digital health solutions;
  • developing and implementing the National Digital Health Workforce and Education Roadmap;
  • enhanced support for registration and meaningful use of My Health Record in the specialist sector and residential aged care facilities; and
  • expanding use of the Service Registration Assistant to streamline practice administration and help ensure that more complete patient health information is available at the point of care.

 mHealth; National Infrastructure Modernisation; NASH Improvements