I joined the Australian Digital Health Agency in September 2020, on the cusp of a seismic shift in digital health and with a global pandemic driving new levels of growth, innovation and development.
COVID-19 has united healthcare providers and consumers to embrace, use and build trust in digital health. Over the past year many Australians have tried telehealth for the first time. We’ve also seen a rapid and widespread adoption of electronic prescriptions and a marked increase in the uptake and use of My Health Record.
In its sixth year, the Agency is well positioned to respond to the changing needs of the health system and its users. Over the next 12 months our priority is to lead, elevate and accelerate digital initiatives within the broader Australian health agenda, including those driven by COVID-19.
This annual report sets out the Agency’s delivery of the 2020-21 work plan, as approved by Commonwealth, state and territory governments in mid-2020. The Agency has met or exceeded all performance targets in the Agency’s Portfolio Budget Statement.
Supporting the Australian Government’s COVID-19 response
In a challenging year the Agency worked with the Commonwealth Department of Health to co-design and develop digital support mechanisms for Australia’s COVID-19 response and vaccination program. This included:
A co-design success story, the rollout of the electronic prescribing project was delivered 12 months ahead of schedule, offering Australians a safer, faster and more efficient way to get their prescriptions and complementing the rapid take-up of telehealth services. The sheer scale and significance of the project demanded and won widespread healthcare and software industry support - in the process, setting a new standard in collaboration between governments, industry, consumers and healthcare professionals.
In 2020-21, more than 11 million original and pharmacy repeat prescriptions were issued electronically to Australians, with more than 21,000 prescribers generating electronic prescriptions. At least 98% of all PBS-approved community pharmacies are dispensing electronic prescriptions and it is set to become a routine, trusted part of Australia’s healthcare delivery system.
My Health Record enhancements
Twenty-three million Australians can now access their vaccination status and COVID-19 test results, along with prescriptions, allergy information, pathology and diagnostic test results, in their My Health Record. This includes a consolidated immunisation view for both consumers and healthcare providers, providing immunisation history details and COVID-19 second dose due dates.
Importantly, consumers can now get proof of vaccinations through their record – including those people ineligible for Medicare but with a My Health Record.
These enhancements resulted from significant work in 2020-21 to continue improving and refining My Health Record for Australians so that it is providing the sort of trusted, authoritative health information that Australians need, available when they need it most.
The consolidated immunisation view was made available to healthcare providers via conformant clinical information systems at the end of April 2021, and by June 2021, almost 270,000 healthcare providers had viewed it.
And it’s not just healthcare providers using technology. Consumers have viewed their consolidated immunisation information nearly 350,000 times since My Health Record’s February 2021 enhancement, with numbers more than doubling from May to June 2021 (from 81,000 to 175,000). In the 12 months to June 2021, consumers viewed their pathology reports nearly 4 million times, with more than 750,000 views in the month of June alone.
Clinician Vaccine Integrated Platform
One of the Agency’s other key contributions to Australia’s pandemic response was the development of a platform that enabled vaccine providers who did not have conformant or integrated software to upload COVID-19 vaccination details to the Australian Immunisation Register (AIR) – thereby meeting legislated requirements and helping them move more rapidly to providing vaccinations to Australians.
The Clinician Vaccine Integrated Platform or CVIP is free and available through a web browser or downloaded as an app. By early July 2021, more than 550,000 vaccination encounters had been reported to AIR by more than 1700 providers using CVIP.
National Infrastructure Modernisation (NIM)
In 2020-21, the Agency successfully completed high-level design requirements and procurement activities for a Health API (Application Programming Interface) Gateway – the first major deliverable under our National Infrastructure Program to develop a more contemporary, modular national infrastructure over time. Work is starting in 2021-22 on this modernised digital platform to become the single point of access into the My Health Record system and other digital health products and services in the future.
The NIM program is also progressing design and scoping for subsequent modernisation phases that will include storage and retrieval of health information based on contemporary health interoperability standards.
Agency change agenda
Reconciliation Action Plan
During NAIDOC Week in November 2020 the Agency launched its first Reconciliation Action Plan, marking the formal beginning of our reconciliation journey.
Our vision is to nurture a vibrant, inclusive and connected Australia that respects Aboriginal and Torres Strait Islander heritage and cultures and values justice and equity for all Australians. We are committed to working closely with stakeholders, partners and communities across Australia to make this a reality within our Agency, in the services we provide and as influencers in the digital health ecosystem.
As the lead government agency for digital health, our relationships with Aboriginal and Torres Strait Islander communities are critical to how we operate and the outcomes we achieve. We are proud to partner with Aboriginal community controlled health services to support the adoption and use of digital technologies in Aboriginal communities across Australia. Many of these health services are leading the way in digital uptake and engagement – the Wirraka Maya Health Service in Port Hedland is one such organisation. In 2020 staff at Wirraka Maya viewed more clinical documents from My Health Record than any other primary care provider in Western Australia - with the immediate benefit of identifying underlying health conditions in patients who may need an earlier vaccination against COVID-19.
We also partner with the National Aboriginal Community Controlled Health Organisation to ensure that Aboriginal and Torres Strait Islander peoples are front and centre in the design and delivery of digital health education, engagement and awareness activities across Australia.
Internally, Agency staff undertake annual cultural competency training to continuously refresh and improve our cultural engagement skills while also participating in key observances on the national calendar, including Reconciliation Week and NAIDOC Week.
Supporting our staff in challenging times
In February 2020, the Australian Public Service (APS) Employee Census highlighted that staff across the public service were concerned about mental health during the pandemic. The Agency launched an internal Health and Wellness Working Group to start an open conversation, and after listening to staff and seeking expert input, the group developed a multi-pronged plan to support the mental wellness of staff during the pandemic and beyond. The plan includes a suite of activities to support staff to manage their wellbeing. It had an immediately positive impact, with the next census results revealing a dramatic uplift in staff opinion on what the Agency is doing to support mental wellbeing (as much as 48% improvement for one criterion). We are committed to maintaining and augmenting our approach to supporting the ongoing health and wellbeing of our staff.
Organisational and governance refresh
In March 2021, the Agency began operating under a new organisational structure designed to reflect our strategic direction and priorities. The structure comprises four divisions:
Digital strategy – responsible for national digital health design and strategy, underpinned by strong clinical governance and digital health standards.
Digital programs and engagement – responsible for external relationships, implementation and change and adoption, as well as being the place of excellence for driving program delivery, reporting and outcomes.
Technology services – responsible for the operation of high-quality, trusted, reliable and secure national digital health infrastructure and health support systems and services.
Corporate services – responsible for delivering the Agency’s corporate enabling services so that they are coordinated, effective and focused on supporting business priorities.
We also undertook a comprehensive review of our internal governance framework to ensure that decision makers are empowered and supported by governance committee arrangements that promote diverse thinking, collaboration, accountability and transparency. Taking a principles-based approach aligned to our organisational values, we launched a streamlined, fit-for-purpose internal governance committee structure in April 2021. In addition to the statutory advisory committees that provide assurance to the Board, the Agency has established four internal committees. These committees provide advice and collaborative engagement on program management, finance and investment, workforce strategy, culture and capability and clinical governance under clearly defined terms of reference and membership.
New look corporate website
In November, the Agency launched a new look corporate website developed with input from consumers and healthcare professionals. The design tells a compelling story of Australia’s digital health journey, using contemporary website design to ensure that it is as user-friendly and informative as possible for Australian consumers, healthcare professionals and all those with an interest in digital health.
The year ahead
The Australian Government has set out a vision for Australia as a leading digital economy and society by 2030. Digital technology innovations will enhance government service delivery and change the way Australians and businesses interact with government.
A key plank of this investment is $301.8 million for enhancements to My Health Record – the centrepiece of our Agency’s national digital health modernisation agenda. This will include connecting specialists in private practice, diagnostic imaging and pathology to My Health Record and helping to digitise support across a consumer’s whole healthcare journey – including connecting residential aged care facilities, improving medication management and transforming health information exchange during transitions of care between healthcare settings.
We will also continue to modernise and strengthen our national digital health platforms to maintain a flexible and future-ready system that is safe and secure, trusted by Australians and always available when they need it. This includes a contemporary Health API Gateway, mobile support for healthcare providers and consumers and a national rollout of secure messaging through Provider Connect Australia.
And to help set a course for the future of digital health in Australia, we will also develop the next National Digital Health Strategy in consultation with health professionals, industry, governments – and most importantly - with Australians, to ensure that they are and remain at the centre of their own healthcare journeys and futures.
Thank you to my predecessor Bettina McMahon for her leadership as the Agency’s Interim CEO until September 2020, especially during the challenges presented by the first waves of the COVID-19 pandemic.
Thank you to Agency Board Chair, Elizabeth Deveny and the Board Directors for setting such an exciting and purposeful course of the future of digital health in Australia that I am delighted and energised about bringing to life.
My final thanks go to the remarkable staff of the Australian Digital Health Agency whose hard work, resilience and commitment to our purpose are truly making a difference in the lives of Australians.