Digital health

Digital Health

Digital health is driving major change in health systems and in our community. It is challenging how we plan, organise and participate in healthcare and care for people at the end of life.

The World Health Organization has defined eHealth as the use of information and communication technologies (ICT) for health. It has also created a Classification of digital health interventions v1.0 which is a shared language to describe the uses of digital technology for health. The schema has four overarching groupings reflecting the needs and uses of the targeted primary user group. Namely

• Interventions for clients where they are members of the public using or potentially using health services, including health promotion activities. This group also includes carers.
• Interventions for healthcare providers who deliver health services.
• Interventions for health system or resource managers who are involved in the administration and oversight of public health systems. This includes managerial type functions such as supply chain management, health financing, human resource management.
• Interventions for data services which covers crosscutting functionality to support a wide range of activities including data collection, management, use, and exchange.

This classification schema helps organise all the different types of technology research, business development and commercial applications as they affect health. It helps researchers, industry and the general public understand the range of activity and impacts of digital health.

Australia's Digital Health Future

The Australian Digital Health Strategy and its accompanying documents (Delivery Roadmap and Action & Impact Report) sets a vision and pathway to create a more connected, person-centred digital health system and realise the benefits digital technology offers individuals, the community, governments, industry and providers.

Four key outcomes are identified in the strategy:

• Outcome 1: Digitally enabled
  Health and wellbeing services are connected, safe, secure and sustainable.
• Outcome 2: Person-centred
  Australians are empowered to look after their health and wellbeing, equipped with the right information and tools.
• Outcome 3: Inclusive
  Australians have equitable access to health services when and where they need.
• Outcome 4: Data-driven
  Readily available data informs decision making at the individual, community and national levels, contributing to a sustainable health system.

Change will be enabled through policy and regulatory settings, secure, fit for purpose and connected solutions, a capable and enabled workforce, and informed, digitally literate consumers.

What do consumers want?

An expert roundtable in 2018 looked at consumer priorities in developing digitally enabled models of care to improve accessibility, quality, safety and efficiency in Australia. The Going Digital Report (2.78MB pdf) identified a set of recommendations for several health priorities:

In chronic care:

To trial virtual care teams to support patients with high care needs; and trial a 'Patients Like Me' platform to enable patients with chronic and complex care needs to safely connect and share experiences with one another.

In residential aged care:

Ensure that residents’ health and social services information is available in a single location, on a platform easily accessible by consumers and providers anywhere, anytime and on any device. Collate and publicise data that allows patients, their carers and future consumers to compare residential care facilities based on health outcomes and patient experiences.

In emergency care:

Develop digital health technologies that leverage My Health Record data to be rapidly accessible to paramedics and other emergency providers; develop a text/image message system to support improved communication between emergency care and other medical teams and assist with referrals to other health care providers for post-discharge care.

In end-of-life care:

Develop and promote existing professional and consumer portals that provider information on care options, medical services and pathways for those nearing end of life; and engage in targeted social media campaigns to encourage consumers and medical professionals to normalise conversations about death.

Technology, digital and palliative care:

There is an increasing use of technology in palliative care and in care provision at the end of life. These technologies include a range of commonly used technologies such as videoconferencing, emails, SMS and web resources. These resources have been used in research studies but increasingly are being used as part of usual care. There are also an increasing number of apps that are relevant to palliative care such as the palliAGEDnurse app, CareSearchgp app, or the MyGrief app.

Telehealth changes initiated in response to COVID-19 have led to greater use of technology by patients with life-limiting illnesses in community, aged care and acute settings. Digital technologies are also being used to explore palliative care datasets, develop predictive algorithms and support remote monitoring of community-based patients. There is an urgent need to build digital health capability in the palliative care community.