The year kicked off with topics that would resonate for the rest of the year, including the growth of digital front door solutions, problems implementing large EMRs, the seven-day delay for My Health Record, AI, various digital health blueprints, action plans and strategies, and Telstra Health rationalising its platforms.

Digital consumer experience software provider Five Faces rolled out a digital front door solution for Alfred Health a clinic at Alfred Health, using a low-code framework developed following the Covid pandemic, when Five Faces worked with Sydney Local Health District on its vaccination bookings and visitor management requirements.

There were a few problems with the enormously complex Acacia EMR roll out for NT Health, with the system live at four hospitals – Katherine, Gove, Royal Darwin and Palmerston Regional Hospital – but there were a few hiccups at Royal Darwin’s emergency department. Acacia is the new name for the electronic health record component of the $259 million core clinical systems renewal program and has been built using InterSystems’ TrakCare clinical and patient administration software as a foundation.

In January, Telstra Health sold its secure messaging and eReferrals business to market leader HealthLink, including the venerable Argus secure messaging service that Telstra Health first bought back in 2013 as part of the purchase of the healthcare division of Database Consultants Australia (DCA). Telstra Health said Argus customers would benefit from HealthLink’s investments in its technology platforms, particularly in API and FHIR-based messaging solutions.

In February, Telstra Health announced it was bundling its MedicalDirector marketplace product suite under a new Smart brand, offering as a single gateway of integration for third parties using the FHIR standard for seamless healthcare data exchange. It included two new digital health solutions for MedicalDirector – Smart Clinician and Smart Manager – with Smart Scripts and a Smart Scribe also in the pipeline.

And it also announced it was partnering with Canadian health information exchange platform vendor Smile Digital Health to bring Smile’s Health Data Platform solution to Australia and New Zealand. Smile’s clinical data repository is built on its “HAPI” open-source implementation of the FHIR specification, which Smile says gives healthcare organisations full access to their network’s data without locking in to any one vendor.

We took a look inside the Department of Health and Aged Care’s 10-year Digital Health Blueprint and action plan, which is tied to the $1.1 billion worth of investments in digital and data revealed in the 2023-24 federal budget. The strategy is in addition to state and territory strategies and the Australian Digital Health Agency’s (ADHA) own national digital health strategy. The action plan outlined investments in MyMedicare, the Australian Digital Health Agency, the My Health Record modernisation program, medication management solutions, and interoperability standards.

Debate kicked off at the start of the year on the federal government’s plans to drop the seven-day delay on uploading pathology reports to the My Health Record, with the Royal College of Pathologists of Australasia (RCPA) and the Royal Australian College of General Practitioners (RACGP) both opposed to the plan for results that are not already available in real time, like flu and Covid-19 tests. They were particularly worried about anatomical pathology and cytopathology reports and genetic test results. The AMA is also opposed. The likely decision hinged on the government’s sharing by default legislation, which was introduced to Parliament in late November and is will probably pass in the new year.

AI was the dominant theme for the year and practice management software vendor Best Practice got in on the act early, working with AI start-up Lyrebird Health to integrate its AI transcription tool into the GP desktop. While the technology is browser-based and can be used as a standalone system to generate clinical notes and letters, Best Practice said the partnership was the first to offer a fully integrated generative AI tool to Australian practitioners. It uses voice-to-text technologyspecifically designed for healthcare professionals that uses speech recognition algorithms to convert medical dictation into written text.

In EMR news, St Vincent’s Health confirmed it had chosen MEDITECH’s Expanse platform as a foundation EMR for its 10 private hospitals. It will will deploy Expanse through the new MEDITECH as a Service (MaaS) subscription model. MaaS is built on Google Cloud and enables the company to offer a fully managed and monitored cloud hosted solution wrapped up into a single monthly fee. At the time, the plan was to go live with five hospitals this year and five next year.

In late February, the Australian Digital Health Agency released its new National Digital Health Strategy, which had a strong focus on system interoperability, health information exchange and real-time access to data for consumers and clinicians. It was accompanied by a delivery roadmap of current and future initiatives, with a series of priorities that require coordinated, national effort over the five years to 2028.

Current priority areas include national secure messaging capability, the roll out of Provider Connect Australia, connecting software vendors and residential aged care facilities to My Health Record, advancing the use of electronic referrals, transfers of care and discharge summaries as business as usual, the development of a national Health Information Exchange architecture and roadmap, improving and expanding virtual care, and uplifting national and jurisdictional digital health infrastructure to flexibly accommodate AI and machine learning.

And in another big year for healthcare technology firm Magentus, owner of the Genie and Gentu PMSs and a range of solutions for pathology, oncology, and radiology, announced it had chosen Google Cloud to help it develop AI solutions, including generative AI and large-language models (LLMs) such as Gemini and MedLM for its medical specialist users. Magentus says is building a centralised and secure foundation for customer data on Google Cloud under the agreement, and will then help medical professionals use Google Cloud’s capabilities, including gen AI and the MedLM family of foundation models for the healthcare industry.

The team from the Sparked FHIR accelerator released a draft of the first release of the Australian Core Data for Interoperability (AUCDI), which comprises a standardised set of data groups and elements for interoperable health information exchange. AUCDI is being developed along with an AU Core FHIR implementation guide as part of the Sparked AU Core project to advance health data interoperability in Australia by accelerating the creation and use of national FHIR standards in health care information exchange.

Still on FHIR, and a big report on the state of healthcare analytics and interoperability, conducted by advisory firm Ecosystm and sponsored by InterSystems and released in March, found that most ANZ healthcare executives said they were planning to play with FHIR. However, a significant amount were holding their horses until they understood the benefits more. On specific questions about FHIR and interoperability, the data showed that 13 per cent of organisations are either using FHIR or they have some sort of FHIR template capability in their organisation today.

And at the end of March, the local FHIR brigade set up an independent watchdog committee to oversee FHIR standards development in Australia and ensure transparency and integrity in the process, chaired by FHIR founder Grahame Grieve and consisting of a host of FHIR experts.

Primary care

The new MyMedicare voluntary enrolment program would keep the Primary Care Networks (PHNs) on their toes all year, encouraging practices and patients to take part. By year’s end, the system would register 2.1 million patients, 6329 practices, and 47,000 providers, a great result considering how convoluted the registration process was at the start.

Software providers came to the rescue, with primary care health analytics software provider PenCS rolling out a new MyMedicare eligibility filter to its Clinical Audit Tool (CAT) and PMS vendor Best Practice and practice intelligence platform Cubiko partnering to help generate lists of eligible patients, and to streamline bulk uploads of registered patient lists from HPOS. MedicalDirector also introduced MyMedicare capability, along with the concept of floating progress notes in a big upgrade to the system, as did Zedmed.

Some of the leading PHNs began to roll out “gamechanger” grants to fund projects, pilots and programs that use digital health technologies to provide improved models of care in the primary care sector, including the Hunter New England and Central Coast PHN.

Acute care

In late January, St Vincent’s Health Australia confirmed that no medical records or sensitive personal information was stolen during a cyber security incident it experienced in December 2023. The hospital, health and aged care provider detected an attack on its network on December 19 and engaged security expert CyberCX to assist it. A spokesperson said last year that it also notified all relevant state and federal governments and their necessary agencies.

South Australia’s statewide patient reported measures (PRM) program went live at its first site at the South Australian Medical Imaging (SAMI) nuclear medicine theranostics service at The Queen Elizabeth Hospital in Adelaide. The program is using NZ company The Clinician’s ZEDOC digital solution for the collection and reporting of patient reported outcome measures (PROMs) and patient reported experience measures (PREMs). The Clinician won a $2.6 million contract to roll out ZEDOC for the PRM program in 2023. Later in the year, The Clinician would win a five-year, $10 million contract with Queensland Health to provide its technology for QH’s patient reported measures and patient safety culture staff survey system.

The Victorian Virtual Emergency Department (VVED) operated statewide by Northern Health planned to expand its capacity to more than 1000 people a day following a $235 million funding injection by the state government. The VVED first launched in November 2020 offering a nurse-led triage service and specialist advice for GPs. It then expanded to provide care for people people living in residential aged care facilities in association with Ambulance Victoria, and for people at home on the COVID positive pathways program. VVED received ongoing funding of $201.5 million over four years in last year’s state budget and is now available statewide for urgent care.

Australian research exploring the clinician and patient experience of digital hospitals found a positive overall satisfaction level reported by clinicians, but a dearth of studies concerning patient experience means satisfaction levels are difficult to gauge. Researchers from the University of Queensland’s new Queensland Digital Health Centre (QDHeC) and Centre for Health Services Research conducted the study, which found that overall, clinicians mainly had a positive satisfaction with digital hospitals and most studies reported a positive sentiment towards usability, although the effects of digital hospitals on patient safety and clinicians’ ability to deliver patient care where mixed.

Aged care

DoHAC identified five separate short-term programs for aged care in the action plan accompanying its new Digital Health Blueprint. These include investments in assistive technology and ICT enablement to support the Support at Home program, which will replace home care packages in July 2025 and the Commonwealth home support program (CHSP) after July 2027. DoHAC said it will also publish information on the new requirement that each residential aged care facility has at lease one registered nurse on site 24/7, with data published along with the new star ratings on the My Aged Care ‘Find a Provider’ staffing pages.

Aged, community and disability care software specialist AlayaCare said it was working with residential aged and home care providers in Australia to introduce the AI and large language model (LLMs) technology its AlayaLabs research and development arm has developed, including solutions for optimising the home care workforce and to improve client outcomes. AlayaCare’s platform uses LLMs and predictive algorithms to help combat high attrition rates in the aged and home care workforce, including an employee retention and churn predictor called the Employee Retention Dashboard which uses multiple data points to inform employers of workers with low work satisfaction.

The big highlight for the aged care technology sector is always the ITAC conference, which was held in March. We discovered how to build a best practice healthy ageing ecosystem, how increases in the digital maturity of aged care organisations has a measurable effect on the quality of care they provide, what all of the digital health strategies mean for aged care, how BaptistCare is using ChatGPT, and how virtual care provider iAgeHealth scored some early runs with its new model of remote care.

Virtual care

NSW Health’s virtualKIDS urgent care service, first developed by the Sydney Children’s Hospitals Network (SCHN), rolled out statewide for children up to 16 with non-life-threatening health concerns. It had been available just to families in the three local health districts with specialist paediatric hospitals but is now available to all families with a referral from HealthDirect. virtualKIDS uses HealthDirect to connect families with a triage nurse to determine the best care pathway and care provider. Later in the year, it would be joined by virtualADULTS as part of NSW Health’s ambitious program to build a single digital front door for all of its virtual care services, operated by HealthDirect.

Digital healthcare platform CareMonitor was deployed to support a new home heart health program to remotely support patients living with heart failure.The Virtual Heart Failure Service is a collaboration between CareMonitor and Ramsay Connect, a joint venture between outpatient care provider Ramsay Health Plus and rehab at home provider Remedy Healthcare. The aim of the program, which is supported by health insurer Bupa, is to reduce readmission rates to hospital by 50 per cent.

Some of the more interesting software, apps and new players in the market that caught our eye this year included:

Telstra Health added new features to its Kyra Flow patient capacity and demand solution for hospitals, including integrating the Medtasker mobile communications and task management platform.

Care communication platform Hayylo rolled out its technology to BaptistCare home care services using its integration with AlayaCare’s home care software, with BaptistCare’s residential facilities also on the cards.

Melbourne-based Microsoft 365 specialist practice FiveP spun out its Baret role-based messaging solution as a standalone business. Baret has been extensively rolled out at Austin Health to replace pagers and reduce urgent clinical reviews and non-urgent phone calls. It is now set to be used for role-based task management, role-based chat groups, and integration with Austin Health’s Oracle Cerner EMR.

PenCS launched its new cloud-based digital health intelligence platform Practice Cloud, designed to enable general practices and Aboriginal member services to interrogate practice clinical and financial data. Practice Cloud includes built-in dashboards and quality improvement programs that support annual CPD hours, along with Pen’s risk of hospitalisation tool.

The major metropolitan Melbourne hospitals are taking part in a five-year study using a smartphone app to pinpoint the allergens and triggers that cause thunderstorm asthma, with the hope of tailoring prevention and treatment options to individuals.

Best Practice Software launched its Best Health Booking online booking management solution, designed to give Bp Premier users real-time visibility in the Bp Premier appointment book for practice teams and in Best Health Booking for patients.

Medical specialist practice management system vendor Shexie partnered with workflow AI company Facere AI to bring tailored AI features and products to Shexie’s product suite, including its flagship Platinum PMS.

We’ll have part two of the 2024 Australian Digital Health Year in Review tomorrow.