The top story this week in health IT news in Australia was the New South Wales budget handed down on Tuesday, which held no surprises, spreading largesse to many virtual health services and in particular to NSW Health’s single digital front door program.

Health Minister Ryan Park revealed a couple of weeks ago that a good chunk of funding was going to go towards the digital front door plans, which have been put together by clinical director of system sustainability and performance and now acting eHealth CEO Amith Shetty and a big team with much expertise during his time with the Ministry of Health.

The budget fleshed out funding for a few of the newer projects under this banner, including a virtual GP and specialist to GP services, and a new virtualADULTS program to run alongside the virtualKIDS service that has been up and running for a year or so.

One of the points of difference for NSW’s proposals and others around the country is that its single digital front door will be managed through just that: a single access point through Healthdirect. Healthdirect will triage every contact and refer callers on to the most appropriate care, whether that is in an emergency department, a virtual GP, an in-person GP at an urgent care service, or elsewhere.

We’ll have a story on that next week going into more of the details, but in the meantime the budget has allocated substantial funding over four years to get the program up and running and to support it.

The digital front door concept is becoming increasingly popular with large healthcare services, including SA Health, which has invested heavily in virtual care services and has in many ways led the country, particularly in paediatric and child health.

Just yesterday, the SA government announced that it was running a new ad campaign for its winter demand management strategy asking people to think twice before turning up at the ED or calling an ambulance if they’re not sure that their condition is really an emergency.

South Australia has some of the worst ambulance ramping problems in the country and is going all out to reduce ED demand, including turning to the digital – or consumer – and front door, as it is being called, and using Healthdirect for emergency triage. SA Health also has a number of other coexisting virtual services that don’t yet come under this a “single” digital front door concept and there are differences with what NSW is planning to do.

The idea of a state or province-wide digital front door was pretty much pioneered in the English-speaking world in Canada, where Ontario has had its digital front door system up and running for some time, covering 15 million people. A lot of what is now called Health811 has been powered by the technology and knowhow of New Zealand’s Orion Health.

We haven’t yet seen too many published statistics showing whether the demand on emergency departments has lessened to any great degree, but digital front doors are just one of a number of programs that it is hoped will to reduce demand on hospitals.

Going by South Australia’s ad campaign at least, its government is convinced that a lot of non-emergency presentations can be reduced through virtual services and the more controversial urgent care centres – which the RACGP is now convinced is trying to steal GPs and ruin general practice – and it’s telling its population to get a grip.

The new ad campaign shows in reasonably graphic detail some of the non-emergency conditions it thinks can be diverted, including cuts and vomiting, and a rather charming image pictured above of a person sitting on the dunny.

There is not just huge interest in and expansion of virtual care services, but the technology that’s now being looked at to help provide digital front doors for individual health services is also changing. Where specialist health IT vendors like Orion Health have led the way, that too is changing a bit. Coming to the fore now are software companies, some of them rather large, which had their start in customer relationship management systems and are now expanding into AI and automated workflows in the healthcare sector.

We’re talking of course of the likes of Salesforce and Microsoft, and even ServiceNow, who are very active in expanding the ethos of CRM into other healthcare applications. We’ll have more on that next week.

The NSW budget contrasted strongly with New Zealand budget from two weeks ago, the first for the newly elected National government and one that pleased few. NZ has pretty much cut about $NZ330 million from the health data and digital area, including money previously allocated for major programs such as Hira.

Much maligned in some quarters and still a little hazy in its aims, the first tranche of Hira, which concentrated on entrenching foundations for what would be nationwide access to health information, is complete, but the money put aside in the 2021 and 2022 budgets for further work has now vanished.

Any more projects under the Hira program will have to be go through New Zealand’s business case approval system, so it’s not likely to be kicking any goals too soon. Nor is health IT in general looking too great for New Zealand, what with Health New Zealand’s briefing to incoming Health Minister Shane Reti, covered here by Pulse+IT’s new NZ reporter Reesh Lyon, showing that Dr Reti has been informed of what is quite a dire state for affairs for its legacy IT estate.

This is of course no secret, as chief digital health officer Leigh Donoghue admitted earlier this year. But with no new money in the offing – apart from some funds for this very interesting project – and huge cuts taking place, it doesn’t look likely that the situation will improve in the near future.

In brighter news, we turn to our poll question for this week and ask a question that we asked exactly a year ago:

Does your organisation have a digital front door strategy?

Back then, 75 per cent of respondents said yes, so we’re interested to see whether that has changed. We’re also interested to hear if your organisation has since introduced a digital front door. If so, is it working as hoped, or is it a waste of time?

Vote here and leave your comments below.