The digital tsunami has changed many aspects of the way we live and work but has yet to have a defining impact on our health and health care. Occasionally you catch a glimpse of digital health innovation but soon enough you’re back in a specialist’s waiting room perusing a months-old magazine and wondering how long it will be before consumers get a meaningful say in one of the most important and fundamental aspects of their life: their health.
Sure, in Australia, where our health system is valued and trusted, we need to proceed with care, but the potential for real, substantive change that will make health care more effective and affordable is huge and you have to wonder why, when many of the enabling technologies are so successfully deployed elsewhere, that change has been so long in coming.
The long struggle to increase take up of electronic health records – with such obvious benefits in terms of avoiding adverse treatment and co-ordinating care – is a reminder that, while technology can enable change, embracing and championing that change often requires a cultural shift. That is certainly the case in health.
Our health system is a big, sprawling network that has, to date, stubbornly resisted change. Incredibly, in this age of online financial services, Amazon, Uber and Airbnb, many hospitals, GP’s and specialists still use fax machines. In other industries, providers have had no choice but to be disrupted. Why? Because consumers demand it and, when competition is only a click away, providers have had to adapt to stay in business.
Until now, health consumers have been spectacularly ill-informed about all aspects of their health and healthcare, especially compared to, say, the travel industry, or the financial services industry since the government compelled greater transparency.
There are some signs of change. At a government level these are driven by the Australian Digital Health Agency and some state government departments of health. More broadly these are driven by innovative technology companies, leading edge health service providers and consumers themselves. We are seeing sites where patients can ‘rate’ their experience with a clinician; subject to appropriate safeguards these types of innovations are to be welcomed as they enable others to make a more informed choice. We are seeing patients with particular health conditions (and their families) bonding together online, often globally, to share information, sometimes being more up-to-date on treatment options than their attending clinicians. This is particularly true in the areas of cancer and rare diseases but also extends to families that are seeking to support loved ones with mental health issues and autism. We know that consumer demand for this level of personalised and targeted innovation is real and growing; in fact, the biggest potential for digital health lies in its ability to empower health consumers to play a key role in driving the appropriateness, quality and cost of their health care.
This has been a long time coming. Back in 1970, Vern Wilson, a former assistant US Cabinet Secretary, said: "The greatest untapped resource in healthcare is the consumer."
Somewhat more recently and closer to home, Professor Graeme Samuel told a digital health conference in May that consumer empowerment is the "optimal discipline" to bring about efficiency, quality and accountability in health and indeed in all markets. Breaking down old paradigms in favour of a more informed consumer who is able to exercise choice facilitated by new technologies is key to reforming health care so it can harness the high powered incentives associated with competition, Professor Samuel said.
When the wave of disruption finally breaks – and it will – we need to be prepared.
There is a strong case for digital health research and development that will improve individuals’ and communities’ health and wellbeing, and advance the Australian economy by helping to enable a more connected, transparent and competitive health system.
Australia has a proud record in health and medical research. Part of that success has been the model fostered by collaborative research centres – CRCs – which, by bringing knowledge together, have paid huge dividends for Australia in many health-related fields including hearing with Cochlear.
Which brings us to our own Capital Markets CRC which started life developing financial markets surveillance technology. The resultant solution, SMARTS now owned by NASDAQ OMX, is used in 50 countries across the globe. We have successfully translated and extended those techniques to the health sector, leading to the formation in 2009 of Lorica Health. Lorica’s data analytics solutions have driven greater market transparency for payers and are now turning to empowering consumers to drive the competition necessary to achieve optimal productivity, responsiveness and innovation in health care.
Such is the enduring value of the collaborative model represented by the Australian Government’s CRC Program that the 19th selection round is now underway. A collaboration of 15 universities, and 45 government and industry partners across Australia and some overseas countries have promised over $130 million in cash and in kind for a dedicated centre for digital health R&D. Our consortium has sought some matching financial support from the CRC Program and we are pleased to advise our Stage 1 bid has made the shortlist of bidders invited to go through to Stage 2. It’s an exciting time for those who hope to be involved and we are sure it’s the best way to drive the digital health research that results in a better functioning health system.
David Jonas is the CEO-designate for the proposed Digital Health CRC. He was the founding CEO of Lorica Health and founder of the Health Market Quality R&D program of the Capital Markets CRC.