Long-serving health sector executive, Michael Walsh, was recently elected as the new Chair of the Digital Health CRC.
He says the organisation’s role in driving innovation in the health sector cannot be underestimated…and harnessing the collective efforts of the private sector, the health system and universities will bring significant benefits to patients and clinicians.
We spoke recently with Michael to get his views on the digital health landscape and the way ahead for the Digital Health CRC.
When did you first become interested in digital health?
I have worked in the health system for many years, including most recently as the Director General of Queensland Health. Before that, I was Chief Executive of HealthShare NSW and the inaugural Chief Executive of eHealth NSW.
I have also served on the Board of the Australian Digital Health Agency, the agency responsible for the implementation of My Health Record, to which 90% of people in Australia are now connected.Through these roles, I have seen the significant benefits that the transformation of health services, enabled by digital health, will deliver to patients and clinicians.
As an example, while I was at Queensland Health, we rolled out the first digital hospital in Queensland – the Princess Alexandra Hospital. Queensland now has the largest Integrated Electronic Medical Record (ieMR) in Australia, with around 12 hospitals in the State already connected and a total of 25 hospitals to be connected. This means that a patient who accesses services at one digital hospital in Queensland can subsequently be transferred to any other digital hospital in the State, and their care record will follow them.
This is immensely significant in terms of ensuring continuity of care, supporting safe and quality care, and even freeing up patients to return to facilities closer to home following an episode of care at one of Queensland’s tertiary hospitals. It also helps to free up beds at the tertiary hospitals.
Clearly, digital health is a fantastic innovator that is already helping clinicians and patients achieve better health outcomes. As we move even further to a digital health future, patients are going to be more engaged and have more information about their own healthcare, and clinicians are going to get more feedback about the effectiveness of the interventions they provide.
The transformation to a new era of healthcare always goes through a transition phase. We are going through this at the moment with digital health, but the benefits are already proving to be significant.
Has digital health been embraced by clinicians?
Many clinicians can see the benefits of digital health, in terms of their own clinical practice as well as the health system as a whole.
Clinicians are always looking to improve the way they provide services to patients, and digital health really enables them to do this. As a simple example, you need only look at the opportunities that have come in the move from x-rays, to ultrasounds, to MRI scans, to CT scans, and now to PET scans. Also, the work that clinicians have led in relation to machine learning and artificial intelligence to assist clinical decision-making is well progressed.
Digital health is delivering benefits for those living in rural locations too. Providing them with access to specialists via telehealth means they are not having to travel to the cities for things like cardiac stress testing – the cardiologist can be sitting in Brisbane and the stress test can be occurring in Longreach. This clearly saves rural people a lot of time and money by not having to travel long distances to get that level of specialist input.
Digital health also promises to deliver advancements in other elements of healthcare – for example, in patient record-keeping and record-sharing. The growing use of wearable health devices, and the integration of health data into smart phones, is providing significant opportunities for patients to work in partnership with their health providers to achieve a better quality of life.
When a clinician needs to discuss the care of an individual patient with other medical colleagues, digital health will enable each of these clinicians to access, in real time, the same information on the patient – including the same tests and results, scans and co-morbidities. This is a really powerful tool in ensuring better care outcomes…and it is something that could never have really happened in the past.
Having said that, being in the middle of a transformation phase (as we are at the moment with digital health) can be really hard. For example, currently we have both paper record systems and digital record systems running across the health system. That can be a real challenge for health administrators and clinicians, but it is something we need to push through, in order to fully realise the benefits of a digital health future.
On an individual scale, how will digital health benefit patients?
Whether it is the individual devices that people are using – enabling clinicians to provide feedback to and interact with a patient – or telehealth, record-sharing and other digital health services, the benefits will be enormous.
Given the speed of innovation, it is difficult to predict how fast the future will soon be the present. However, over the next 20 years, mobile devices like our phones will be integral to the way we interact with healthcare services.
In a sense, they are already becoming so – but this will only grow. For example, we’ll see our GP, get an e-prescription, go along to a pharmacy, show our phone to the pharmacist and get our script filled, and the record of the prescription will be saved on the spot.
Additionally, there will be a lot more interoperability between all aspects of our health system, so clinicians will be able to move smoothly between the primary healthcare record, the hospital record, third party community service records, pathology records, and radiology records – to name just a few.
Patients will have access to much more information about their health, so we’ll see a reduction in the asymmetry of information between clinicians and patients – where clinicians have access to a lot more information than patients.
This will enable patients to understand with much greater clarity what they can do to improve their own healthcare experience, and help contribute to their own health outcomes.
Often the interaction between a patient and clinician is very short and intense. The ability for a clinician to convey in this short period of time what a patient can do to improve their healthcare – and for the patient to fully understand and remember everything that went on in the consultation – is difficult. Digital technology can assist greatly in this regard.
Ultimately, it will also mean that a patient can make a more informed choice about what clinician they go to, because they will be able to see how a particular clinician works and what their outcomes are.
Additionally, a lot of interventions occur now that have little or no value to the patient. Digital health will help patients to understand that, sometimes when they go to a clinician, no intervention is the right intervention.
For example, I am a middle-aged man – probably older than middle-aged, actually! – with all the things that go with that, including crackly and sore knees. In the past, a clinician would have given me an arthroscopy to clean up my knees and said that’s a good thing for me, but the evidence now suggests that this doesn’t help my current quality of life nor help my prognosis for the future.
Data analytics has helped clinicians to see this more clearly, and it is also helping them to better explain to the patient that, rather than denying them an intervention, they are in fact providing the right intervention by not undertaking an unnecessary arthroscopy or other procedure.
In the future, we’ll also see better targeted interventions because of rapid developments in personalised medicine, much of which is being powered by digital health.
At the moment, for example, major interventions for blood pressure or high cholesterol are all based on group studies. The rapidly progressing study of genomics is allowing more targeted and personalised interventions. Currently, in most clinical trials, the genotype of each of the individuals in the group studies is not known, so if your characteristics match a particular grouping then that is the type of drug you will be given.
In the future, however, genomics and the application of digital health will help us to know individual genomic makeups, so interventions will be targeted much more to you as an individual. We will know the particular drug that works best with your genomic structure. We are going to see greater personalised interventions because of digital health.
Why did you decide to get involved in the Digital Health CRC?
The relationship between clinician and patient has been the core one that has existed throughout history, and digital health is taking this to another level. Digital health is like the third person in the room, along with the patient and clinician. The Digital Health CRC is at the forefront of this innovation and is well placed to ensure that digital health developments bring useful enhancements to the clinical environment as quickly as possible.
I am committed to ensuring that digital health enhances the relationship between clinician and patient, achieves a stronger collaboration between them, and produces better outcomes.
Getting involved in the Digital Health CRC means I can get closely involved in this immensely exciting era of innovation, working with industry, the private and public health sectors, and academia. This is something that interests me greatly.
What will be the pressing issues for the Digital Health CRC in the coming years?
It will be around how we ensure industry – the people who are out there looking at how to innovate with technology – can work with the innovators in the private and public health sectors and academia to most effect. The challenge and biggest opportunity will be how industry, the private and public health sectors, and universities can work together to accelerate innovations that benefit patients and clinicians – or equally importantly, decide that they can’t make a particular idea work.
In looking at any new innovation, the key will be for them to innovate, focus hard, fail fast, and then succeed as quickly as possible.
How can the Digital Health CRC help the sector to do that better?
Our CRC is all about partnerships. It’s about being out there connecting private sector organisations with the health system and universities, and identifying how they can collaborate.
We are successfully negotiating a large number of projects, but there are never enough – we will continue to place pressure on ourselves to develop more and more projects as fast as we can. Crucially, these projects need to be evidence based and sound in their parameters. We don’t want to go ‘willy nilly’ into something just because someone says it is a good idea – we need to ensure for ourselves that it has merit.
Having said that, we also need to remain mindful of the commercial and marketing imperatives that drive innovation in this space.
What can the sector itself do better?
Everyone’s focused on providing care today, so it is always a challenge for health services to look up from the immediacy of providing care, to consider how we can actually improve the way we provide care and improve the way the system provides care.
That’s always a challenge, and every single provider has that challenge. Part of the Digital Health CRC’s role is to work with organisations and individuals so they can look up from the immediacy of providing day-to-day care, or their academic pursuits or their commercial pursuits, and consider ‘What are the opportunities here and what can be generated?’
Engagement with digital is no longer an option. There is broad agreement that digital health is beneficial – whether that is through telehealth, data collection and analytics, providing decision support to clinicians, providing feedback to clinicians around their practice, or giving information to patients through data and digital platforms. Everyone agrees with this – so the question then becomes how we grow that, and we all agree there needs to be investment to make that happen. That’s where the Digital Health CRC can play an important role.
How is the Digital Health CRC viewed by the Federal Government and others?
You are always building your reputation, but my feeling is that we are well regarded. We are quickly developing a portfolio of projects, and we have one of the largest levels of government investment of all the CRCs (at $55 million) so they see us as important and they continue to maintain their engagement and investment in us. We also have a large number of Participants at around 80, which is high for a CRC. Naturally, everyone wants us to make sure we are moving as fast as we can and delivering as much as we can – so it is very pleasing that we are in a significant phase of project delivery, as we continue to deliver in our second year of operation.
What is your key message to Digital Health CRC Participants?
We are focused on accelerating innovation and new ideas in the digital health space, and leveraging private and public funding for the common good. To all our Participants, I would say ‘We want your ideas, we want you to be open to partnering across academia, industry, the public sector and private sector, we have a large investment of Federal Government funding that we need to manage to leverage that effort and engagement, and we want to do that as quickly as possible and with as much evidence-base as possible.’ What we are doing is incredibly exciting, and we have a wonderfully diverse group of Participants who will be with us on the journey!
In any spare time you have, what are your interests?
I like bushwalking, cycling and running, and I enjoy travelling around Australia as well as overseas. I’m looking forward to doing the Three Capes Walk in Tasmania, in February, with my wife…assuming my knees hold up!
Read a full biography of Michael Walsh by clicking here and then scrolling down to our Board Member listing.
Contact Michael Walsh via email by clicking here.