Title page

Contents

Acknowledgments 4

Overview 5

1. The digital technology promise in healthcare 11

1.1. The promise of digital technology 12

1.2. Adoption of digital technology in the health sector 15

1.3. Governments can help facilitate the digital transformation in health 17

1.4. The contribution and approach of this paper 18

2. Electronic health and medical records 19

2.1. Digital technology is changing the way we use valuable health information 20

2.2. Creating a network of networks 31

3. Telehealth 38

3.1. The telehealth transformation 39

3.2. Is telehealth a high-quality mode of care? 44

3.3. The impact and benefits of telehealth 47

3.4. The policy landscape needs to evolve 49

4. Remote care 56

4.1. Remote care can improve the management of chronic disease, but uptake appears to be slow 57

4.2. Governments can improve quality signalling to facilitate uptake 64

4.3. Targeted funding arrangements could ensure high-value remote care 66

5. Artificial intelligence 73

5.1. AI can improve almost every aspect of healthcare 74

5.2. AI changes the risks in healthcare 81

5.3. The policy landscape needs to evolve 83

Appendix 88

A. Consultation 88

B. Measuring the benefits of digital technology in health 91

B.1. Measuring the costs saved from telehealth use 92

B.2. Measuring the benefits of Electronic Medical Record systems rollout 93

B.3. Measuring the benefits of digital technology, including AI, on workforce tasks 95

References 96

Table 2.1. My Health Record can support a range of content, but coverage varies 26

Table 2.2. Progress in rolling out EMRs varies across states and territories 29

Table 3.1. Telehealth is a large part of the Medicare-funded sector 39

Table 3.2. Patients' experience of telehealth is as good as or better than that of care in general 46

Table 3.3. Selected provider standards and their scope 51

Figure 1.1. The health system is facing challenges such as rising wait times, workforce pressures and sparse services in some areas 13

Figure 1.2. Types of digital technology and their benefits for the health system 15

Figure 1.3. Health and social service providers are investing in digital technology 16

Figure 1.4. This paper is structured around the ways different digital technologies could support the health system 18

Figure 2.1. The large network of providers makes information sharing challenging 23

Figure 2.2. MHR use is mixed between providers, and more providers upload records than view them 28

Figure 3.1. There has been a huge increase in telehealth usage in recent years 40

Figure 3.2. Most people who use telehealth are satisfied and consider it high-quality 46

Figure 3.3. Medicare-funded telehealth consultations have mostly substituted for in-person services 48

Figure 4.1. DTx mostly fall into three categories 59

Figure 4.2. Medicare-funded remote monitoring of implantable cardiac devices has grown steadily 62

Figure 4.3. The proposed mHealth Apps library could improve information flows 66

Figure 5.1. Key productivity benefits from AI in health 75

Figure 5.2. Areas of potential impact for AI on the health workforce 76

Figure 5.3. Types of health information 80

Figure 5.4. Key risks around use of AI in healthcare 82

Figure 5.5. TGA coverage of AI software 84

Boxes

Box 2.1. Case study: Royal Children's Hospital EMR 21

Box 2.2. Beyond tertiary care: State and territory localised platforms 30

Box 2.3. Privacy and health information across jurisdictions 31

Box 3.1. Case study: Healthdirect 41

Box 3.2. Case study: The Royal Prince Alfred 'virtual hospital' 43

Box 3.3. Case study: A telehealth service for diabetes-related foot disease 44

Box 3.4. The clinical effectiveness of telehealth 45

Box 3.5. Restrictions on Medicare subsidies for telehealth 53

Box 4.1. What are digital therapeutics? 57

Box 4.2. Case study: digital cardiac rehabilitation 61

Box 4.3. Case study: South Australia's Virtual Clinic Care program 63

Box 4.4. How is remote care currently reimbursed? 67

Box 4.5. A tale of two systems 68

Box 4.6. Case study: mental health DTx 72

Box 5.1. Case study: AI assisted skin cancer screening 78

Box 5.2. Case study: CareMappr 79

Table A.1. Consultation 88

Table A.2. Roundtable participants on 4 December 2023 (in collaboration with the Digital Health Cooperative Research Centre) 90

Table A.3. Roundtable participants on 18 January 2024 90

Table A.4. Roundtable participants on 29 January 2024 90

Table B.1. Travel and waiting room time costs saved from telehealth use, 2023 93

Table B.2. Cost savings from reducing unnecessary pathology and imaging tests following EMR system implementation 94

Table B.3. Cost savings from reduced length of stay in ED and admitted care following EMR system implementation 95

Figure B.1. There are significant consumer, patient-level and system-wide benefits 91