CHF has undertaken numerous activities during the pandemic to gauge consumer sentiment on federal government initiatives.  Among these have been Australia’s Health Panel surveys on telehealth and the COVIDSafe app, and CHF’s establishment of a Consumer Commission to inquire into the lessons of COVID-19 and to make recommendations about how we can re-imagine healthcare.  The feedback has been clear and strongly positive.  Consumers have embraced telehealth and the e-prescriptions (where available) and are looking forward to other digital solutions that make their lives simpler.

The Commission identified other areas of digital health that should also be retained post-COVID.  These include cultural change --- for example embracing technology rather than resisting it --- scaled up data and information sharing, and expanded use of social media engagement.

CHF has advocated keenly on the telehealth issue as part of our recent budget submission and directly to the Minister.  Our aim is for telehealth not only to become a permanent feature of the healthcare system, but also to remain broadly available with minimal restrictions to access as a supplement to in-person consultations.

However, not all initiatives have completely won over consumers (and providers).  The Commission reported varied attitudes to and uptake of My Health Record – despite it being the flagship digital effort pre-COVID.  Concerns about privacy and ease of use have left considerable scar tissue - a reminder of just how important it is to engage all stakeholders, including consumers, in the design and implementation of future tech solutions.  All is not lost with My Health Record, but significant work remains to shore up its utility.   

Digital as a ‘game changer’

CHF sees digital health as a catalyst for a paradigm shift in healthcare.  It will move us from a provider-centric healthcare system to a consumer-centric model that rebalances existing power structures and encourages partnership in care.  To date, digital health has largely been bifurcated between technology catering directly to providers, and products marketed at consumers.  As this distinction slowly erodes, it will be essential to place the consumer front and centre of design, implementation and assessment of systems.

Already we see consumers integrating digital tools into their everyday lives; through smart watches, scales, sleep monitors, etc.  They can then analyse these outputs via apps and other third parties.  The ‘ease of use’ such tools provide essentially activates the consumer, even if at a low level, and the resulting data stream can prompt and help prevent adverse health outcomes.  Just think about the COVIDSafe app we have today, or the potential for remote monitoring apps we might have in future.  More broadly speaking, the next step will be managing these data streams and integrating them into a digital health ecosystem.  And as the consumer is now the producer of data, they will have renewed agency for choice and management that do not exist today. 

There are potential pitfalls that we must consider, and that government should take the lead in addressing.  Inequities already exist in our current healthcare system and may worsen because of digital progression.  A new funding model will need to be considered as digital upends traditional economics.  And any path forward will remain inherently ambiguous – after all, technology is impossible to predict!  A flexible policy agenda and legislative mindset are thus essential.   

However, digital infancy also lends us the time to encourage collaboration between key stakeholders.  Consumers have already identified areas that they see as essential investments – areas where stakeholders can start working immediately to better realise digital health in a safe and sustainable way.  These include:

• Increased digital literacy (for both consumers and providers)
• Access to infrastructure (digital as a right – not a luxury)
• Human centred design (where we can learn from the corporate world)
• Whole person approach (measure the entire experience, not just clinical ones)

Any ‘new’ healthcare system infused with digital tools will only succeed if providers, consumers and technologists are synchronised in their approach and their expectations.  No single stakeholder can force this through – not even government.  But the sooner we reimagine our digital strategy to acknowledge this fact, the sooner we can begin to fully realise the benefits of digital health for all.