The time for head scratching is coming to an end as major WA health providers sign up for a digital revolution.
By Eric Martin
Government and private West Australian healthcare providers are taking the leap to modernise their digital systems in a bid for greater efficiency as well as safety.
The WA Country Health Service (WACHS) has joined the South Metropolitan Health Network and St John of God Subiaco in adopting the Charm Evolution laboratory information management system (LIMS), which allows clinicians remote access and streamlines clerical tasks.
This software recently became the first oncology system to integrate with My Health Record.
The digital push is being led by health tech companies Citadel Health, Wellbeing Software and Genie Solutions that consolidated operations across Australia and the UK under the new brand, Magentus.
Magentus advisory board member David Wells says LIMS is at the forefront of large-scale improvements to workflow and patient care across disparate disciplines and vast geographies.
“Innovative diagnosticians are collaborating with clinicians beyond traditional organisational silos throughout labs, hospitals, and trusts to deliver a higher quality of care that is increasingly integrated and multidisciplinary,” he said.
“Our most advanced pathology and radiology networks are also successfully incorporating the fast-growing plethora of clinical AI apps, giving greater access to more predictive analytics and putting more personalised care within reach.”
For SJOG Subiaco, Evolution’s centralised oncology patient record combined treatment plans with appointment scheduling, simplified reporting for all outpatient consultations and same-day and overnight inpatient services and provided oversight of all prescriptions and treatments.
WACHS believes the LIMS will help deliver safer cancer services for patients across an area spanning more than 2.5 million square kilometres.
“To truly move diagnostics forward, we must accelerate the adoption of scalable data and interoperability standards,” Mr Wells said.
“The evolving virtual lab management across all patient settings can accelerate diagnosis, reduce the need for intervention, and keep more people healthy in the long run.
“Beyond this, plugging a clinical AI into this process could identify correlations of concern between image reporting and test results, helping clinicians optimise treatment plans based on similar patient cohorts.”
However, while the LIMS address the clinical and managerial aspects of healthcare operations, the lynchpin of the campaign in WA (and the rest of Australia) is likely to depend on the effectiveness of the end user application designed for consumers.
The results of the latest Australian digital review last year found that globally, “easier digital patient navigation was strongly linked to increased and successful rates of screening, earlier medical diagnosis, and cancer outcomes worldwide,” and lead author, Professor Raymond Chan, Director of the Caring Futures Institute and Dean of Research (Nursing and Health Sciences) at Flinders University, has called for cancer patient programs, including navigators and digital tools, to be funded through the health system.
“Our research (published in CA: A Cancer Journal for Clinicians) shows that patient navigation is clearly improving participation in cancer screening for breast, cervical, colorectal, and lung cancer and reducing times from screening to diagnosis, and diagnosis to starting treatment,” he said.
“Navigating the healthcare system as a cancer patient can be an overwhelming experience…but the evidence suggests good patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and may reduce hospital re-admission.”
Professor Chan explained that barriers included lack of health and system knowledge, lack of financial resources or health insurance coverage, geographic distances from care providers, and lack of social support – which describes the situation faced by many WACHS patients.
For regional West Australians, the design and implementation of the patient interface has the potential to ‘make or break’ the system.
The State Government appointed the Atos Group to provide a scalable Hybrid Cloud to speed up the deployment of these digital services and manage the public interface architecture, which will be built with technology supplied by Dell/EMC, VMware and ServiceNow.
Atos was selected as one of three strategic partners under a five-year agreement to deliver the government’s GovNext-ICT Program, which endeavours to use the maturing capability of the private sector to provide flexible Cloud-based Computer/Storage, Network and Communications infrastructure services to all government agencies.
The aim is for a more governed and coordinated approach to ICT utilisation, procurement, and delivery, and to make high quality services available throughout WA.
However, phone and internet issues often experienced in the regions, is a considerable barrier.
RMIT-led research published September last year highlighted the significant gap in digital inclusion for First Nations people compared with other Australians, which widened substantially with remoteness.
They found that about 43% of the 1,545 First Nations communities and homelands across Australia had no mobile service – including some with only a shared public phone or no telecommunications access – meaning that 45.9% of remote First Nations research participants were ‘highly excluded,’ compared to 9.4% of the Australian population.
With residents in remote communities typically on low incomes, 84% of these respondents with access to a mobile shared it with others, 94% of these used pre-paid services, and 53.3% said they had sacrificed paying for essentials such as food or bills to stay connected, compared to 19.1% of other Australians.
“It’s clear that First Nations people, and those from the culturally and linguistically diverse populations and rural and remote areas have worse cancer outcomes and experiences,” Professor Chan said.
“This challenge can begin even before the cancer diagnosis, during screening and early detection, at the time of diagnosis, and continue throughout treatment, follow-up care, survivorship, and palliative care and end-of-life care.”
Boston University and the American Medical Association have described digital access as one of the key invisible structural determinants of health.
“Disparities in digital access contribute to inequitable access to health information and inefficient patient-clinician communication, delaying timely delivery of relevant health communication, appointment reminders, and follow-up care,” the statement said.
Mr Wells explained that these digital health tools supported clinicians with insights drawn from historical and real-time patient data, accelerated diagnosis and reduced the need for intervention.
“More accurate and integrated diagnostics could serve as an early alarm for future pandemics or help uncover previously unknown genetic links to chronic conditions. Interconnecting wearable technology, mobile apps, or home cameras could even help predict mental health issues or the potential for falls based upon movement, gait analysis, or other indicators,” he said.
“The richness of data collected and analysed would mean any change in patient pathways could be quickly identified and the most appropriate treatments and actions implemented.”
RMIT’s Digital Health Hub Director, Professor Kerryn Butler-Henderson, explained that from the humble pedometer to smartwatches that warned of heart problems, many Australians have been using digital technology to help make health decisions for decades.
“But despite its enormous potential in addressing healthcare challenges, an accessible overview of people’s understanding of health information and digital health tools has been lacking,” she said.
“Health literacy is about having the ability and skill to obtain, comprehend, evaluate, and utilise trusted health and wellbeing related information, so people can play a greater role in their own care.”
According to the CSIRO, these digital literacy issues, if left unaddressed, can lead to long-term digital disadvantages for families and communities.
“Having little or no access leads to reduced familiarity with digital technology, which then erodes confidence, fuels disengagement, and ultimately sets in motion an intrinsic sense of not being ‘digitally capable,’” the CSIRO’s Dr Sarah Bentley and Dr Claire Naughtin said.
“And as AI tools increasingly reshape our workplaces, classrooms and everyday lives, there is a risk AI could deepen, rather than narrow, the digital divide.”
For those living in metropolitan areas, “digital technology could potentially contribute to an enhanced standard of healthcare, empowering individuals to manage their well-being more proactively with greater ease and accuracy,” Professor Butler-Henderson said. While for those in the bush, the breakthrough could just as easily be considered a utopian work of science-fiction.
“Yet with a better understanding of digital literacy levels, work to improve these [digital health tools] can be better targeted towards the often-marginalised groups who need it most.”
Her team of researchers from RMIT have been part of an international body developing The Global Atlas of Literacies for Health (GALH), one of the first online tools displaying interactive data visualising levels of health literacy and digital health literacy from evidence-based studies conducted with patients and health professionals across Europe.
“The atlas makes health and digital health literacy evidence visible to the public, government, health organisations, policy makers and educators… and will become a critical tool in literacy reform,” she said.