Putting the consumer at the centre – A conversation with Leanne Wells

As CEO of the Consumers Health Forum of Australia, Leanne Wells gives the consumer perspective the attention it deserves.

Leanne Wells Leanne Wells, CEO of the Consumers Health Forum of Australia

Hi Leanne, and welcome to #Share! Let’s talk about the Australian health system from the consumer’s perspective. What are we doing well, and what could we do better? And what role does digital health play here?

Leanne Wells: Thanks, I appreciate the opportunity. Overall, we do have a good health system when you can get to the mix of services you need. Our challenges are not so much about the quality and safety of care or our workforce, they’re about access and equity and affordability. They’re our pain points.

Looking down the pipeline, there’s burgeoning chronic disease and aged care needs, and at the same time our mental health statistics and lifestyle factors like obesity are also quite concerning. Addressing these issues in practice means coordinated care, and that in turn means sharing information between providers, particularly when our people are transitioning from hospital to home or aged care. That's where digitally enabled information sharing is so critical, and this is always taking place against the backdrop of the growing conversation about the need for value-based care.

Digital health is of vital importance, right from supporting self-managed health care and health literacy, but also through to bolstering primary care services. It’s enabling outreach and shared care, linking the workforce, and enabling people to talk together for case conferencing, remote diagnosis, and so on.

#Share: One of the exciting features of digital health is that it lends itself to reducing healthcare inequities, because of the relative ease of remote access.

Leanne Wells: Absolutely. Digital health has an enormous enabling role to play here. Rural health is a good example. We know we've got worse health outcomes in country Australia, and that's obviously a product of the complex conditions like workforce supply and paucity of services.

Models of care that feature telehealth in the bush (and the city for that matter) are really smart solutions. It enables better use of the workforce, which is always in limited supply. If we can use that workforce to do telehealth and case conferencing consultations for example, those are the models of care that can really assist with areas where we've got poor access. Not only in regional Australia but in some of the outer metro areas too.

Another way that digital health improves access, social convenience, and better use of the workforce is by improving health literacy. We know that poor health literacy impedes access to health care and we know that people generally think that they’ve got good health literacy until they get sick or develop a chronic condition and actually start trying to navigate the services they need.

People often need help to navigate the system as a whole, as well as to understand more specific topics like knowing which digital health apps might be authoritative and evidence based. So there’s a real need for quality assured information on trusted digital health platforms that people can access easily.

#Share: Now let’s focus on the current environment. What’s your perspective on the current state of play in digital health in Australia?

Leanne Wells: It’s hard to contemplate any aspect of healthcare policy or service delivery that's not going to have a digital health element in the future. Digital is everywhere. The system, our policy, our protections, our regulations have got to realise its value and how it can drive innovation and better care delivery. Fortunately, we’ve got an ambitious national digital health strategy and implementation framework that’s COAG endorsed.

One front that we all need to work on will be to realise the value of the investment that Australia’s made in My Health Record. It’s a critical part of our national health architecture. This means working on issues ranging from trust and social licence through to striving for increased use and demonstrated benefit and utility. It’s an ongoing imperative.

We know that some doctors continue to express doubts about My Health Record, but the doctors and patients who routinely use My Health Record are strong supporters. Right now, there is still a lot of confusion and misconception about what My Health Record is and isn’t; there is clearly a need to build understanding further. For example, following the additional legislative protections that were put in place last year, there needs to be more understanding that “delete really means delete”.

Another front is interoperability. This a really important conversation that's going to help define our health care future.

One of the challenges from a consumer and a community perspective is that some of the jargon in the digital health space can be quite daunting. What do we actually mean when we talk about interoperability? When you get around the table with your customers and community change agents, you unpack that interoperability is really about connecting the system through digitally enabled health care transitions and all of those really practical things, that's when the light bulbs go off and the scope for innovation can be explored.

We know from our experience that consumers can often be assistive agents of change, and the flip side of that is if consumers and the community feel that the trust and social licence is not there, it can actually deter advancement, rather than an agenda being embraced.

This is one of the reasons why it’s so important to take a co-design or co-creation approach to developing digital health solutions, no matter what level you're talking about.

That could be either at a very local coalface level all the way to national roadmaps for interoperability or other topics. Deciding at the outset to include the consumers who are going to use these systems at every stage of development means that their trust, their confidence, and their ideas for innovation are also built into the system all the way through. That’s a pretty important take out message from us.

See also: My Health Record: what now?