Harnessing the power and promise of big data to drive better value for patients in health care requires a collaborative approach between all stakeholders along the patient journey.
Health care organisations and governments will need to safeguard data from emerging threats. COVID-19 accelerated the rapid growth of digital health. Now, we expect a period of retrospective cyber and digital risk management as organisations consider how much their digital risk profiles have changed since the pandemic began and as they recover after the rush of technology transformations. The criticality of such security measures has only been underscored by recent large-scale violations, from Medibank to QIMR Berghofer. Expect the time for recovery to be limited by ongoing commercial cyber threats – such as ransomware or data theft – which take advantage of health data distributed in complex ecosystems. Leading organisations will prioritise defences that protect critical systems and patient outcomes, including network segmentation and segregation to minimise the impact of attacks, strict asset management to reduce unknowns in their ecosystems, and deployment of well-rehearsed response plans.
4. Drive for Scalability and Patient Experience
Australia and New Zealand are attractive markets for health care innovation. In addition to a digitally literate populace, the relatively small digital health market (~1% of global market5) provides innovators with a lower-risk environment to demonstrate impact before expanding globally. Companies that are ‘born-digital’, that is, have data and digital technologies at the heart of their operating models, are those most likely to break-through to scale.
Investment in digital health in Australia and New Zealand has grown dramatically in recent years and is likely to continue. Invested capital grew at 100% CAGR to reach US $200 million from 2017–2021.6 The number of digital health deals has remained strong into 2022, even while biotech funding activity has softened sharply globally. While investors based in Australia and New Zealand are most likely to participate in the market, investment from outside the region is on the rise. International investors participated in 14% of deals in 2017, 43% in 2020, and 38% in 2021.
In one of Australia’s largest Series B funding rounds, the clinical artificial intelligence start-up Harrison.ai raised AU $129 million in December 2021, led by Hong Kong-based Horizons Ventures. Eucalyptus, a company that aims to disrupt today’s primary care and prescription journeys using asynchronous care, recently closed an AU $60 million Series C round led by US venture capital firm BOND Capital. With increasing interest from non-ANZ investors, the local industry needs to be on the front foot.
“We’re seeing plenty of trade missions shopping digital health across the US venture capital scene. It’s incredible. However, we’ve never seen an Australian or New Zealand trade mission to the US, which is a shame.”
—Chris Young, former Vice President of New Virtual Market Development and Incubations at Ascension.
Many Australian and New Zealand industry leaders are also exploring digital health start-ups. Private health insurers are looking to adopt digital health to support their members to stay well, using direct programs or partnerships with born-digital companies.
Patient expectations are high across the system. Australia’s rollout of COVID-19 anti-viral treatments highlights the many factors involved in scaling a digital prescription-to-door service that meets consumer expectations. While the technological supports are in place (e.g., risk-based triage surveys, MBS-funded telehealth from GPs, ePrescription services), the patient experience has not been smooth. It has been difficult for patients to access appointments with their usual GP and receive prescriptions to their door within the clinically recommended window. In contrast, in New Zealand, anti-viral treatments can be dispensed by pharmacists without a doctor’s prescription, which has increased uptake – especially in areas of high socioeconomic deprivation.
Where to From Here?
Patient expectations for digital services and experiences must be met. The bar for digital patient care and experience will continue to rise, lifted by digital companies that saw material gains during the pandemic (e.g., Peloton, Netflix, Amazon). Patients with low levels of health literacy or preferences for face-to-face interactions will need to be brought on the journey as well.
Providers will need to remain committed to delivering clinical value while providing increasingly sophisticated services.
Design will need to focus on patients and clinicians. Many of the patchwork, stopgap approaches to virtual care observed early in the pandemic failed. Design of digital health services needs to start with ethnographic research of patient and care team experiences, including their digital interaction and the broader processes and systems they are operating within.
“…Poor user interfaces, and a lack of true integration into clinical processes. If they can’t fix these, they’re doomed to mediocrity,”
—Chris Young, Former Vice President of New Virtual Market Development and Incubations at Ascension
Direct-to-consumer digital health models with a hyper-focus on specific patient needs will continue to grow. Digital companies that cater to specific patient segments or individual moments that matter continue to emerge. Eucalyptus’ portfolio includes companies focused on fertility (Kin), menopause (Juniper), men’s health (Pilot), and sexual health (Normal). Each digital experience is tailored to the specific care need, rather than to the patient. The dynamic nature of these digital services means the platforms can adapt in real-time to what patients value.
At-home diagnostics will pave the way for new digital-first pathology services. As people experience the convenience and privacy of at-home testing, demand for new rapid diagnostics (such as rapid antigen tests for STIs and influenza) will rise if they are affordable and accessible. Companies that ‘correct and connect’ physical diagnostics into digital health care platforms – such as making pathology reports easy to read – will deliver direct benefits to patients.
“Health is about the patient, not the provider – we seem to have forgotten that along the way.”
—Dr Steve Hambleton, Director Digital Health CRC and Chief Clinical Adviser to ADHA
Successful digital health start-ups in Australia and New Zealand will benefit from portfolio business models. Robust, scalable tech platforms must be designed with all users (patients, providers, payers) at the core. The financial success of individual ventures in Australia and New Zealand will be buoyed through portfolio and platform business models that enable shared development costs, open architecture, common data standards, and importantly, a critical mass of patients and providers.
5. Build on Strong Relationships
COVID-19 saw everyone working together in new ways to keep communities safe.
The pandemic placed massive demands on the health care industry and, for the most part, the industry delivered. As part of the push to innovate, critical health care relationships were strengthened and will become the backbone of a more digitally enabled health system.
Relationships between patients and care teams. Patient relationships with primary care teams have always been important. 91% of Australians and 94% of New Zealanders have a usual GP who became the first point-of-contact for care and support during COVID-19, as the acute system was in crisis.
5
5
Australian Health care Index, October 2021; Ministry of Health PHO Enrolment Demographics May 2022
Notes:
5
Australian Health care Index, October 2021; Ministry of Health PHO Enrolment Demographics May 2022
GPs supported individuals to monitor their own symptoms, take proactive steps and, in most cases, care for themselves during illness.
Relationships within an organisation. Sharing information within organisations reached new levels. Within hospital groups, monitoring was essential to assess risks to public health, financial position and workforce strains. Hospitals needed to understand exactly how the network was performing, from available beds and ventilators to the epidemiological trends of who was most sick and who was at most risk of transmission. Organisations took an agile approach to build these connections.
“During the pandemic, everyone (health care providers, governments and software vendors) came together to deliver digital capabilities at pace and scale. We need to leverage these partnerships and deliver more connected capabilities to support health care.”
—Daniel McCabe, First Assistant Secretary Digital Health, Commonwealth Department of Health
“At times in the past, the health system was designing our approaches around the technology, rather than shaping the development of the technologies for what we need in our health care systems.”
—Dr Jean-Frederic Levesque, Chief Executive Officer, NSW Agency for Clinical Innovation and Adjunct Professor at the Centre for Primary Health Care and Equity at UNSW
Relationships between organisations. Co-operation across the system also reached new levels, with rapid connectivity to make COVID-19 test results, vaccination history and health records available immediately. Partners from across the system – including pharmacies, public hospitals, the Ministry of Health, Aboriginal Community Controlled Health Organisations, pathology centres and GPs – were connected by a digital infrastructure that also made it easier to deliver other digital services, such as a fully digital patient journey from consultation to electronic prescription to medication delivered to the door. Technology also did more than support the provision of care – it opened new doors as therapeutics and vaccines were scaled in months rather than years.
Where to From Here?
While the health care ecosystem has recognised the transformational impact of these relationships and is continuing to strengthen them, some specific actions are needed to see them thrive.
Business, government, and social entrepreneurial efforts will need to align. Active and authentic engagement across sectors will realise ambitions and clarify the strategic investments and policy settings needed to support the transition to digital health. Focusing on the lessons learned by global peers will also make it easier to avoid mistakes.
The health care system will need to look beyond organisational silos. To collectively improve patient experience, all parts of the system will need to make progress so that one weak link doesn’t break the digital chain. This includes a digital front-door approach, taking up the mindset that part of the industry’s role in supporting health is to seamlessly steer patients to the care that makes sense for them.
“Working together (Federal government, the states, community sector and private industry) means we’re more likely to come up with building blocks that can be reused and repurposed across the system.”
—Professor Mary Foley AM
The health workforce will need to be engaged and trained in digital throughout their careers. Digital will become the easier and more intuitive way to connect across the system. Clinicians will choose to use digital channels to connect with other care providers, researchers and clinical trial operators. This means the health workforce will need to be equipped with knowledge and capability to use digital tools.
Policy will need to keep pace with and to adapt to disruptions. Policy will need to be more flexibly applied and adjusted – including regulation, health technology assessments, and funding. Real-world evidence can support post-market reviews of products, services and software, and support the ongoing assessment of digital health solutions.
A digitally enabled health care system has huge value for government, industry and patients. Not only can digital health be used safely, but patients value it – particularly those who need it the most. Making the most of the changes the pandemic made possible can change the trajectory of care for the most vulnerable, while reducing the cost to the system.
Telehealth now represents ~40% of all chronic disease MBS consultations, and ~50% of all mental health consultations
To achieve the next frontier of digital health in Australia and New Zealand, the health care system will need to:
- Integrate the predictive power we have for individuals and population health to develop proactive and preventative services
- Work hand-in-hand with care teams to design what works for them and their patients
- Plan for the patient and their health care experience, smoothing out the fragmented silos of our system
- Drive change across the health care industry to make progress together, uniting around a new vision of digital health
“Now is a great opportunity to change, because the public understands its value”
—Professor Sharon Lewin, Director, Doherty Institute
As we share our predictions for the digital health market in Australia and New Zealand, we look forward to collaborating across the industry to realise the potential of digital health.
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