Interoperability: Key to Seamless Health Data Exchange

Every day, Australia's health and aged care systems record mountains of patient data. Medications are prescribed, treatments administered and discharge summaries recorded.

The ability to exchange this data is vital to optimal patient care and has the potential to impact every Australian.

Currently, hospitals, GPs, allied health clinics and aged care providers each store electronic data in different systems and formats using various 'rules', making the exchange of information difficult—at times impossible.

Clinicians' access to your previous tests, images and patient history can be difficult, meaning you may find yourself repeating the same information to different healthcare providers or having unnecessary repeated tests.

Imagine an aged care resident falls and needs to be transferred to hospital.

On arrival, doctors need important information about the patient and their medical history. What medications are they on? Do they have any allergies? In cases where the patient or resident is vulnerable and unable to communicate or advocate for themselves, access to this information can save lives.

Interoperability is the ability to seamlessly exchange data between services and systems and is particularly important in healthcare, because the same health data often needs to be accessed by multiple people, potentially across different organisations.

As part of the commitment to the digital transformation of healthcare in Australia, CSIRO's Australian e-Health Research Centre (AEHRC) is dedicated to improving interoperability. Here are two examples that show how the AEHRC is connecting care in Australia.

Standardising data to accelerate interoperability in the health system

Sparked is a federally funded collaboration between the Department of Health, Disability and Ageing, the Australian Digital Health Agency, CSIRO and HL7 Australia.

Sparked is contributing to interoperability in Australia by working with government representatives, software vendors, clinicians and researchers to apply a certain type of data standard in Australian healthcare known as Fast Health Interoperability Resources (FHIR).

Standards are set of rules, guidelines or benchmarks established to ensure consistency, safety, quality or performance in various aspects of products, services or processes.

Standards work hard behind the scenes of other daily processes, such as online payments, to ensure information can be exchanged.

In the case of healthcare, having standards in place means that when your GP creates a record of your health complaint, this information, as well as any imaging or diagnostic steps that were taken, can travel with you to your next point of care so you don't have to continually retell your story.

Dr Adrian Gilliland is a GP and joint owner of a large regional GP practice in NSW and an active member of the Sparked community.

He said that the biggest impact of the Sparked collaboration would be in "the ability to share and retrieve crucial health information to make the right decisions with my patients working as a GP rather than spending wasted time chasing this information or making suboptimal choices due the information not being available".

The Sparked collaboration has already made strides towards standardising data collection in the primary care sector. The completion of the Australian Core Data for Interoperability will foster the implementation of a national set of data collection standards for multiple use cases – including aged care.

Researchers at AEHRC are also committed to adopting FHIR-approved standards in the digital care tools they develop.

An example is the MoTHer platform , designed to help women and their clinicians manage gestational diabetes which was recently updated to reflect the latest FHIR guidelines. We'll now look to leverage the Sparked standards, which will make it easier to integrate into healthcare systems.

Interoperability across the ages

CSIRO recently co-published the Australian aged care data landscape report with the Digital Health CRC, which details the unique set of challenges the aged care sector faces when it comes to improving interoperability.

Australia's ageing population is placing increased strain on both the aged care and health systems. At the same time, workforce issues mean aged care is struggling to meet this demand and employ enough staff to provide residents with consistent care.

Another factor is digital literacy. Some aged care workers may not receive enough training on systems used to record and access health information.

Aged care facilities also face unique challenges in collecting data.

Unlike most hospitals or treatment centres, aged care facilities have several points of care. Residents might receive care or treatment from their beds, in their rooms or in any one of the facility's communal areas, complicating how workers collect and record patient data.

Note-taking can be further complicated if a limited number of devices is shared between many workers and if the devices are located in a central location such as a nurses' station. A worker caring for a resident on a busy morning might be stopped 20 times before they can get to a device and write down their notes.

Standardising and digitalising data collection

Interviews with aged care workers and stakeholders conducted by researchers revealed another key issue: there is no consistency in what data is collected.

Standardising data collection isn't a straightforward task. Liesel Higgins, Team Leader of AEHRC's Digital Therapeutics and Care Project Support team, explains that aged care providers have their own perspectives on data collection.

"The word 'data' means different things to different people. From an aged care perspective, data is basically any information collected about people using the aged care system. It includes everything they do to live life," Liesel said.

"This means that data can include information like what care they need and what treatment they receive, but also personal indicators like their religion and finances."

Standardising what information is collected is the first step in digitalising data collection. AEHRC researchers hope improving this process can alleviate some of the burden on aged care workers.

By standardising and digitalising data collection processes, AEHRC is helping to ensure that older Australians receive timely and coordinated care.