Australian digital health continues to reinvent the wheel

We know we keep banging on about it but another week in Australian pandemic news has again brought home how weak and disjointed our collective IT response has been, despite the considerable arsenal of top-notch systems that have already been developed for our health authorities and governments to use.

And yet we continue to try to reinvent the wheel. Nowhere was this more apparent than the announcement of a new Australian Digital Health Agency-led (ADHA) project for an assessment framework for mobile health apps. ADHA held a webinar on the topic this week that in our opinion was so badly staged we are not even deigning to report on it.

In summary, regulators are proposing to set up a new assessment framework that will take several years to put into action, has no discernible legislative weight and for which app developers will still have to pay. Meanwhile, there is an existing guide to assessing digital health apps in Australia that is up and running at the moment, is freely available and is peer reviewed, and has already been paid for.

It is called the Digital Health Guide, developed by the private sector and funded by the public. And yet both ADHA and the Medical Software Industry Association (MSIA) are insisting on going through the whole process again, meanwhile charging app developers for the privilege of being assessed. It doesn’t make sense, but it also calls to mind the absolutely torturous process through the Therapeutic Goods Administration (TGA) of the Software-as-a-Medical-Device (SaaMD) regulation, which require a PhD to understand.

And despite calls from Australia’s leading health informatics groups, this week made it clear that each state and territory in Australia is on its own when it comes to app development and standards for vaccination passports, with political considerations and “customer service” taking precedence over security and authenticity.

NSW has already announced it is moving down this track with its trials adding a direct Australian Immunisation Register (AIR) link to its Service NSW app to display vaccination status. And just yesterday, Services Australia’s deputy CEO of transformation projects Charles McHardie told a Senate COVID response hearing in Canberra that it was working with the states and territories on adding functionality to each jurisdictional app, including the check-in apps pioneered by ACT Health and also in use by Queensland, Tasmania and the NT. (There’s a good round-up of where the states are at here.)

Asked by Senator Kimberley Kitching if this meant travellers would have to download eight different apps to travel around Australia, Mr McHardie said the four jurisdictions using the Check-In CBR app were interoperable (the ACT, NT, Tasmania and Queensland), but the others would need to download individual apps. While this would be in near real-time, it still isn’t optimal when a single, national solution is possible.

Services Australia argues that the need for different state solutions comes down to the fact that public health orders are state-based, but it does makes us look a little ridiculous, a wealthy country of just 25 million that can’t organise itself on a national scale.

There is a solution that could be very quickly instituted, based on internationally agreed standards, which will be discussed in an HL7 webinar next week. The Australasian Institute of Digital Health has thrown its support behind it, but unfortunately we doubt if anyone in our state or federal health departments are listening. COVID-19 seems to have broken Australia’s federation, and each state and territory is going it alone now.

It’s a sad state of affairs. Our poll from last week asked whether you thought we needed a national solution for domestic vaccine passports. You voted in the affirmative by 87 per cent to 13 per cent. It is obvious, however, that several of our commenters were adamantly in the negative.

Vote here and leave your comments below.