‘Mexican standoff’ over who will foot interoperability costs

3 minute read

Elizabeth Koff also flagged a growing disconnect between the public and private sectors' attitude to and desire for digital health solutions.

The managing director of Telstra Health says there is a “Mexican standoff” over who will pay the costs of bringing meaningful interoperability to the Australian healthcare system. 

Elizabeth Koff, former Secretary of NSW Health and now MD of arguably the country’s biggest healthcare software provider, told delegates at the AHHA’s Value-based Healthcare Conference in Brisbane yesterday that it was pleasing to see the Commonwealth’s recent commitment to digital health transformation. 

“It’s the first time in a long while that the Commonwealth has made a significant financial contribution to the digital space,” said Ms Koff. 

“That’s pleasing, in the first instance.” 

But, she said, there was a disconnect between what was being discussed within healthcare policy circles and what was important to patients. 

“Interoperability is what is necessary, and it is the Holy Grail,” she said. 

“But to the man in the street, it isn’t anything exciting that’s not going to shift the dial. It’s basic ‘hygiene’ that should have been done ages ago. 

“We have digital systems that don’t talk to each other.” 

In conversations with the federal Health Minister Mark Butler, Ms Koff said she had given her advice. 

“I’ve said he should pick a few areas where basic digital hygiene can occur and can demonstrate significant benefits — the interface between GPs and hospitals is my personal favourite. There really is an opportunity to do something there,” she said. 

The flipside, said Ms Koff, was a complicated, overcrowded space. 

“The digital space is really crowded,” she said. “It is full of bespoke, boutique solutions and is hard to get your head around. 

“Because the market developed in an ad hoc way there aren’t the standards. The question is who is going to pay for the interoperability solutions because the costs of some of these changes is extraordinary. 

“They’re expensive for aged care, for GPs, for disability organisations. Governments can afford them but there is a missing middle ground.  

“Everybody has described the space ‘in between’ where care needs to be integrated. But there is a Mexican standoff as to who is going to pay for the connectivity within that interstitial space.” 

Ms Koff also took the opportunity to flag a growing disconnect between the public and private sectors’ attitude to and desire for digital health solutions. 

“We do have solutions in the private sector, but I am amazed at the lack of digital maturity in the private healthcare sector,” she said. 

“There doesn’t seem to be a strong appetite for it.”  

Ms Koff said that on the 2022 financial year only 30% of private hospitals were breaking even or profitable, and “that’s a significant issue for the business model”. 

“I’m a strong advocate for the private health system, because the public system cannot support the scope of care required by the Australian population, but with private health insurance making huge profits, but private hospitals struggling, there has got to be a recalibration,” she said. 

“There needs to be some sort of incentive for digital buy-in. 

“We know that you need the trinity of connectivity, data and AI to effectively transform the system, but you also need all the players adopting all three things. 

“And it’s a very diverse landscape of digital maturity out there.” 

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