Wild Health

If you’ve ever dreamed of moving to Scandinavia today’s Wild Health podcast might push you over the edge.  Our two guests this episode discuss Denmark’s extraordinary healthcare model and the interoperability that underpins its success. Professor Janus Laust Thomsen is a Danish GP and leader of Center for General Practice at Aalborg University. He says single patient identifier numbers and a shared communication standard are critical to Denmark’s healthcare success.   Doctors in all healthcare settings experience seamless transfer of medical data between providers regardless of which patient management system they use. “If a patient moves to another city and a new GP, they will have their health records transferred electronically. As a GP, you almost don't even notice that they are a new patient based on what you can read in their electronic patient journal,” Professor Thomsen said. Professor Jens Søndergaard is also a GP and leads the General Practice Research Unit at the University of Southern Denmark. He says that the national digital communication standard has expanded virtual care and amplified the role of GP as gatekeeper to a community’s health. “Denmark is moving advanced diagnostics out to general practice. We have shown that these diagnostic tools can be used in general practice to a high degree of quality and it gives value for the patients,” Professor Søndergaard says. It all sounds very hygge and you will be forgiven for looking up flights to Copenhagen after listening today.  But be warned. One of Denmark’s data privacy safeguards is personal liability if you let in a hacker. No absolution if you work in government either. Not surprisingly, they’ve got a great track record for data protection. If moving to Denmark now looks less appealing, perhaps just a visit to the LEGO shop instead? 

Building internal capability to drive innovation is key to health reform and today’s podcast guest is doing just that.  Dr Penny Andrew is executive director of Waitematā health district in New Zealand and a key driver at i3 – an institute for innovation and improvement within New Zealand Health.  Dr Andrew shares on Wild Health podcast the critical nuances of change leadership that underpin innovation. She’s crystal clear about who should and should not needs to be involved. “It sounds trite but the really good ideas are the ones that are grown on the ground. Those team members have really good knowledge about what will work and what won't work,” she says. Dr Andrew is not a big fan of external consultants coming in to implement a new tool then leaving straight afterwards.  “For innovation, you need a whole lot of skills. You need data scientists. You need designers. You need engineers. We’ve even got anthropologists helping us with the user experience and change. So, you need a lot of skills,” she says.  Instead of outsourcing these capabilities i3 run technical and leadership development programs that build talent on the ground. The programs create enhanced skills in a wide range of areas. “We have clinicians, pharmacists, anesthetists et cetera that have built up their skills in being able to develop systems. They’ve developed amazing electronic tools that improves the user experience in terms of clinical workflow,” Dr Andrew says. While Dr Andrew says she’s constantly scanning the globe for better approaches there may well be a lot for Australia to learn from one of our closest neighbours.

Interoperability – or data sharing – is the lynchpin for all meaningful health reform in Australia.Why is this so?  Michelle O’Brien explains all. She’s one of Australia’s most respected voices in digital health and joins us to explain interoperability and why it’s important.Michelle says that early disease detection, virtual care at home, better management of chronic disease and preventative health are all only possible with interoperability. MBS reform and outcome based renumeration also hinge precariously on this aspect of digital health systems.As a former business executive at Medical Director and MediRecords Michelle knows the potential benefit of data sharing.“My biggest fan club is gerontologists because they ‘get it’. They see how data can be used to detect early onset of ageing diseases and intervene. Getting a diagnosis earlier can change the progression of someone's life,” Michelle says.Can interoperability change the progression of healthcare in Australia? Michelle O’Brien is pretty convincing in explaining how it can. 

Dr David Dembo says that data is full of signals that can help transform healthcare.That data might be a fluctuating heart rate, or the fact a teenager is listening to Barry Manilow – it all has a story to tell, we just need to listen.A former GP, Dr Dembo now heads up Health Catalyst Australia and New Zealand. In this episode of The Tea Room he speaks about how to use patient engagement tools, such as automated communication and remote monitoring, in a non-invasive way to augment care and maintain visibility before, during and after treatment periods.“Modern medicine is far too complex for humans unaided by technology to practise safely. That means you need data-informed decision-making at the point of care delivery. And the data is there, it just needs to be aggregated, read, cleansed and repurposed in a meaningful way,” Dr Dembo said.He says that clinicians and healthcare managers have tools at their disposal to optimise patient experiences, no matter who or where the patients are.

AI in healthcare is only going to get bigger and new Macquaire University research reveals how to do it better.In this short podcast we hear from Associate Professor Paul Formosa from Macquarie University. He’s been researching how patients respond to AI making their medical decisions compared to how they respond if a human is involved.Professor Formosa says that patients see humans as appropriate decision makers and that AI is perceived as dehumanizing even when the decision outcome is identical.“There's this dual aspect to people's relationship with data. They want decisions based on data and they don't like it when data is missing. However, they also don't like themselves to be reduced merely to a number,” Professor Formosa says.There are key takeaways for designers and developers in the research.“It's important that people feel they're not dehumanized or disrespected as that will have bad implications for their well-being. They may also be less likely to adhere to treatments or take diagnosis seriously if they feel that way,” Professor Formosa says.The kind of data that is captured could provide the nuance required to shift negative perceptions AI decision making. Professor Formosa says that we also need to think about the broader context in which these data systems are being used.“Are they being used in ways that promote good health care interactions between patients and healthcare providers? Or are they just automatically relied on in a way that interferes with that relationship?” Professor Formosa asks.

PODCAST: The CSIRO have heard the calls for advice on how to design ehealth solutions for Aboriginal and Torres Strait Islander people. But the key is not designing for any particular community, it’s designing with them, over a long period and with authentic relationship.In today’s podcast we chat Georgina Chelberg from the CSIRO’s Indigenous eHealth Research Centre. The centre is creating a best practice guide for designing digital health solutions with Indigenous peoplesMs Chelberg says that at the core of good design are community priorities and the need to be honest about structural racism.