ANZ News

ACT Health is rolling out Wavelink’s Spectralink Versity enterprise mobility solution across five of its facilities, including Canberra Hospital. The deal involves the roll out of 2000 of the Spectralink Versity handsets by July. Spectralink Versity is an Android smartphone, purpose-built for healthcare. It is durable, waterproof, and has secure messaging capabilities, in addition to personalised settings for each user. A higher-grade model has a barcode scanner, which enables integration into EMRs. ACT Health will be using a combination of both models. Wavelink Health Practice Lead Alan Stocker told HITNA that part of the evaluation criteria that it went through was a checklist of requirements such durability, being able to be used with medical gloves and a single sign-on for practitioners. “ACT Health is effectively ditching the utility belt, which sees healthcare professionals carrying a number of utility devices like hospital issued phones, pagers and barcode scanners. They carry around about five devices at any given time,” he said. “As it was managing a number of devices, this also meant that it had in place different maintenance contracts and multiple relationships with various vendors. And even with a number of devices, they weren’t delivering on what ACT Health wanted to do.” Spectralink Versity eliminates that as it integrates all the uses of multiple devices into one. According to Stocker, the units are designed to be used in an enterprise environment and also integrate with EMRs. “A medical practitioner doing their rounds can go up to a patient, load up their EMR app, scan the patient’s hospital wristband, which then brings up their information,” he said. “In addition, before we sell this to a hospital, we look at their wi-fi networks and make sure that it’s enterprise-grade. This means that we make sure of coverage no matter where Spectralink Versity is being used in the facility as if there’s a black spot, the healthcare professionals are not going to be receiving critical messages.” [Read more: ACT Health replaces outdated bedside whiteboards with digital bedside technology | Royal Darwin Hospital improves patient care with virtual desktop program] The devices connect to an electronic dashboard, which manages a number of functions, such as real-time staff whereabouts and rostering. Stocker said with interoperability and connected devices becoming more prevalent in other parts of the world, Australian healthcare organisations need to keep up to stay ahead of the curve. “In Australia, we haven’t quite seen the adoption of many smart devices in hospitals. We’re about five years behind to countries like the US. So, connected health is a huge part of Wavelink and we’re now driving this strategy to make healthcare easier for practitioners,” he added. Spectralink Versity has also been taken by Northern Hospital in North Melbourne, a number of aged care groups including Arcare, Shepparton Villages, TLC Aged Care and Townsville Aged Care, as well as in smaller quantities at a couple of other hospitals. The company is also running a number of proof-of-concept trials with hospitals and state health groups around the country.

eHealth NSW has been established as a distinct organisation within the New South Wales (NSW) Ministry of Health in Australia to provide statewide leadership on the shape, delivery and management of ICT-led healthcare. One of the most recent appointments at the agency is its new Chief Clinical Information Officer, Dr Mark Simpson, who joined in January this year. Healthcare IT News learnt from Dr Simpson in an email interview about his new role at eHealth NSW, major projects that he will be working on, as well as his thoughts on the evolving role of the CCIO. Could you tell us more about your role as CCIO at eHealth NSW? I’m hugely excited to have started work as the Chief Clinical Information Officer for eHealth NSW, a role in which I am working collaboratively with NSW Health clinicians from across the state on transformative digital health strategies, programs and services. It’s an exciting time to join eHealth NSW. The 10-year eHealth Strategy for NSW Health: 2016-2026 has led to a great core level of coordinated delivery of digital services across the state, and the next six years will secure the consolidation of that fantastic start – as well as encouraging a much broader engagement of the clinical nursing and allied health professionals who are at the heart of this digital strategy.   You mentioned in an online article by digitalhealth.net that that if there was one top line to describe your CCIO role at NHS, it would be to foster clinical engagement in a broad sense with the clinical team. Does this statement still apply to your new role at eHealth NSW? Based on your experience, how do you think the CCIO role has expanded or evolved? The CCIO role I hold here has very much the same aspirations and expectations as my previous one did at the NHS. In NSW, the state lead role for CCIO does cover all of the local health districts in Australia’s largest state with a population of near eight million. The role is very much a bridge between eHealth NSW, the frontline clinical teams and the implementation teams and my CCIO role is focused on ensuring clinical engagement is at the heart of all projects. There’s a particular focus on how the design of the end products can incorporate Human Centred Design and the kind of user experience that truly enhances the interactions of all clinical staff in a wider sense, including medical, nursing and allied health professionals. Having been one of the first CCIOs in England in 2012, the original CCIO role back then was overall very much as an enthusiastic clinician who was the first of my type in a large tertiary teaching centre which was very much focused on delivering digital systems such as the EMR into a large complex hospital, and in the ensuing seven years the CCIO role has of course matured.  The role has evolved to encompass much more strategic thinking, with many of the complexities of safely implementing large-scale projects into many and varied clinical environments such as secondary hospitals, specialist units, mental health and also bridging into community and primary care. A smaller number of CCIOs have taken on a more formal role of sitting on executive boards and representing the clinical informatics aspect of care at the executive level. This really starts to change the model and engagement for future CCIOs to one in which they can encompass the next level of engagement with the concept, the innovation, the design phase, the safe implementation and the post implementation optimisation lessons learned, which can then feed back into next-level projects. It's also afforded us a larger population of CCIOs, and that’s now evidenced by the great opportunity to deliver teaching, training, education and a level of standardisation of career expectations through such advances as the Digital Academy in the UK. eHealth NSW Chief Executive and Chief Information Officer Dr Zoran Bolevich mentioned at the HealthShare NSW and eHealth NSW Expo 2018 in Sydney that “the next phase of eHealth NSW’s journey will see the organisation embark on bringing a digitally fragmented patient records system together.” Is that something that you will be working on directly? Absolutely; this is one of the central aspects of the process, to engage at a state level with the widest possible clinical engagement process. In NSW the digital landscape is maturing and still somewhat fragmented and this means that information related to patient care is not always available as seamlessly as possible, so the next phase is to look at how to optimise the concept of a potential single digital patient record.  At this stage, the processes involve how engagement with both CIOs, CCIOs and the program governance will manifest itself going forward. The opportunities to ensure clear and seamless transfer of patient information – so that it is always available at the right place and at the right time, and optimises the right care – is something that is absolutely central to my role as CCIO. Could you share with us some of the major projects that you would be embarking on at eHealth NSW?                                                                                                                                                                   The major projects I’m focusing on as eHealth NSW’s CCIO are many and varied. Significant work is underway as part of the eHealth Strategy for NSW Health, which commenced in 2016 with large-scale programs of work including the optimisation of the electronic medical record, the continued success and roll-out of the electronic medication management, along with many other EMR-related projects including managing deteriorating patients, diabetes and end of life care for example.  Looking ahead, large topics for my agenda include the single digital patient record, the safety and quality aspects of all delivery of digital care across the state, and the utilisation of mobility including how that truly impacts and supports frontline clinicians, nurses and allied health professionals. I’m also focusing on the ability to harness new and novel ideas through innovation, research and academia into production and delivery to coalface clinical staff so that they have the most optimal impact on patient care and the safe delivery of services.  The drive to optimise the electronic medical record will be well understood by our frontline staff but I want to ensure everyone has the opportunity to offer feedback and improve the service they cherish while at the same time being part of a broader team of clinicians, nurses and allied health professionals who together are realising the next major milestones of the eHealth Strategy for NSW Health. Patient records and clinical information is inextricably intertwined with big data. How do you see yourself working with colleagues who handle data and analytics at eHealth NSW?           Above photo: eHealth NSW's Clinical Engagement and Patient Safety team. Credit: eHealth NSW The role of eHealth NSW CCIO encompasses the areas of clinical engagement and patient safety and quality assurance and these are the key areas on which my team and I will work closely in the coming four years.  The use of focused data and analytics, including big data and population data, is central to a much closer understanding between the impact of digital care and its safe and optimal delivery of service. I also see some golden opportunities to increase the level of support and open the feedback loop from the analytical aspects of the data to better understanding areas where excellent practice exists and what we can do to share that in practice. This will help us to clearly highlight areas where there are other pressures or challenging situations which require either further resources or more specific and targeted clinical engagement. What are some of the milestones or goals that you would like to achieve as the new CCIO of eHealth NSW?         This is a fantastic opportunity which has brought me halfway around the world to be a part of this digital health strategy as the CCIO of eHealth NSW. My goals are to ensure, to the very best of my abilities, full engagement across the widest possible clinical network. This includes engaging all of the CXIOs, as well as those who are involved in clinical informatics in all guises within the local health districts, so that a wide and active clinical network becomes one of the central pieces to delivering truly impactful digitally enabled healthcare to the people of NSW.   Some other major goals I've set myself is to increase patient and consumer engagement, as this has the opportunity to impact on both the outcome of our digital programs through partnering with those who have the most to gain from the digital strategy itself. Mobility-harnessing innovation through future design is high on the agenda over the coming four years, given the great opportunities to address the significant user challenges in converting design into optimal delivery befitting the clinical environments and having a true patient safety impact. I’m also very interested in engaging with the educational training and undergraduate postgraduate trainers to start delivering a structured career path for future generations of CCIOs or equivalents both across NSW and indeed Australia. Many of the lessons learned globally could be utilised in delivering a career framework that will help guide all staff with an interest in patient safety through digital health to ensure a smooth and focused career path which hopefully will lead to succession planning for Australia’s next generation of CCIOs.                                                     

In healthcare, fast access to critical patient data can mean the difference between life and death. If doctors can’t get the patient’s information they need when they need it, the quality of care can be severely compromised with potentially unpredictable consequences. This means that the storage and protection of data is of vital importance in healthcare. Downtime must be avoided at all costs – even in the event of a catastrophic failure, whether that’s a natural disaster or cyberattack. However here’s the problem: storing, securing and intelligently managing data has become increasingly difficult, time-consuming and expensive for healthcare organisations. There are several reasons for this. To begin with, the volume of healthcare data is growing at an astronomical rate, driven in part by necessary efforts at healthcare organisations to digitise all their patient health records. Another driver of data growth is diagnostic devices like CT scanners, MRIs and X-ray machines, which produce massive amounts of imaging data. As these technologies continue to advance, the image files they produce become better, have higher resolution and grow larger and larger in file-size. As hospitals are generally required to store medical images for seven years in accordance with disaster recovery compliance requirements, their image archives are expanding by as much as 40 per cent annually, according to AT&T ForHealth division. The Internet of Things is yet another driver of the data management challenge for healthcare organisations. Connected devices like fitness monitors and in-room sensors all produce their own streams of data, all of which must be stored and managed. Add it all up and the storage demand at even a small medical practice or hospital can quickly reach petabyte-size. However the challenge does not stop there - as the data grows, the time, budget and resources required to store, protect and manage this critical patient data grows as well. What healthcare organisations need is a data management and data protection solution that delivers constant, uninterrupted data availability. In addition to being reliable, the solution must be affordable, so it doesn’t break the budget. This is a huge ask, to say the least. The solution must also guard against ransomware and cyberattacks, because healthcare organisations are increasingly under attack from a growing list of threats. For example, ransomware can infect a hospital’s vital patient data or information systems and hold them hostage. Hospitals are particularly susceptible to this kind of extortion due to their dependence on up-to-the-minute information from patient records. Without quick access to their information systems, hospitals simply cannot do their job. For hackers, hospitals are a great target because they can’t risk the lives of their patients and are therefore much more likely to pay ransom. This is partly why healthcare suffered more ransomware attacks than any other industry in 2017, according to a report from global cybersecurity insurance company Beazley. The report found that 45 per cent of all ransomware attacks in 2017 were aimed at the healthcare sector. The good news is that the market offers solutions designed to handle the ever-increasing amounts of healthcare data securely and cost-effectively, ensuring that quality care is never jeopardised by lack of access to vital information. Here are five ways healthcare organisations can protect themselves against the triple threat of out of control data costs, system downtime and loss of data integrity: 1: Look for converged primary and secondary storage To properly deal with explosive data growth, healthcare facilities need an approach that delivers comprehensive storage and data protection services in a single, integrated and easy-to-use solution. By integrating primary, secondary and cloud data-management capabilities, healthcare organisations can eliminate storage and data protection silos while decreasing the risk of any downtime. 2: Benefit from cost-effective, scale-out storage Small and medium-size healthcare practices and hospitals face many of the same data challenges as very large healthcare providers, but they have fewer resources and smaller budgets available. That’s why they need scalable storage that will adapt to their data needs. Healthcare organisations should be able to start with a single node with a few terabytes of capacity, then seamlessly and non-disruptively scale to multiple petabytes with zero configuration or application changes. 3: Protect against data degradation Medical images, in particular, are highly vulnerable to data degradation. The silent corruption of data in medical images caused by bit rot is a significant concern. The problem is compounded because legacy systems store images such as X-rays to a picture archiving and communication system and may not detect if data has been compromised. As a result, the information read from the legacy storage system may be corrupt and unusable. Healthcare organisations need modern data solutions that can guard against this kind of data degradation. 4: Inoculate against ransomware Data protection is a top priority for healthcare organisations as they battle against the constant threat of cyberattacks. Healthcare providers need to have strong encryption throughout the data lifecycle without having undue management complexity. The answer to this challenge is immutable object storage. Modern healthcare organisations solve this issue by implementing a storage solution that protects information continuously and takes data snapshots every 90 seconds. Because the object store is immutable, these snapshots remain completely unaffected in the event of an attack. As a result, healthcare organisations can recover the most recent version of data, and thus thwart any ransomware attack. 5. Insist on a tangible ROI Cyberattacks are increasingly common and as a result, hospitals are seeking insurance policies that provide coverage in the event of a data breach or loss. As every medical record is assigned a dollar value by insurance companies as part of the risk assessment, this can quickly add up to tens of millions of dollars in premiums. However, these insurance premiums can be reduced when hospitals can demonstrate they have effective data management and protection strategies in place. Recently, one healthcare provider was facing a $22 million insurance premium, but was able to reduce this premium by deploying an appropriate data management and protection solution, thereby delivering immediate ROI on the project from day one. With the right data management solution, healthcare facilities can not only protect their data and decrease costs, they can better treat their patients and ultimately save more lives. Florian Malecki is the Senior International Director of Marketing at StorageCraft.

Two Australian organisations have joined forces in a bid to improve remote healthcare delivery and attract more doctors to rural and remote communities across Australia. Swinburne University of Technology has partnered with CSIRO startup Coviu to embed digital health technology in the classroom, clinic and research by using the latest telehealth technology to treat Australian's remotely. The partnership will see Coviu, a company which specialises in online health consultations by using AI to connect doctors with hard-to-reach patients, provide access to its technology for Swinburne students, researchers and clinical services to redefine models of healthcare. Swinburne will embed Coviu technology into the curriculum of nursing, occupational therapy, psychology, dietetics, health science, and digital health and informatics. These will be taught at Swinburne’s new Health Precinct. The technology will also be implemented into Swinburne’s new Master of Physiotherapy, and Graduate Certificate in Teleaudiology, set to launch from mid-2019. Coviu CEO and Co-Founder Dr Silvia Pfeiffer said the partnership enables Swinburne students to break down the distance and barriers between healthcare professionals and patients. “The distance between healthcare providers and those they serve can require enormous amounts of effort, time, and money to overcome. Coviu aims to knock down this barrier by making video visits the new standard of care,” Pfeiffer said. “Our goal is to bring fairer access to healthcare for all citizens, regardless of their location, and this partnership takes us one step closer.” According to Pfeiffer, research has shown that up to 80 per cent of clinician visits can be provided online with comparable clinical outcomes and that it’s essential for the next generation of medical professionals to be equipped with the necessary tools and knowledge to make online consultations effective. “Beyond geographical constraints, there’s often a stigma attached to seeking support for certain health services; for example, mental health. However, for many people, this disappears when they can do it from the comfort and privacy of their own home. This makes telehealth a fantastic solution for those seeking aid, regardless of location," she added. [Read more: Deakin Uni launches Institute for Health Transformation | Murdoch Uni launches new research centre for precision medicine] Swinburne University of Technology Digital Health and Informatics Academic Director Dr Mark Merolli said health and digital technology go hand in hand, and this partnership reflects Swinburne’s commitment to leading digital health and its passion for innovation in all aspects of teaching, training and research. “Having our students prepared for a workforce where healthcare is increasingly delivered remotely, is imperative and something that is at the core of digital health’s future in Australia. We need graduates that are comfortable using this technology and Swinburne will produce them,” he said.

Having a bimodal approach to ICT operation – one that marries a predictable evolution of products and technologies with the new and innovative – has become a necessity in healthcare. Building the essence of an enterprise bimodal capability balances out current organisational needs, such as service and project delivery, and addresses the future needs of healthcare, according to NSW Health Hunter New England ICT Services Executive Director Chris Mitchell. “Health ICT certainly seems to lag behind other industries in some areas, so building capability around innovation is an important agenda item,” Mitchell said. “Top-down innovation is rare; it really needs to come from the front lines – the people actually doing the work. It’s about providing the processes and avenues for anyone in the organisation to have somewhere to suggest ideas, which are then reviewed and prioritised in line with organisational goals and strategies. “In order to facilitate this, building an innovation and architecture practice within the ICT function to focus on organisational future needs can assist,” he said. According to Mitchell, developing new models of care can deliver better outcomes and value, particularly around integrated care, ensuring that all care providers are communicating effectively with patients and each other, and placing the patient at the centre of clinical decision making. “Disruptive innovation can impact the delivery of care for health systems, providers and consumers. For health systems, innovation should be about making things easier and more efficient. From a provider perspective, the ability to review patient data remotely, as an example, or conduct a telehealth appointment can completely change the way that a provider works,” he said. “From a consumer point of view, online portals, mobile apps and telehealth can change the patient experience for the better.” Mitchell said a shift in traditional funding models is moving healthcare from volume to value. “We are now looking to pay for outcomes achieved rather than procedures performed. Traditional funding models based on the general view that any activity is worthwhile and should be funded is changing to a more value driven approach – doing the right thing at the right time and minimising wastage.” And budgets, funding and societal expectations is driving this change, he added. “Continuing with a volume-based approach will ultimately end in poorer patient outcomes as well as an unsustainable budget trajectory. We must be focused on doing things better and more efficiently,” he said. LEADING THE FRONT NSW Health Hunter New England has been leading the front by driving innovation in a number of ways. Mitchell said it is moving to more value-based care models by understanding challenges that its senior clinicians and managers face. “We have a view of moving from volume to value and assessed some of our legacy activities. One of the takeaways from an ICT perspective was reviewing our EMR system order templates to remove unnecessary tests, and potentially, add system notifications that alerts the ordering provider about expensive pathology tests where the outcomes are rarely reviewed,” he said. “Further to this, we continue to roll out electronic clinical systems with around 75 per cent of medication management across the district now digital and all major ICUs have implemented biomedical equipment integrated systems. “We have also been doing some work around ereferrals, whereby primary care clinicians can refer patients into the Hunter New England hospital system electronically and directly from their practice management systems,” he added. [Read more: Collaboration is a key part of health systems today: panel | Tech development, regulation, investment and implementation key to digital health] But this change did not come without its own set of challenges. “Funding is a perpetual challenge. There is always a significant investment cycle required for technology before payback becomes apparent. We also faced some difficulties around organisational change but educated staff about the opportunities around improving patient safety, engagement and outcomes.” In order to develop and maintain a culture of innovation, Mitchell said the desire for, and platform to, change needs to be built into an organisation’s DNA. “It’s all too easy to put together an ‘idea portal’ and dust off the hands and say “we’re doing innovation”. It’s not as simple as that,” he said. “It is a cultural thing around leadership espousing the values of innovation and driving positive change – helping people to not be scared of change and embrace it instead. It’s difficult to achieve as the pace of change is speeding up. So, to build a future where innovation is key, we need to be building the platforms for change within our organisations.” Mitchell will further discuss the topic of disruptive innovation for value-based healthcare during a CXO panel at the upcoming 2019 HIMSS Health 2.0 eHealth Summit in Singapore.

Swinburne University of Technology, a public university located in Melbourne, Australia, has partnered with Coviu, a telehealth software platform, to further embed digital health technology in the classroom, clinic and research. What’s it about The partnership will engage students studying health-related courses, and the wider community, in using the latest telehealth technology, equipping them to treat Australians remotely and redefine models of healthcare. Coviu, a company that specialises in online health consultations, will provide access to its technology for Swinburne students, researchers and clinical services. Coviu is also a finalist and winner of the 4th Innovations Challenge Award for their PhysioROM solution at the HIMSS AsiaPac Conference in 2018. Students will learn how to break down the barriers created by distance between healthcare professionals and patients. Swinburne will embed Coviu’s technology into the curriculum of nursing, occupational therapy, psychology, dietetics, health science, and digital health and informatics. These will be taught through Swinburne’s new Health Precinct, which utilises the latest in technology and facilities. The technology will also be implemented into Swinburne’s new Master of Physiotherapy, and Graduate Certificate in Teleaudiology, set to launch from mid-2019. On the record “Having our students prepared for a workforce where healthcare is increasingly delivered remotely is imperative and something that is at the core of digital health’s future in Australia. We need graduates that are comfortable using this technology and Swinburne will produce them,” said Dr Mark Merolli, Academic Director of Digital Health and Informatics at Swinburne in a statement. “Health and digital technology go hand in hand, and this partnership reflects Swinburne’s commitment to being a leader in digital health and our passion for innovation in all aspects of teaching, training and research,” he added. “Research has shown that up to 80 per cent of clinician visits can be provided online with comparable clinical outcomes. We’ve worked hard to make our telehealth technology simple to use for both patients and providers, however it’s absolutely essential that the next generation of medical professionals are equipped with the necessary tools and knowledge to make online consultations as effective as possible. Our partnership with Swinburne will ensure that this process takes place,” said Dr Silvia Pfeiffer, CEO and co-founder of Coviu.

Despite increased industry efforts, healthcare is experiencing cyberattacks at an increasing rate. So what does the industry need to do to salvage the situation? According to Forcepoint Information Security Senior Director Alvin Rodrigues, the industry needs to embrace new ways of protecting data. At the recent Australian Healthcare Week conference, he mentioned that a behaviour-centric, analytics driven approach to cybersecurity is necessary. “Having just a reactive mindset to cyber threats doesn’t work anymore. Cyber attackers have expanded the boundaries of attacks beyond the horizon of just the healthcare organisation to reach other players or partners of these organisations,” he said. “Therefore, you need to consider how you get visibility of the landscape and as a result of that, how you control and manage access from a collaborative standpoint with compliance in mind. A risk-based approach ensures that cybersecurity is aligned to the way that the organisation is run.” According to Rodrigues, healthcare has been the main target of hackers who are after patient information and credentials. Hacking and malware are the first points used to get these information and ransomware is on the rise, he said. “Health information is more valuable than financial information because the shelf life of healthcare information is longer than financial information,” he said. “If someone gets a hold of your credit card information, all you need to do is call your bank and deactivate it. But if that someone gets a hold of your health records, the person can take advantage of that in multiple ways. “The lack of encryption and insider threats are also concerning. These are due to the way that hospitals are run. Many hospitals are still using outdated technology, resulting in these issues. In addition, doctors aren’t aware of cybersecurity – it’s still predominantly an IT department issue.” In addition, with healthcare becoming increasingly connected, Rodrigues said hackers are more likely to target organisations because all data sits in one pocket. [Read more: Reinventing data security with cryptographic technology | How important is medical device classification in a healthcare organisation’s cybersecurity strategy?] As such, he said having risk adaptive protection is necessary and that it delivers:  Dynamically, adaptively and automatically protects data and minimises data exfiltration Identifies intentions through alerts of anything out of the ordinary  Provides evidence for litigation  Minimises friction between security and other departments Home-required cybersecurity training and education A corporate aware security culture.  “We need to beef up our cybersecurity posture so that we can minimise the unknown threats that enter our organisations,” he added. Data scientists, through the use of AI and machine learning will be able to understand human behaviour better when it comes to cyber attacks. Organisations that embark on this human-centric cybersecurity strategy moves processes away from one that is threat based to one that is risk and analysis based.”

With an ageing population and the introduction of new technologies, the healthcare industry in Australia is, no doubt booming. But is this growth substantiated with the relevant skilled employment it requires? Australia has been paving the way for the growth in healthcare. Federal and state governments have recently been investing millions towards building and upgrading healthcare precincts, such as the South Australia healthcare precinct, and universities are opening their doors to institutes that focus on digital transformation. Most recently, Deakin University unveiled a new institute for health transformation, while Murdoch University launched a research centre at its Perth campus, with a focus on precision medicine. And according to a McKinsey Australia report, powerful new automation technologies such as machine learning, artificial intelligence (AI) and advanced robotics are already transforming the Australian economy, workplace, education system and community. As automation technologies and digital integrate into the workforce, the report identified that the mix of skills required in all jobs will shift. For example, it found that people will spend more than 60 per cent more time using technological skills. However, without proactive leadership to manage the transition to a steady state, automation is expected to have disruptive distributional impacts, such as an unemployment rate spike by up to 2.5 per cent during the peak of the transition. Specific to healthcare, the Australian Jobs 2018 report by the Department of Jobs and Small Business, identified that the largest numbers of new jobs were created in healthcare and social assistance over the five years to November 2017, with job numbers up by 301,600. It found that the sector employed almost 1.7 million people as of November 2017 and these numbers are projected to grow by 16.1 per cent over the five years to May 2022. “The strong growth in healthcare and social assistance in recent years is projected to continue, with this industry projected to add significantly more jobs than any other industry,” the report stated. DIGITAL-SAVVY TALENT In a Seek report, Mercy Health’s People, Learning and Culture Group Executive Director Kate McCormack said the boom in healthcare has caused a “war for talent” across the sector. “We are a people business and our doors never close. The attraction, retention and utilisation of the workforce are our greatest strategic challenges,” she said in the report. [Read more: Inability to meet patient engagement demand is “hobbling” Australian healthcare providers: study | We need to get the digital basics right and quickly: Tim Kelsey] At a recent Australian Digital Health Agency (ADHA) event, eHealth NSW CEO Dr Zoran Bolevich said there is a pressing need for the workforce to develop itself and substantiate this need in health literacy. “We need more data scientists, more clinicians with digital health skills, more technologists with an understanding of health and more clinicians with the understanding of technology. We need to start developing these new workforce capabilities now; it’s an urgent need,” he said. At the recent Australian Healthcare Week in Sydney, Metro South Health Workforce Services Executive Director Dave Waters said retaining talent in healthcare is a challenge. “To do that, we need to maintain and extend talent into advantageous roles such as data scientists or specialists that are moving into predictive analytics and AI. As more organisations roll out clinical informatics, in particular, we need to ensure that we have a pipeline in place for such capabilities,” he said. Waters also spoke about the need to use data to improve patient outcomes by using the former to find the right fit for a role. “Is there some way where I can fill a role that might actually improve patient outcomes? That’s where data comes in. Using datasets for workforce planning will enable organisations to identify some of those sweet spots for sustainable performance,” he said. A DIRECTION THAT WORKS Metro South Health is one of Queensland’s largest health services by population and employs more than 13,000 staff. Having completed an ambitious project to fully digitise its four major metropolitan hospitals and one rural hospital in 2018, the organisation is tackling recruitment head on. Metro South Health Recruitment Consultant Boyd Clifford said as a result of technology, there is now a wide range of digital-focused occupations within healthcare, from project managers to business analysts, all of which require a diversity in training, education and background. “Our digital systems, including the integrated electronic Medical Record (ieMR) and mobile apps, are helping us achieve more accurate, efficient and personalised care. To deliver these digital innovations, we need talent with both IT skills and an ability to improve processes and design solutions for patients and clinicians,” Clifford said. [Read more: What lies ahead for the next wave of digital health and digital hospitals? | Data analytics is the “gold mine” for operations improvement] With the uptake and continuing evolution of technologies, Clifford said there will be an emphasis on candidates being fluent in a multitude of different systems, or the ability to very quickly acquire those skills on top of the more traditional skills required for roles. “As training is critical to the implementation of digital technologies, Metro South Health has been offering its employees extensive training in the use of systems, as well as ongoing support,” he said. “We also work together with training providers and universities to ensure they are up-to-date on the latest healthcare technologies to ensure our employees of the future have the knowledge and skills we need.” Clifford also said that going digital has enabled its employees to focus on soft skills that are required for the healthcare industry. “The introduction of technology has only enhanced the patient experience, enabling our clinicians and service providers to spend less time doing paperwork and more time with patients,” he said. “You will always need that person-to-person interaction and care with healthcare; technology only enhances this. In this sense, soft skills such as communication and the ability to work as part of a high-performing team are critical capabilities in the healthcare sector.” SKILLS OF THE FUTURE Also at the recent Australian Healthcare Week in Sydney, NSW Government Health Education and Training Institute (HETI) Chief Executive Adjunct Professor Annette Solman said the future state of the healthcare workforce needs adaptive leadership that looks into the whole of health system view and data analytics. “We do need to ensure that our workforce is strong and has the right competencies and capabilities. A digital health workforce does comprise of clinical and non-clinical staff, ICT professionals, people from a range of professions, etc. They all have a critical role to play,” she said. “The roles need to focus on adaptability, creativity, teamwork and data analytics. Data analytics is driving knowledge in relation to the workforce, patient care, and capabilities of the future.” She called for the focus on skill sets that machines aren’t able to replicate. Some examples include:  People data to optimise workforce planning Maximising value of humans and machines A hyperconnected workplace reshape.  “Learning in healthcare is changing to include flexibility and blended learning. The three capabilities in demand are higher cognitive skills, social and emotional skills, as well as technological skills. The reason for that is to take people out of the traditional ways of thinking,” she said. “How we identify the future skills of the digital workforce builds our organisations. We need a continuous mindset of continuous learning and upskilling. We need to be across new technologies, emerging ideas, what patients want and what clinicians are experiencing.” PREPARING FOR AN AUTOMATED FUTURE UiPath ANZ Technical Director Luke Kelly said with Robotic Process Automation (RPA) infiltrating healthcare, an ‘Automation First’ era – an era where there will be one robot for every person – will be upon us. “For healthcare, this creates the need to recruit talent that understands not only digital requirements but also automation, RPA and how to best identify the processes fit for applying automation whether in an attended (human in the loop) or unattended context,” he said. However, this doesn’t mean that robots will be taking over humans’ jobs, according to Kelly. “Despite the fear mongering around robots and AI taking jobs, the future economy still requires professions, and every professional need to be digital literate. That literacy needs to expand to robotic literacy,” he said. The key to working amongst robots is to ensure that the machines take care of repetitive tasks, Kelly mentioned. “All those mundane repetitive actions are tasks that a robotic assistant can take care of, while the health care professional can put their considerable education and experience to good use to make a real difference, without being out of a job,” he said. “This has the power to increase efficiency and productivity, but more importantly accuracy. Incorrect data can cause major risks and issues for healthcare providers and patients alike. “An advantage of RPA is a digital workforce doesn’t get fatigued, distracted, or misunderstood, which leaves the human workforce to focus on what they’re good at – saving lives. Healthcare practitioners also have more time to work on value-added tasks that require more creativity and critical thinking.” [Read more: Does the Federal Budget lack funding to modernise Australia's healthcare sector? | What does the new Secure Cloud Strategy mean for healthcare?] With much of the repetitive work automated, Kelly said junior employees will be able to learn more skills earlier in their careers, such as analysis, consulting and evaluating. “Industry 4.0 doesn’t need more coders, it needs robot trainers. Organisations need to upskill their current workforce to thrive in this ‘Automation First’-era and improve digital literacy,” he said. “It’s surprisingly easy to learn to program or ‘train’ robots, meaning that anyone at any level can begin learning about RPA.”

Compliance audits dictate that healthcare institutions have complex needs when it comes to managing staff capabilities and related training as a result of critical systems implementation and National Safety and Quality Health Service standards (NSQHS) management. This means that Learning Management Systems (LMSs) are becoming increasingly important as is their quality and functional richness. The maturation of more robust and flexible educational technology standards, such as learning records management ‘Experience API (xAPI)’, also means institutions need to implement modern LMS that are being developed alongside the latest technologies. But, deploying an LMS can be daunting, especially for learning and development teams that are already facing work overloads. However, this can be simplified by: Assembling a representative, internal stakeholder group drawing from all the craft groups and key business units. Use them in the evaluation and keep them engaged in a governance role after deployment. Make them champions supporting the system internally. Choosing a good LMS, which should have strong standards support (SCORM, IMS, QTI, LTI and xAPI) and have a clear track record in healthcare and its problem space and a vector of ongoing development to keep up with trends in ICT. Choosing a good Ed Tech partner: There are specialist firms, usually with SaaS offerings. Look at their track record in healthcare and talk to clients about them. Look for one that offers close partnerships and expertise in the deployment and configuration of the LMS, and is not just a hosting service. Check their reputation for ongoing support. Planning out the project: Lean on your Ed tech partner for this as they would have done it over and over. Be sure to include a change management plan. Keep the project lean and don’t overcook it. An LMS deployment is not as complex as an EMR or Property Management System (PMS) one. Integrating HRIS and Single Sign Ons for process automation and change management. Automating key processes such as enrolment in mandatory training by job role. Focusing on the user: Ensure each type of user receives user experiences focused on their needs and make it as simple as possible.  Cooperating as a community of practice: Form a community with other institutions using the software to share ideas, resources and lobby. IMPROVED PROCESSES THOUGH INTEGRATION AND AI-STYLE AUTOMATION Hospitals such as Austin Health and Eastern Health have all created detailed user data integrations between their Human Resources Information Systems (HRIS), as well as their LMS and Single Sign On with identity management systems. The Single Sign On makes access to LMS easy for the user, but HRIS integration is key. The rich metadata on users such as their job roles, business units, associated cost centre data, their managers, their leave status, etc. all contribute for use in the LMS’ AI-style rules engine. For example, a ward nurse will have a set of key compliance training courses to do, such as basic life support. A nurse working in ICU will have others such as advanced life support. These rules can all be mapped into the LMS rules engine. As staff join the hospital workforce or move between roles, the relevant rights training will appear for them on the system. It will also make the difficult process of managing NSQHS compliance easier as the AI rules can be mapped to the NSQHS framework to ensure the right staff are trained in the right things and that reports track and demonstrate this achievement. COOPERATE: COMMUNITIES OF PRACTICE The LMS, once installed and configured, is like a living organism inside the institution’s ecosystem and needs ongoing nurture and governance. This is frequently overlooked, affecting the ROI expected from the investment. One way to keep that nurtured is to cooperate with other institutions using the software. For example, Austin Health and Eastern Health, along with other hospitals such as Royal Adelaide and Goulburn Valley are all members of the Totara Health User Group. This group meets every two months to share ideas and pursue strategic threads of interest. For example, a common pain point has been in the transfer of health professionals from one hospital to another. The group’s members have initiated an R&D project funded at a network and government level to use the modern xAPI Ed Tech standard and switchboard key compliance training records between their LMSs automatically. This has done away with the shoeboxes of printed certificates and time wasting of manual record keeping, letting the professionals focus on the important business of saving lives.   Alexander Roche is the Founder and Principal Educational Technologist for online learning infrastructure and services company, Androgogic.