For a recent HTN interview, we caught up with Michael Wornow, a computer science PhD student at Stanford University to discuss some of his most recent projects, including his involvement with research on Advancing Responsible Healthcare AI with Longitudinal EHR Datasets.

Michael began by introducing himself as a PhD candidate currently in his 5th year, working on developing and operationalising AI models in healthcare under Dr. Nigam H. Shah (professor of medicine) and Dr. Chris Ré (professor of computer science).

He first highlighted key areas of their research, stating, “we’ve been very focused on not just making advancements on the methods side of things, but also thinking about practical deployment considerations, developing more rigorous evaluation frameworks, and publishing our research to make it more accessible”. Diving deeper into his own personal work, Michael shared how he has focused on “developing machine learning systems to improve how hospitals operate,” by using electronic health record (EHR) data.

He noted the two main threads underlying his research were: (1) how to improve the individual point decisions that clinicians make within larger workflows, and (2) how to understand and automate the larger end-to-end workflows that these decisions are a part of. When outlining the overall motivation, he narrowed it down to one core question: “How do we use AI to improve care delivery?”

The foundation model approach 

To explain the background of his research, Michael told us a bit about the “foundation model” approach to machine learning, where instead of training many task-specific models that are each specifically designed for one narrow task, you train “one big model on tons of unlabelled data” and then use that one foundational model to complete a variety of “downstream tasks”. Giving an example of this, he noted ChatGPT as “one of the most successful foundation models”.

When relating the foundation model approach to his research, Michael went on to say, “when our lab started this work several years ago, we hadn’t quite seen that translation to the EHR domain. So, one of the first questions we asked ourselves was, how well does this approach transfer to the clinical setting? And to better understand that, we needed more rigorous benchmarks.” Michael continued that, “Unfortunately, there’s only a handful of public datasets available to researchers. So, if you’re not attached to a large hospital like Stanford, it’s very hard to curate the scale of data necessary for training and evaluation.”

Even for those like Michael who are fortunate enough to rely on the data from a hospital, there are still issues to contend with, as he noted, “the data can be very messy and is not typically standardised across papers. Not only does that make it impossible to do science in the strict sense of being able to replicate findings, but it also makes it very difficult for people to build on each other’s work, which slows down progress.”

Michael compared the accessibility of pretrained models in healthcare to more general-purpose models like BERT or Llama, noting how they “will have millions and millions of downloads, since virtually anyone can work off these models and fine-tune them for their own use cases.” However, Michael noted that the same thing didn’t exist for healthcare “even though we know that foundation models are great and we’ve seen strong initial successes with them in the healthcare domain.”

Given these potential benefits, the question facing the team boiled down to, “Can we enable more open and reproducible science around foundation models trained on EHR data by publicly releasing better datasets, benchmarks, and models?”

Advancing responsible healthcare AI with longitudinal EHR datasets

To answer this question, Dr. Shah’s team released three different benchmarks and datatsets over the past year: EHRSHOT, INSPECT and MedAlign.

EHRSHOT explored how to model the “structured information within the EHRs of roughly 7,000 deidentified patient records,” Michael said. The dataset covers information such as procedure codes, diagnoses, lab orders, and more. Michael explained that “the most unique aspect of EHRSHOT is its longitudinal data, i.e. it covers the full health history of a patient (potentially over decades) rather than just being restricted to an ICU or ED visit like other public datasets such as MIMIC and eICU.” This was important because “some of the tasks we were looking at only made sense in a longitudinal setting”.

INSPECT was led by other students in Dr. Shah’s lab – namely, Zepeng Huo, Shih-Cheng Huang, and Ethan Steinberg – and focused on the multimodal nature of healthcare data. “EHRSHOT is focused on structured information like billing and procedure codes. However, INSPECT also contains images and text linked to the same patient”, Michael said. The third dataset was MedAlign, which was led by Scott Fleming and focused on text-based clinical tasks.

In addition to the data contained within these benchmarks, Michael highlighted how the team has also trained their own foundation models from scratch on “roughly two and a half million deidentified patient records at Stanford Hospital.” The team has publicly released ~20 EHR foundation models on HuggingFace, a community platform for AI researchers, “making it available for approved researchers to download and fine-tune our model for their own projects.”

Key findings and successes from the research study 

When asked about key findings from the research, Michael said that creating the foundation models and “putting them on Hugging Face” was one of the most important aspects of the work, as it will “hopefully encourage more sharing of trained models amongst healthcare researchers.” He added that “getting more raw data out there was also important” because almost everyone currently works off the same one or two public EHR datasets. He noted that this “makes it difficult for the field to learn generalisable, reproducible lessons, as the vast majority of research over the past decade is essentially based on one dataset of roughly 40,000 ICU patients from a single hospital in Boston”.

Michael emphasised that developing new datasets is not easy, noting how “it took about a year and half” and a “heroic amount of work by Nigam and Jason Fries, a research scientist in our lab, who both put a ton of effort into pulling together all of the papers, codebases, and stakeholders” for the team to publish their datasets. Ultimately, however, it was “worth it from the positive feedback we’ve gotten from a ton of people interested in this sort of data”. He added that “because of Jason’s and Nigam’s efforts, it will hopefully be easier for future dataset releases at Stanford as well.”

Looking ahead: the future of research in this area

When asked where this type of research will be in the next 5-10 years, Michael predicted that “AI models will be so good that it will be irresponsible for doctors not to use them.”

He went on to describe how these technologies could also help solve issues in healthcare inequality and accessibility, outlining how “many people don’t have access to a doctor, and even among those that do, there can be huge variation in outcomes. Infinitely scalable AI models trained on huge corpuses of medical knowledge can help level that playing field and give everyone access to state-of-the-art care.”

Lastly, he mentioned a recent effort towards fostering more cross-institutional collaborations to “create better standards for the deep learning for healthcare community” across evaluations, models, methods and frameworks. Michael highlighted the working group he’s been involved with called MEDS (Medical Event Data Standard), led by Matthew McDermott, professor at Columbia University, which encourages collaboration from across the globe to facilitate a standardised approach to machine learning for healthcare.

Other key areas of research

Finally, Michael spoke to us about other research areas and projects that he’s been working on, including the use of large language models to accelerate the process of finding eligible patients for clinical trials. He said this could help reduce the need for clinical research co-ordinators to “scroll through every patient record one-by-one and manually check them against a list of forty to fifty eligibility criteria.” Instead, using an LLM, “we can do that in seconds at high accuracy.”

Michael has also been looking at automating administrative workflows within the hospital. He highlighted some work on automating basic workflows in Epic and outlined a vision for reducing the manual burden on clinicians “so that instead of the nurses running back and forth between the patient bed and their desk to place an order, they could just click a button and the computer would be able to automatically place the order for them”.

When closing our discussion, Michael shared some insights on what excites him most about the future of this research area. “When you sit in the computer science building here at Stanford, you can literally see the future being invented around you,” he said. “The hospital sits right across the street. Despite being so close geographically, however, there remains a large gap when it comes to technology. Bridging this gap is what really excites me.”

Reflecting on their dataset releases, Michael added. “I’ve been fortunate to collaborate with some of the most talented people in the space during my PhD. However, there’s still a lot of work to be done. I hope that these dataset and model releases encourage more smart folks to work in the space, and that these resources help to foster the development of a larger community around open and reproducible deep learning for healthcare.”

We’d like to thank Michael for taking the time to talk to us. Find out more about his research here.

Google has announced a partnership with the Institute of Women’s Cancers, with the aim to find ways in which AI tools can help “improve outcomes” for female patients with breast cancer and gynaecological cancers.

Formed at the France AI Action Summit, the partnership aims to develop an understanding of how AI can “help better address cancer” with research focusing on the role of AI tools when predicting the progression of cancer and any potential risks of relapse. Other areas of focus include utilising their combined expertise for the “identification of new biomarkers that can predict which patients will benefit from specific therapies” and exploring the “origins of tumours, their evolution over time and the specific characteristics of rarer and more complex cancers”.

To help support this, Google is reportedly investing more than $2 million in funding to French research university, Université PSL to “accelerate applied AI scientific research”, as well as offering AI skills training for staff at the Institute of Women’s Cancers and research and treatment centre, Institut Curie.

Speaking on this new partnership, Anne Vincent-Salomon, director of the Institute of Women’s Cancers commented: “Combining our expertise in research with Google’s advanced technological capabilities offers hope for significant advancements in our mission to improve our understanding and prediction of cancer’s progression, and develop more effective treatments.”

Earlier this month, Google revealed the latest 16 companies selected for its 2025 Google for Startups Growth Academy: AI for Cybersecurity program. Each company is said to receive training from Google to help them learn how to appropriately scale their AI-powered solutions. The academy is to take place in Warsaw over a one-year period, starting on 26 March, with Google providing “personalised workshops and mentoring sessions” which will reportedly include insights from AI and cybersecurity experts. Learn more about the 16 companies benefiting from this project.

AI in healthcare: the wider trend 

One of our most recent polls indicated that the majority of healthcare professionals (41 percent) see support for safe adoption as the main barrier to responsible AI. Inadequate regulation received 25 percent of the vote, with lack of evidence and evaluation receiving 22 percent and data and data bias receiving 13 percent.

The University Hospitals of Leicester NHS Trust and University Hospitals of Northamptonshire NHS Trust Group recently joined a European network for responsible AI, where members focus on improving the quality, safety, and trustworthiness of AI in healthcare.

Our latest HTN Now webinar, supported by Restore Information Management, focused on the practicalities of AI technologies, including implementation, adoption, the role of data and best practices. We also took a closer look at examples of AI in health and care and how to deal with risk and regulation around AI implementation.

Stay informed about AI and data in healthcare with all the latest news from HTN, including expert interviews and insightful panel discussions.

Apple has partnered with Brigham and Women’s Hospital in Boston, to launch a “major” longitudinal study via its Research app to assess health data gained from Apple devices, as well as third-party tech.

According to Apple, this is said to help explore the ways in which different areas of health may connect, “such as mental health’s impact on heart rate, or how sleep can influence exercise”, while also looking at how this technology “can be used to predict, detect, monitor, and manage” any changes in health.

The Apple Health Study will reportedly cover a range of areas, including activity, ageing, cardiovascular health, circulatory health, cognition, hearing, menstrual health, mental health, metabolic health, mobility, neurologic health, respiratory health, and sleep. Apple notes how they aim to build on key learnings found in their previous three studies: the Apple Women’s Health Study, the Apple Hearing Study and the Apple Heart and Movement Study, which allowed them to capture data from 350,000 individuals.

Calum MacRae, M.D., Ph.D., a cardiologist, professor of medicine at Harvard Medical School, and principal investigator of the Apple Health Study at Brigham and Women’s Hospital spoke on this new research: “We’ve only just begun to scratch the surface of how technology can improve our understanding of human health. We are excited to be part of the Apple Health Study, as it will continue to explore connections across different areas of health using technology that so many people carry with them every day.”

The company added that the study aims to identify insights for future product development, particularly how a change in health can “affect one or more parts of the body, and others may affect wellbeing overall”. With the overall the aim of the study, to progress towards a more proactive approach to health.

Digital healthcare research and data: the wider trend 

The STANDING Together research project, published in The Lancet Digital Health, included more than 350 experts from 58 countries, allowing input from a range of international experts on 29 consensus recommendations. The project produced a series of recommendations to help ensure inclusivity in datasets used to train medical AI systems, allowing “everyone in society to benefit from technologies which are safe and effective”.

From our own research, a recent poll on our LinkedIn page shows that 41 percent of our audience believes support for safe adoption is the main barrier to responsible AI in healthcare. A further 25 percent said it was inadequate regulation adoption, 22 percent said lack of evidence and evaluation, and 13 percent said data and data bias.

An expert panel including Deborah El-Sayed, director of transformation and CDIO at Bristol, North Somerset and South Gloucestershire ICB; Dan Bunstone, clinical director at Warrington ICB; Stephen Bromhall, interim chief officer for digital and data at South East Coast Ambulance Service; and Laura Thompson, director of marketing at The Access Group, joined us late last year to talk about approaches to tackling challenges from an ICS perspective; new models of care and pathway transformation; the role of technology in supporting the move from reactive to proactive care; and how a system approach can accelerate preventative care.

A partnership between University Hospital Southampton and TRL is reportedly aiming to reduce road deaths by linking health records and road traffic collision data. It forms part of the wider Pre-hospital Research and Audit Network (PRANA), which links data from ambulances, police, the Department for Transport, and coroners, as well as emergency care, intensive care, trauma, and rehabilitation registries.

Welcome to HTN’s international news in brief, where we round up some of the health tech headlines to have caught our eye from around the world over the last couple of weeks.

Sarasota Memorial invests $160 million in new EHR

Sarasota Memorial Health Care System announced at the end of November that it would be replacing its current EHR system with Epic’s “single, integrated platform” at the cost of $160 million, with hopes that the new system will replace “numerous standalone and ancillary systems” over the next two years.

David Verinder, Sarasota Memorial’s CEO, called the investment “a significant step” toward ensuring patient care both now and in the future, saying, “we look forward to the many benefits the nationally recognised system will bring to our patients and medical teams managing their care”.

The implementation will also see the roll-out of the My Chart patient portal, which will enable patients to access their health records and “securely exchange information with their care teams”.

Health NZ shares plans to “significantly reduce” digital roles

Health NZ has shared plans to “significantly reduce” digital roles, with emails sent out last week to those affected. The health service stated that the restructuring is “part of a drive to save $100 million per year from the data and digital budget”.

The announcement outlines the move as part of a wider effort to redirect available funds and resources to the frontline. This latest development follows news that $380 million initially outlined for digital and data functions had been recalled by the 2024 budget.

Italy and the UNDP launch Digital Flagship with Africa initiative 

The United Nations Development Programme (UNDP) has announced the launch of the Italian government’s Digital Flagship with Africa initiative, focusing on supporting digital transformation in “key sectors” including health and education across the Côte d’Ivoire, Ghana, Mozambique and Senegal.

A primary goal of the initiative is around accelerating digital transformation across the African continent, with Ursula Owusu-Ekuful, minister for communications at Ghana’s Ministry of Communications and Digitalisation, speaking of hopes it will “foster a more inclusive society that benefits all citizens” and “catalyse digital solutions in agriculture, health and education, while bridging the urban–rural divide”.

Construction of National Digital Health Center underway in Togo

The construction of a new National Digital Health Center is officially underway in Togo, following a ceremony to lay its foundation stone.

The center will focus on three “major health challenges”, including maternal and child health, non-communicable and tropical diseases, and epidemic and pandemic management. It will ultimately play a role in helping to ensure “effective operational governance of digitisation activities in the health sector”, such as tele-ultrasound, distance learning, and remote consultations.

The project is financially supported by UNDP Togo, and is estimated to cost around $2 million USD. Mrs Binta Sanneh, resident representative UNDP Togo, noted that the construction will help realise the “shared ambition” to “sustainably address the problem of Universal Health Coverage (UHC) through the use of digital technology”.

WHO and KSA expand Hajj health card initiative to support millions undertaking holy pilgrimage

The World Health Organization and the Kingdom of Saudi Arabia have expanded the Hajj health card initiative to support “roughly 3 million pilgrims who undertake the holy pilgrimage every year”.

The health card includes health information, medication needs, and pre-existing conditions, allowing those making the pilgrimage to offer access to their “accurate, up-to-date patient summary information” for healthcare providers.

The WHO shares that further collaboration has been agreed with KSA to expand upon the successful pilot, with “expertise and support from the Saudi government and their digital implementing partner LEAN” offering help around data security and technical issues to those countries joining the initiative.

Unity Health Toronto goes live with new EPR

Unity Health Toronto has gone live with its new Epic EPR, “the largest clinical transformation project in Unity Health history”, following a two-year project focusing on bringing the health system together “as a better connected organisation”.

Prior to the go-live, three of Unity’s hospital sites had their own electronic or paper-based systems, with the move to one EPR system hoped to “improve communication, efficiency, clinical decision-making and quality of care”. The MyChart patient portal was released simultaneously, allowing patients to manage their health journey, view health records, retrieve test results, and more.

The decision to work with Epic on the new EPR followed “a robust engagement and procurement process”, according to Unity Health’s announcement, which also highlights the ability to configure offered by Epic, and the potential of this to help the health system “boost it artificial intelligence (AI) efforts” and “more easily roll out various AI tools across its sites”.

For a recent interview, we caught up with Dr Nojus Saad, president and CEO of the Youth For Women Foundation, France, and MENA digital healthcare researcher and ambassador. Nojus shared his experiences in digital healthcare spanning countries including France, Iraq, and India.

As a medical doctor with an MBChB (Bachelor of Medicine, Bachelor of Surgery) and a multidisciplinary background in digital health, Nojus explained that he has several years’ worth of experience in “multinational research, policy development, and social entrepreneurial expertise around digital healthcare, gender justice, and healthcare innovation; with a particular entrepreneurial and research interest in AI and Machine Learning, mHealth, and the internet of medical things”.

Digital experiences to date

Nojus’s experiences to date are varied and include founding the Youth for Women Foundation in 2018, now headquartered in Gif-sur-Yvette, France. The aim was to “to empower women and young people against the widespread gender-based violence and femicide in the rural and semi-urban communities of Iraq”, with digital access and literacy incorporated into the foundation’s projects “as the primary enablers of health education and empowerment for disadvantaged women and young people”. Numerous projects in this space have positively impacted the lives of “over 6,100 women, adolescents and young adults,” Nojus said, “in over 70 rural, semi-urban, refugee and vulnerable communities of Iraq, India and France”. This has taken the form of health promotion training, community-based research programmes, and national advocacy campaigns for policy reform.

In 2020, Nojus joined the Internet Society as the United Nations Youth Ambassador of the global UN Internet Governance Forum. He served as a Digital Policy Fellow at the Internet Corporation for Assigned Names and Numbers, co-developing and reforming global technical policies of the Internet’s DNS for a healthier, more inclusive and interconnected Internet for all.

Other experiences include working periodically with the International Telecommunications Union as an ambassador of the Generation Connect initiative, advocating for healthcare-inclusive digital solutions in the Western Asia and Northern Africa region; and working with Bond UK as an expert advisor on locally-led development. This role involved consulting with the UK government’s Foreign, Commonwealth and Development Office and the international development sector “on investments around rural research and artificial intelligence opportunities for international non-governmental organisations,” Nojus explained, “particularly focusing on healthcare transformation of rural and vulnerable communities of the Global South.”

Recent digital projects

Moving on to discuss more recent digital projects, Nojus shared how this year he was invited to join an executive programme on politics and diplomacy for health in Sweden, hosted by the Stockholm School of Economics and Karolinska Institutet.

“My research case study analysed the role of diplomatic relations in driving international collaborations on Al research and development for health equity and innovation in the Global South, with a specific focus on promoting knowledge sharing, youth-led social entrepreneurship, and health technology transfer,” he explained.

Nojus also recently helped to judge the 4HERPOWER Global Innovation Challenge at MIT Solve, a scheme supporting and investing in youth-led digital health solutions for advancing the sexual and reproductive health of Global South countries. Winners received a funding prize of $280,000 along with six months of technical support programming from MIT faculty and professionals.

In late 2024 and into 2025, Nojus told us that he and his team are planning to establish a telehealth hub “in one of the largest regional hospitals in Iraq”, to promote access to quality healthcare and consultation services from healthcare providers around the world.

Developing a blueprint for a digital-first health system

Nojus is a regional ambassador and a researcher on the Digital Transformations for Health Lab (DTH-Lab) in Geneva, which he described as a global consortium of partners working to drive implementation of a series of digital transformation recommendations made through ‘The Lancet and Financial Times Commission on Governing Health Futures 2030: growing up in a digital world’. We asked Nojus to share insights into his work in this space, particularly what the blueprint for digital-first health systems might look like.

Nojus described how he has been working on establishing and promoting the adoption of the blueprint, which aims to ensure that systems are co-designed and governed by young people; responsive to health needs; and strengthen digital health citizenship.

“I’ve also been supporting the implementation of a framework for governing health futures that provides governments, technology companies and various stakeholders with guidance on how to build a trusted and inclusive governance architecture,” he added, “based on data solidarity and Health for All values”. The blueprint is due to be launched in late 2025.

“In the first phase, we have recently launched the global interim report, ‘Building a blueprint for digital first health systems: Findings from Global Youth Consultations‘. This was the culmination of six global consultations with young people over a year and a half. In addition to the report, a collection of youth-authored essays was published as a partnering document to showcase key concerns from some of the DTH-Lab Regional Youth Champions.”

What has this research highlighted about the digital determinants of health?

“At the DTH-Lab, I’m helping to establish a sustainable platform for engaging multiple diverse stakeholders in the healthcare space to take coordinated actions to address the digital determinants of health; especially digital health literacy. We’re aiming to better understand the context of the major societal and structural changes that digital transformation embodies.”

At present the Lab is working on bringing together academics and practitioners from different disciplines, with the aim of developing a “conceptual framework for the digital determinants of health to guide policy action and future research priorities in the EU and internationally,” Nojus shared. “We are also generating new knowledge and evidence on how digital determinants intersect with other determinants to impact health and well-being and why they ultimately require new forms of governance.”

To address critical evidence gaps, the DTH-Lab is partnering with organisations in India and Nigeria to study young people’s experiences of digital determinants in different contexts.

Offering an example of a national project that the Youth For Women Foundation has delivered, Nojus shared some insight into the Digital Health Literacy Program in Iraq, which focuses on building digital skills and literacy across 15 civil society organisations and more than 75 young people. An example of a project here has seen the Lab encourage the programme to organise social media awareness campaigns for combating disinformation around COVID-19, which Nojus said has reached “hundreds of women and young people online, across Iraq.”

Adolescent digital health

In terms of his work on adolescent digital health, Nojus said that as well as contributing to the field of digital inclusion in adolescent healthcare by working with the World Health Organisation, he has also been working with The Lancet as a research peer reviewer in the Second Lancet Commission on Adolescent Health and Wellbeing, “aimed explicitly at contributing to the UN Summit of the Future in 2024″.

During the 2023 Commission Meeting in Cape Town, South Africa, Nojus put forward “significant insights on digital and commercial determinants of adolescent health, emphasising entrepreneurship and digital health innovation.” In this, he sought to foster a strong multi-disciplinary basis for an upcoming research report, scheduled for publication later this year.

At the Partnership for Maternal, Newborn and Child Health’s Global Forum For Adolescents, Nojus co-organised a workshop on embracing sexual and gender diversity in sexual and reproductive health and research. This aimed to explore how social media and digital technologies can positively transform mental healthcare for LGBTQIA+ adolescents and youth, worldwide.

Finally, Nojus shared how he had the opportunity to “champion Australian investments in adolescent mental healthcare, particularly through mobile health services, for young people in the rural and vulnerable communities of the MENA region”, as part of an advocacy fellowship at Orygen Global in Australia.

Experiences in other countries: France, Iraq and India 

We asked Nojus what he has learned about the state of digital health internationally through his career so far, as well as his thoughts on how France is performing in comparison to peers.

“The landscape of digital health reveals vast disparities that are shaped by various factors,” Nojus reflected. “First, adoption rates vary significantly, particularly between urban and rural/semi-urban areas. Major digital health technologies are predominantly concentrated in capital cities and large urban centres, significantly limiting access for rural populations.”

Nojus considered that regulatory frameworks play “a crucial role” in national digital health journeys, saying: “France exemplifies stringent data privacy laws (GDPR), and while this ensures security, they are also slowing down innovation. In contrast, Iraq and India are navigating evolving regulations that impact implementation and scaling of digital health solutions.”

Infrastructure is another challenge, Nojus continued, “especially in countries like Iraq, where conflicts have strained healthcare infrastructure. Limited internet connectivity and power shortages further hinder digital health adoption, particularly in remote regions.”

An issue that Nojus’s work has highlighted is that marginalised communities, including refugees, women, LGBTQI+, impoverished, disabled, and elderly populations, “face the greatest challenges in accessing digital health services”. Therefore, he emphasised that “overcoming digital illiteracy, language barriers, lack of awareness, and affordability issues are critical for ensuring inclusivity.”

Looking to recent technological innovations, such as AI-driven diagnostics, wearable health devices, and blockchain-enabled health records, Nojus noted that they have “the potential to transform healthcare delivery”. However, he said, “Trust remains an indispensable factor influenced by cultural norms and socioeconomic conditions. Building trust through community engagement and culturally sensitive approaches is essential for successful adoption.”

Nojus is a “huge advocate for investing in healthcare entrepreneurship, since it plays a significant role in driving innovation and addressing healthcare gaps. There must be substantially more investment opportunities for young entrepreneurs to deliver digital health solutions tailored to local needs, especially in expanding access to marginalised communities.”

Medical education can also play a part in this, Nojus continued, as it “must increasingly integrate digital healthcare to prepare future healthcare professionals for telemedicine, digital diagnostics, and data-driven decision-making, ensuring they are equipped to leverage technology effectively”.

Focusing on France, Nojus said: “The landscape of digital health adoption is rapidly evolving, fuelled by recent advancements that underscore the country’s continued commitment to healthcare innovation. A notable accomplishment is the nationwide rollout of the Dossier Médical Partagé system in 2018, an electronic health record platform which has profoundly impacted patient care by facilitating seamless access to medical records across healthcare providers, greatly enhancing care coordination and patient safety.”

Progress in interoperability and data sharing has been equally impressive, he said, “driven by initiatives spearheaded by the Digital Health Agency, which have not only ensured secure and efficient exchange of health information among healthcare professionals, but also bolstered informed decision-making and improved treatment outcomes.”

Telemedicine has emerged as a “transformative tool”, Nojus added, particularly in response to the COVID-19 pandemic. France “swiftly adapted regulations to enable widespread adoption of remote consultations, extending beyond primary care to encompass specialised services such as mental health and chronic disease management. The integration of telemedicine solutions under the Digital Health Roadmap 2023-2027 has significantly broadened access to healthcare services, particularly benefiting underserved populations and remote areas.”

Nojus also highlighted the Digital Health Strategy for 2023-2027, which outlines “ambitious objectives across four strategic pillars: prevention, patient care, access to healthcare, and fostering a supportive environment for digital innovation”, and “to empower individuals in managing their health, optimise healthcare delivery through digital tools, and cultivate an atmosphere conducive to technological breakthroughs”.

He also noted that tehnologies such as AI-driven diagnostics and mobile health applications “are revolutionising clinical practices and enhancing patient engagement… AI, for example, enhances diagnostic precision and tailors treatment plans to individual needs, while mHealth apps empower patients to monitor their health remotely, promoting proactive healthcare management.”

Nojus stated that he “firmly believes” that France’s holistic approach to digital health “harmonises stringent regulatory standards with pioneering technological advancements” and said that this “synergy fosters a healthcare ecosystem that places paramount importance on patient-centric care, equitable healthcare access, and continuous innovation.” Ultimately, “such steadfast dedication positions France at the forefront of global healthcare transformation, driving tangible enhancements in healthcare delivery and patient outcomes.”

Looking to the future

Finally, we asked Nojus for his thoughts on the biggest challenges for the advancement of digital health in France, and what he would like to see in this space over the next five to 10 years.

“Navigating the regulatory landscape in France’s digital health sector can feel like a complex puzzle,” Nojus acknowledged. “While stringent rules protect patient data and ensure safety, meeting compliance requirements demands considerable time and resources, which can be daunting for both startups and established companies aiming to introduce new technologies swiftly.”

Interoperability presents another major hurdle, according to Nojus, as “each healthcare provider operates with its own IT systems and data formats, complicating the seamless sharing of patient information. This fragmentation slows down care coordination and makes it difficult for healthcare professionals to access comprehensive patient data efficiently.”

Driving digital adoption in hospitals and clinics encounters resistance “due to the old ways of thinking”, and “since many healthcare facilities still rely on traditional pen-and-paper methods, there is reluctance to transition to digital solutions. Convincing skeptics that digital technologies can enhance patient care and streamline workflows requires persistent effort and evidence-based research.”

The digital divide is “evident”, he continued, especially in rural and underserved areas, and addressing these disparities is “essential to ensure equitable healthcare access for all individuals, regardless of their background or location.”

Equipping healthcare professionals with the necessary skills to navigate this digital landscape is also crucial, he said, and “continuous training and education programs are essential to empower them to use digital health tools effectively”.

Overall, he called for a balanced approach that involves fostering collaboration, streamlining regulatory processes where feasible, and incentivising innovation in digital health. “By adopting a more flexible strategy and making strategic investments, France can harness the full potential of technology to transform healthcare delivery and enhance patient care across the country.”

Looking ahead, Nojus shared his excitement for some of the transformations in digital health that he considers “could redefine healthcare globally”, including digital-first health systems in the global health which could potentially overcome longstanding barriers to access; people-centric and youth-centric healthcare, where healthcare “adapts to individual needs and preferences, making it more responsive, engaging, and proactive in promoting lifelong health”; and the integration of AI and machine learning. He also acknowledged the potential around VR and AR technologies for personalised therapies and interactive health interventions; and enhanced interoperability and international healthcare systems featuring the seamless sharing of data across borders.

“In realising these visions, I believe that fostering innovation, ensuring equitable access, and maintaining ethical standards will be essential keys. By embracing these possibilities, we can pave the way for a future where technology enhances human connection and transforms healthcare experiences for the better.”

We’d like to thank Nojus for sharing his insights and experience with us in the international digital health space.

The European Commission has announced that AI Act, a legal framework seeking to address the risks of AI in Europe by setting out clear requirements and obligations in support of “trustworthy AI”, has officially entered into force.

Designed to address risks with AI systems that could lead to “undesirable outcomes”, the Act includes provisions to help mitigate risks created by AI applications; to ban AI practices that pose “unacceptable risks”; to set out clear obligations for both deployers and providers of AI applications deemed to be high risk; and to put in place enforcement and a governance structure at both European and national level.

Under the Act, high risk AI systems include those relating to critical infrastructures which could “put the life and health of citizens at risk”, and those linked to the safety components of products, such as an AI application in robot-assisted surgery. The Act will see these kinds of systems subjected to strict obligations prior to their launch on the market, which cover appropriate human oversight to mitigate risk, detailed information to allow an assessment of compliance, and high quality datasets.

The European AI Office, which was established earlier this year, will be responsible for the Act’s enforcement and implementation within member states, fostering collaboration, innovation, and research in AI.

Artificial intelligence in healthcare: the wider trend

Tomorrow (6 August) HTN is hosting a virtual panel discussion asking whether the reality of AI in healthcare lives up to the hype, along with how to manage bias in healthcare data. Join us at 10am – 11am to listen to panellists discuss what is needed to manage bias, what counts as responsible AI, how to ensure AI is inclusive and equitable, and more. Register for your free NHS ticket here.

In July we reported on the news that global healthcare AI company Huma Therapeutic Limited completed a Series D funding round with financing of over $80 million and launched the Huma Cloud Platform, designed to help accelerate the adoption of digital and AI across care and research.

We also covered how a team from the University of Huddersfield is working on the development of a secure threat intelligence sharing platform, with the aim of helping to protect AI-enabled diagnostic tools from cyber attacks.

And HTN highlighted the partnership between Leeds Teaching Hospitals NHS Trust and health tech startup Newton’s Tree which will see the startup’s enterprise AI platform deployed across the trust, to support Leeds in rapidly scaling its ability to evaluate AI applications.

Digital healthcare in Europe

Over on our sister site HTN International, we’ve been sharing plenty of news and updates on health tech across Europe.

We highlighted how Nordic-based tech company Tietoevry has successfully bid for contract from a large Swedish university hospital with its openEHR solution; that the Ministry of Health in the Netherlands issued a tender for the procurement of a platform, services and infection disease control system worth an estimated €100 million; and that Spanish digital healthcare company Mediktor acquired San Franciso-based Sensely, provider of an “empathy-driven” conversation platform designed to support hospital systems and insurance services.

Don’t forget to check out HTN International for insights and interviews on digital healthcare on an international level, from Europe and beyond.

UnitedHealth Group confirmed a threat actor gained access to its tech division Change Healthcare last month, which supports pharmacies and hospitals across the US. The company updated the market yesterday to note that it expects to restore Change Healthcare’s systems by mid-March.

We recently sat down for a chat with Ricardo Baptista Leite about the potential and considerations for artificial intelligence, key learnings from his career and his thoughts on the digital health landscape in Portugal.

Along with his background as a medical doctor, Ricardo has experience in a number of settings including his current roles as CEO at HealthAI, global agency for responsible AI and health; founder and president of the UNITE Parliamentarians Network for Global Health; national spokesperson for health in Portugal’s Social Democratic Party; and guest lecturer at NOVA Medical School in Lisbon. 

Hi Ricardo, thanks for joining us! Can you tell us about your current role and background?

I came CEO for HealthAI in May 2023, but my first life was as a medical doctor trained in infectious diseases. I’ve served in politics as a four-term member of parliament in Portugal, I’ve been a city councillor and deputy mayor of my hometown and I’ve also had an extensive academic career ranging from global health, health politics and digital health.

In 2017 I founded a non-governmental organisation which I continue to preside over today – the UNITE Parliamentarians Network for Global Health. It is a network of current and former members of parliaments, congresses and senates from over 105 countries around the world. With the support of the World Health Organisation (WHO), our aim is to work towards science-based, evidence-driven policies for better health for all. 

HealthAI: the purpose 

We are a non-profit foundation under Swiss law, based in Geneva. Initially HealthAI was founded in 2019 under the name I-DAIR (International Digital Health and Artificial Intelligence Research Collaborative).

When I came on board, it was clear to everyone on the board and in the team that we needed to rethink our positioning as an organisation. 2019 wasn’t a long time ago, but the world has transformed since then. The pandemic saw acceleration of digital adoption and the widening of digital divides and societal gaps, but it also saw the rise of artificial intelligence from largely a research topic to a mass consumer product.

In the face of all of this transformation, HealthAI embarked on an in-depth process to speak to to governments, legislators, scientists, technologists and more, to hear viewpoints and considerations. One word kept coming up – fear. That fear was relating to AI and machine learning, and it stems from many factors, from lack of understanding of the technology to fear that the technology will take over jobs and human capacity. At the end of the day, it’s fear of the unknown.

Despite this fear, there is a lot of investment in the AI space for health in particular. But if people are fearful, whether it’s the regulators and policymakers or the citizen, this can lead to a brick wall where people don’t adopt the technology in the long run.

All this has fed into the thought process behind what HealthAI’s role is and where we fit in. We’ve designed a model in which we will end up with a global regulatory network for responsible AI in health, ensuring that each country has the tool to validate AI technologies in accordance with international standards. We’re not the ones developing those standards – that’s the remit of WHO and related organisations, and we have been working with WHO since we were founded.

Our aim is to make sure that the capacity exists in each country so that each country, with their own sovereign independence, can validate AI tools. We’re working to connect regulatory teams around the world into one global network, to allow sharing of knowledge to help accelerate the validation process safely and tackle any challenges that may arise – for example, through enabling the sharing of early warning systems to highlight issues or unintended effects. At its core, our work is about helping to ensure safe, quality, equitable and effective AI tools for all citizens when it comes to health; and it’s also about supporting investment and adoption of technology with the potential to improve health outcomes.

The potential of AI

My role at HealthAI has been a dramatic change of career for me, and that’s because I honestly believe that we now have the technology and computational capacity to embrace AI and machine learning and core related technologies, to actually transform systems and health in particular. We didn’t have that five or 10 years ago.

High-income countries have been pushing for what we call disease-driven models, in which we spend almost all of our resources reacting to diseases. The focus has been on people attending hospital when they are sick and healthcare systems trying to cure them or make them comfortable. But we know that if we address the multiple determinants of health early on and throughout life, in a consistent manner, we can transform that disease-driven model into a system that is focused on health, wellbeing and quality of life. We can lower the burden of disease on society, we can lower the demand on health systems, and we can free up resources to treat the people who inevitably will get sick.

The technology needed to do this was non-existent until very recently, and I think AI will play a very important role. We’re already seeing AI being used in many fields, with imaging probably one of the most advanced at this time given the way that it can perform analysis and detection on images. But there’s much more down the road in terms of population health, diagnosis, early detection and warnings, even prevention.

AI has a key role to play in freeing up time so that clinicians can get back into contact with their patients too. That may seem a contradiction, but I do believe that machine learning can help us re-conquer the compassion and humanisation of healthcare that we have in many ways lost. I read a study from the UK which said that 70 percent of the time, when the patient is in their GP’s office, they are looking at the back of a screen whilst the doctor is typing. We need to get that screen out of the way, we need to get back to face-to-face contact with eye contact, where doctors have the time to do a physical assessment and hold a proper conversation. Every big tech company is investing in what they call virtual scribes, which aim to collect all of the information about an interaction and process it for the electronic health record without the doctor needing to input the data themselves. There are a lot of things like this which I believe over the next few years will become standard.

The important thing is that we make sure that it is inclusive, that access is equitable. If we do that from the start – and that’s one of the advantages of being at the crest of this wave – it’s an opportunity to design this right from the start. That’s something we haven’t done with past technologies, and we need to learn our lessons from that. Ultimately, doing this will benefit everyone; because if we have a healthier population, we won’t need as many resources to treat such a high number of patients. Our healthcare workers, who are over-stretched and tired across the board, will have more time to care and will be supported to be more effective in their work.

This is the positive angle of what AI can bring to the health system – we just need to make sure that we mitigate the risks along the way.

UNITE Parliamentarians Network for Global Health: the role of digital

As a network of legislators from over 100 countries, we work with current and former policymakers. We focus on three main pillars: health as a human right, understanding the importance of strengthening health systems, and global health architecture and governance.

Digital has a presence across these three areas. The first pillar focuses around developing universal health coverage, and that involves trying to ensure access to digital in the most rural parts of the world so that people can use it to access healthcare.

For the second pillar, strengthening health systems, the role of digital is critical. As part of this work, UNITE has partnered up with Fondation Botnar (a Swiss philanthropic foundation seeking to improve health and wellbeing for young people across the world, advocating inclusion of young voices, equitable use of digital technologies, and supporting innovative programmes and research). We have created a digital health policy desk which is designed to promote good practices when it comes to policy and promotion of digital health. The initial focus is on several countries including India, Tanzania and Argentina.

It’s amazing to see the advancements that can happen just by raising awareness and building capacity. It has led to policymakers truly engaging and understanding that digital needs to be perceived not as purchasing computers and thinking that it will solve the problem, but actually using digital to make the transformation from that disease-driven model to one that focuses on prevention, quality of life and wellbeing.

Key learnings

Last year I read a book that really impacted me, called ‘Power and Progress’ (Daron Acemoglu and Simon Johnson). It looks at the evolution of technology over the last 1,000 years. The authors point out that every time a new technology has come out, the owners of that tech have said that it would change the world and enable everyone to live a better life. But most of the time, this hasn’t happened. In most cases, the technology has come out and benefitted the few rather than the many.

The few times that we have seen technology have a societal impact where even the most marginalised benefit, was when the technology was designed and deployed from the start to be fair, inclusive, equitable and accountable. These are the principles that we now transport into what we call responsible AI.

Technology is fascinating. Most of us who work in this space love it. But we need to have a very clear conscience of our history, as humanity, and how we have sometimes failed in the past. We need to make sure that we leave a better world for future generations, and to do that, we need to make sure that technology follows those principles that we call responsible. As well as making sure that they have the impact that they were designed to have, we need to make sure that there are safeguards and mechanisms in place to detect when we fail.

When I got into med school, one of the first things you learn as a medical student is primum non nocere – first, do no harm. This principle is also applicable to digital health. First, do no harm doesn’t mean avoid risk at all costs. It means mitigate all of the risk that you can and make sure that the benefits clearly outweigh the risks, just like with medicines. With medicines, there are adverse effects that we know about, that we tell patients about when we prescribe them. But we know that the vast majority will benefit from the potential good that the medicine will do, versus the minority who may experience side effects – and we make that prescription in the knowledge that the potential to benefit outweighs the harm that may occur. We need to use that kind of logic as we design new models for digital.

At HealthAI, we’ve been very much inspired by the medicines model. Before technology is deployed into a market, there should be a regulatory process, there should be an authorisation to access that market. It’s in the interest of companies too, because nobody wants to be liable of possible negative consequences of their own technology. If there are mechanisms and clear rules, it becomes easier for the companies to know what they need to comply with and how to get access to new markets. By creating a global regulatory network, we are hoping to learn from the lessons of things that perhaps weren’t done as well as they could have been with medicines regulations.

Digital health landscape in Portugal

Portugal is going through a tremendous reform in terms of its health system. We have upcoming elections so we still have to see how that will play out.

Looking back to the last decade or so, Portugal has been in the forefront in many aspects. Between 2011 and 2014 Portugal imposed a number of regulations which seem trivial now, but at the time they were quite groundbreaking. Electronic prescription of medicines was one; it is essentially the only way to get access to medicines these days in Portugal, and it was critical during the pandemic. There is home care for patients who are still under hospital care but monitored remotely via technology – we’re seeing those programmes advance a lot at the moment.

In terms of interoperability, about 15 years ago Portugal created a platform where every hospital, even if they are using their own electronic health record, can access patient data from a common cloud service.

There is some fear that a lot of the money being invested in digital, which is in the hundreds of millions of euros, is being used to update hardware. I would say that is a missed opportunity, if we are not able to use that funding, that one-shot opportunity, to make use of digital transformation to go beyond purchasing computers. We don’t just want to transform what we are doing on analogue and make it digital, we should be using that transition to reform and redesign the health system all together.

We have our own national health service in Portugal, some great past experience to build on and amazing healthcare workers. I think Portugal has the potential to do many things within its health system, but there needs to be clear vision. Let’s see what comes out of the next election.

What would be the one thing you would do, if you had the opportunity in the Portuguese health system?

I believe that if you have a role to change things in your health systems, you have to think of it from two levels. One is what we would call your emergency response – making sure that patients get access to a family doctor and that you reduce the waiting lists that are crippling health systems around the world, with Portugal no exception. For that, you need an emergency programme. But that does not solve structural problems.

The first structural thing I think Portugal needs to do is create a health data agency, where all of the health data is collected. It makes your health system much more efficient, because you are capable of following in real time the evolution of what is happening in the health system at the patient level and at the healthcare worker level, and you can perfect the system as you move forward. You can only fix what you measure and what you know.

Also, looking at the rise of technologies such as synthetic biology and precision medicine and machine learning, we know that the quality of data is going to be critical to success. It’s a question of being prepared and building that repository.

At the same time, if you want to ensure early access to the best treatments for patients in your country, then having a health data agency makes it much easier for clinical trials for example.

These are just some examples of how such an approach would put Portugal in the vanguard. Having a national health service of our own is a huge opportunity for change that may not be there 10 years from now. I believe we have what it takes; we just need the right vision and leadership.

Rounding off the interview, Ricardo urged anyone who may be interested in HealthAI to reach out. 

It’s very important that countries come on board – that anyone who has something to say about this is part of the process from the beginning. We are hoping to see countries validate AI tools from 2025 onwards; we’ll then have a global repository with all of the validated technologies. Hopefully, we can co-create globally and we can put AI to the service of the people. That is only possible if everybody chips in. Click here to find HealthAI’s contact details.

Many thanks to Ricardo for taking the time to join us.

Earlier this month, we explored electronic health records across Africa as part of our new international deep dive series; today, we’re taking a look at digital health education and the experiences of medical students in this area across China and Austria.

Digital health education in China… 

In a study published last month in BMC Medical Education journal, researchers explored the perception of digital health among medical students in China, along with the current implementation of digital health education in the country.

By surveying medical students in China, the researchers sought to explore how medical students view digital health and its future, the practical problems associated with provision of digital health in China, and the types of knowledge and skills that medical students want to develop in this area along with how this training can be delivered.

On digital health awareness, 57 percent of respondents had already taken a digital health course. 23 percent of medical students surveyed were “unfamiliar with or unsure about digital health”, and 13 percent were found to “not know the definition of digital health”.

However, more than 80 percent of respondents believed “that the future use of wearable devices and mobile apps and the future use of telemedicine is advantageous”, Specifically, the study found that 86 percent believed in the benefits of big medical data; 85 percent of respondents believed in the benefits of wearable devices; and 84 percent believed in the benefits of telemedicine. 64 percent said that they believe in the benefits of clinical decision support systems (CDSS). On this, the researchers highlight a need to “strengthen education and training related to CDSS and AI to ensure that [medical students in China] can use AI as a tool in the future.”

In terms of education, more than 80 percent said that they “want to learn more about digital health in medical courses”, with 38 percent sharing a belief that they need to learn more. However, six percent of those surveyed said that they did not want to learn about digital health, with 36 percent stating that they were “not sure of the advantages of digital health practices in the future”. In addition, 41 percent of respondents said that they wanted to develop their understanding ethical issues and legal knowledge around digital health.

With regards to this, the researchers state: “Our study found that respondents’ awareness of ethical issues and legal knowledge related to digital health is significantly lower than their knowledge of clinical practice and application… For the next generation of physicians who will work in digital medicine, acquiring the ethical knowledge reflected by artificial intelligence and other relevant digital technologies is an extremely important part of their medical curriculum that should be given attention early in their engagement with digital health technologies.” They add that ethics courses should be included in the design of digital health training courses to “meet the needs of the next generation of physicians and improve their medical humanistic competence”.

Another takeaway from the study is that “medical students prefer hands-on training and practice to the passive knowledge transfer of lectures”, with 78 percent stating that they would rather be taught about digital health using practical training and internship methods; only 10 percent said that they would choose traditional lecture methods. “This finding provides a new vision for digital health curriculum design for medical students,” the researchers note. They suggest that the ‘Student as Partners’ initiative, in which staff and students work together to create curriculum approaches, “is a good reference for digital health course designers”.

The study can be found in full here.

… and in Austria 

In a similar study published in the National Library of Medicine, researchers sought to explore the attitude and perception of medical students towards digital health in Austria, with focus on the educational content valued by students and the topics they would recommend for training.

When medical students were asked to recommend training areas for the digital health curriculum, the top 10 recommended topics were digital diagnostics; artificial intelligence and machine learning; patient self-diagnosis with apps and internet; simulation and data visualisation; decision support systems; handling overwhelming internet information; bio signals and bio signal processing; data structures and big data; robotics; and ethical and legal aspects of digital communication channels.

The researchers highlight how the ethical and legal aspects were at the bottom of the top 10 list. Although 89 percent rated data protection as “very important” for their professional careers, only 18 percent recommended it as an area in which to focus training, with opinions split over whether or not the current curriculum content is sufficient. According to the researchers, their study suggests that “medical students leave it with the application developer and medical agencies to ensure high data protection” and they add that they believe there is a tendency for medical students to be “afraid about communication in the digital world”. In addition, their survey found that “more than half” of respondents “expect a worsening of the patient-physician communication due to digital health”.

In addition, the study points out, “the results show that medical students miss an overview about the many and various areas of digital health applications.” When asked to recommend areas for further training, the results indicate that “medical students focus on digital diagnostics, which is very popular and covered by many public sources. Beyond digital diagnostics knowledge and interests significantly drop.” Here, the researchers recommend medical students require educational support to “better understand the benefits as well as the limitations of digital health” overall.

Based on their findings, the researchers make the following recommendations; that existing training for medical statistics be interwoven with clinical reasons to develop data-driven reasoning; that “concepts, benefits and limitation of state-of-the-art applications need to be taught as part of the respective medical speciality in the second part of their studies”; and that open lecturers should be organised to promote interest and to present “outstanding digital scientific and medical digital health projects”.

In addition, the study indicates that “medical students at the beginning of their studies are more interested in digital health technology”; therefore, the researchers say, “fundamentals and basic application concepts of digital health technologies need to be trained in parallel to biology and chemistry as part of the pre-clinical subjects”.

The study can be found in full here.

References 

Ma, M., Li, Y., Gao, L. et al. The need for digital health education among next-generation health workers in China: a cross-sectional survey on digital health education. BMC Med Educ 23, 541 (2023). https://doi.org/10.1186/s12909-023-04407-w

Baumgartner M, Sauer C, Blagec K, Dorffner G. Digital health understanding and preparedness of medical students: a cross-sectional study. Med Educ Online. 2022 Dec;27(1):2114851. doi: 10.1080/10872981.2022.2114851. PMID: 36036219; PMCID: PMC9423824.

The Australian Government has published their national interoperability plan for 2023 – 2028, highlighting five priority areas with actions including researching UK practice around national minimum standards for health technologies, and developing a national digital health standards catalogue.

The plan begins by noting the “fundamental building blocks” required to establish a connected healthcare system – accurate healthcare recipient and healthcare provider identities, standardised digital record keeping, and clear consumer rights regarding personal information and privacy.

Interoperability principles

The document sets out 10 principles designed to “accelerate the shift towards a more interoperable national healthcare system”, adding that “implementing digital health initiatives that align with these principles will significantly increase the digital health maturity of the sector and enable contemporary, innovative models of care.”

The principles are for health information to be discoverable and accessible; for use of health information to support individual privacy, choice and safe access to information; to use national healthcare identifiers across the healthcare sector; for national digital health standards and specifications to be agreed and adopted; and for the value and quality of care to be multiplied in a digitally connected health system. In addition, the principles include measured digital health maturity informing interoperability system design; for investment to support interoperability and an efficient health technology sector; for collaboration and stakeholder engagement to underpin interoperability; and for high-quality data to be used for safe and meaningful interoperability.

Priority area: identity 

Here, the plan stresses the need to leverage existing functionalities in Australia, primarily the Healthcare Identifiers Service and the National Health Services Directory. “Adopting healthcare identifiers will ensure that individuals, healthcare providers and healthcare provider organisations are uniquely and correctly identified when exchanging health information,” it states.

Along with the overall push to adopt and use identifiers, the plan shares a number of national actions in this area. An immediate action is to develop a Healthcare Identifiers Roadmap that will coordinate a response to recommendations regarding identifiers. The roadmap will also review legislative barriers to the wider uptake of healthcare identifiers, and report on healthcare identifier adoption.

In the short-term, plans include developing and implementing a programme of improvements in healthcare identifier matching, including a focus on data quality and user interfaces; reviewing conformance requirements for using identifiers when managing uploads to the My Health Record system; and developing deeper organisation identifier network structures to support enhancing online network registration. This last action will include working with vendors to address software limitations.

There are also national actions planned around The National Health Services Directory, which the plan states “should be managed as core national infrastructure.” An immediate plan is to roll out and support the implementation of Provider Connect Australia, described as “a single place to update your business information that reduces duplication and streamlines notifications.” In the short-term, Australia aims to assess the feasibility of integrating the National Health Services Directory and the Healthcare Provider Directory, in the hopes of reducing duplication and rationalising the national directory infrastructure.

Priority area: standards

The priority here is to “drive digital transformation through effective leadership and a sustainable approach to standards governance. This will ensure that digital health standards, specifications and terminology are developed consistently and collaboratively, and are fit for purpose, widely adopted and implemented using relevant conformity assessment schemes.”

In terms of ongoing actions, the Australian government is engaging with the health technology sector and health departments to integrate national terminologies and classifications natively, and developing specifications and standards through further engagement. Australian participation in international standards development is also being supported.

Immediate priorities include developing and implementing a national digital health standards catalogue; implementing the National Digital health Standards Programme to develop a “dynamic, comprehensive and collaborative digital health standards environment”; publishing a set of national guiding principles for those developing or implementing digital health standards in Australia; completing a gap analysis to prioritise the digital health standards that are most urgently required to accelerate interoperability; and developing stakeholder relationships.

In the short term, the plan shares plans to coordinate discussions on expanding minimum datasets; develop a national library of resources to provide translation mapping from national terminologies to other popular terminologies; engaging with the sector for API information exchange; developing a conformance framework and rules; and establishing a standards development cooperative.

Priority area: information sharing

Next, the plan sets out a need to “increase information exchange between healthcare providers and individuals by making information discoverable and accessible. This includes consideration of an individual’s safety, consent, privacy and data quality.”

The document highlights how ongoing actions include promoting the use of the API Gateway to support interoperable information exchange, and the government and health services specifying interoperability requirements in procurement requests.

In terms of immediate priorities, Australia will establish an intergovernmental working group to “harmonise procurement and use of standards” based on best practice approaches; develop and maintain an online interoperability toolkit; and assess the current interoperability between GP and residential aged care facility systems.

Looking to the short term, the document shares plans to engage with consumers to investigate options for consent management; research international practice, with noted focus on the UK national minimum standards for digital health technologies; and build capability to identify and manage individuals through a care management network.

Priority area: innovation

In this section, the plan highlights how interoperability should be driven through “future innovations that apply the interoperability principles to new digital health initiatives and functional enhancements.”

Giving examples of current activities, the document notes that in the 2021/22 budget, $7.2 million was announced to develop an integrated electronic diagnostic imaging referral system. In addition, an electronic prescription initiative has been undertaken with the Department of Health.

“During consultation with stakeholders on interoperability and on the 2023-28 National Digital Health Strategy, many potential use cases and digital technologies have been identified showing how digital health can transform the way healthcare is delivered, and how individuals can manage their health,” it states. This strategy and accompanying roadmap will highlight priority focus areas and innovative initiatives. The document adds that many of these initiatives “will rely on the principles and actions in the Interoperability Plan, and at the same time build the capacity for a more interoperable health system”.

Some of the key initiatives to be set out in the digital strategy include a project looking at key pain points between primary care and acute settings and enhancing exchange of and access to near-real-time data sharing; and a multi-year programme of re-platforming the My Health Record System, with delivery of infrastructure that can be used across the digital health ecosystem. Another initiative is the development of the pregnancy and child digital health record programme, and a programme of work focusing on building digital capability in aged care residential facilities.

The immediate priority is to develop educational content in partnership with users, to increase awareness of interoperability.

Priority area: benefits

Finally, the document notes the four categories that interoperability benefits generally fall into – patient experience, safety, productivity and reduced costs, and improved data for practice and research – and emphasises how digital health maturity should be measured in order to identify areas for investment.

The plan shares a number of current and ongoing activities in this area; Queensland has piloted the HIMSS Digital Health Indicator, for example, and the government is participating in the development of a Global Interoperability Measurement Model – “a tool for a country or territory to assess its interoperability progress by measuring foundational, structural, semantic and organisational interoperability”. In addition, the University of Queensland has developed an assessment methodology for maturity models, which will be used to assess “the best digital health maturity model options for wider use”.

Australia is also undertaking a survey of hospital, pharmacy, general practice, allied health, specialist practice and aged care organisations in order to provide an interoperability benchmark to track future progress.

The plan goes on to share policy tools to support interoperability, including examples of national arrangements that encourage adoption.

To access the document in full, please click here.