In planning for the future, the ACT Health Directorate has developed a set of key strategic priorities and objectives to guide the development of future health services across the public healthcare system in the ACT. The Directorate is also investing in a range of important strategies to operationalise these objectives and support reform priorities.
This strategy was developed taking into account the strategic context in which person-centred care is delivered in the ACT. Global, national, and regional considerations were taken into account to ensure the ACT is well positioned to meet future demands and challenges.
The Global Context
External forces are shaping the nature of health services delivery, these include an increasing focus on population health, changing models of care, advances in Health IT, and evolving fiscal landscape.
1. Population health and community expectations
Increasing recognition of the benefits of preventative health and early intervention
2. Models of care
- Person-centred care
- Delivery of care closer to people’s homes
- Precision and personalised medicine
- Telehealth and virtual care delivery
3. Advances in health technology
- Rapid technical advancements, along with growth and availability of data
- Substantial State and Commonwealth Government investments (for example, My Health Record)
- Large investments in electronic medical record systems internationally
- Commercial application of technologies such as Artificial Intelligence, Internet of Things, Robotics
4. Rising medical costs
More expensive medical services per person coupled with more frequent access
- Quality of treatment with advancements in technologies, facilities, and medical training
- Increasing percentage of state and territory budgets
5. Dynamic funding environment devoted to healthcare
- Continued focus on standardised hospital pricing through activity-based funding
- Emerging focus on accountable care by governments and private health insurers
The Local Context
The ACT community has access to an extensive range of health services – from intensive care to pathology to mental health – delivered from the Canberra, Calvary Public and University of Canberra Hospitals, Walk-in Centres, community-based venues, as well as in peoples’ homes. In addition, Canberra Health Services
provides health services to residents of NSW, particularly those located in the southern region of the state.
Population growth and demographic change will have a significant impact on the demand for health services in the ACT in the coming years. The ACT Government population forecasts (March 2017) predict the ACT’s population will increase from 402,549 persons in 2017 to 470,839 persons in 2027 (16.9% growth). This is projected to be coupled with an increase in the proportion of the population aged over 65 years.
The ACT Government Digital Strategy outlines three strategic principles:
- Growing the Digital Economy,
- Delivering Digital Services, and
- Building Digital Foundations.
These strategic principles aim to ensure we continue to build on the digital foundations already available to deliver more integrated and efficient digital solutions for all healthcare providers, health consumers, families and carers.
The ACT Health Directorate works closely with the Australian Digital Health Agency. As the operator of the first public hospital to send discharge summaries to the My Health Record, the ACT Government remains committed to increasing the number and types of documents fed to and received from the My Health Record, to increase access to information for healthcare organisations nationally.
The Healthcare Information and Management Systems Society (HIMSS) have an Analytics Electronic Medical Record Adoption Model (EMRAM). This model incorporates methodology and algorithms which automatically score hospitals around the world relative to their Electronic Medical Records capability. The score scale range is between 0 – 7. Canberra Health Services have been rated as 1.5. This strategy outlines how the ACT will work towards increasing our rating and adopt a Digital Health Record.
The overall investment in health by the ACT Government today stands at $1.7 billion annually. Included in this are investments in technology and digital-enabled solutions to assist in delivering safe, effective and efficient services.
Achievements to date
Smart patient meal system, Health Services Directory, NICU webcam, Public Wi-Fi, ACT Health website refresh, improvements to patient entertainment and information.
Expansion of queue management, electronic wayfinding, replacement of the Laboratory Information System and release of an acute care information mobile app.
Collaboration and Research
Achievements to date
Single Patient Administrative System, Master Patient Index, alerts management, pathology and radiology reports sent to My Health Record.
Patient information exchange with primary care, standardised clinical terminology, single patient Digital Health Record.
Achievements to date
Electronic ordering for pathology and imaging, deteriorating patient system, medication management, referrals and the build and launch of new facilities.
Electronic patient journey boards for clinical planning, mobile clinical communications and digital record access.
Pictured below: Imaging results via Clinical Portal (RIS-PACS)
Figure: Some of the technological achievements made across the ACT public health system.
While there has been progress in technology, there remains significant areas for improvement, primarily as a result of:
- The implementation of multiple service-specific systems (a best-of-breed approach) that has led to pockets of excellence but also fragmentation and siloing of information within individual systems
- Proliferation of systems making change difficult, due to complex integration requirements (currently more than 250 systems)
- Decentralised system management
- Multiple sources of patient information
- Reliance on paper-based records (currently “hybrid records”)
- Many demands for resource allocation in a difficult fiscal environment
- Ageing infrastructure that requires investment to meet the demands of contemporary health service.
To continue building for the future, the Digital Health Strategy identifies capability focus areas over the next 10 years. It aims to address the issues highlighted above, whilst minimising risks associated with delivering on healthcare needs.
Territory Wide Health Services Strategy
Providing the right service, at the right time, in the right place, and by the right team—every time.
The Directorate has developed a Territory Wide Health Services Strategy. This strategy is a high-level strategic plan that establishes the overarching principles to guide the development and redesign of healthcare services across the Territory from 2019-2029.
This strategy is a key aspect of the Directorate’s ongoing commitment to making “Your Health – Our Priority” for all Canberrans and is aligned with the organisation’s vision, values, strategic goals, and objectives.
Person-centred, safe and effective care
The ACT Health Quality Strategy 2018-2028 provides a framework through which improvement in the services offered to people can be focused and measured. The Quality Strategy sets out how quality will be improved across the the public health system and will build on work already achieved. It presents a shared understanding of quality, with a commitment to place safety, quality and people at the centre of everything ACT Health Directorate does.
ACT Health Directorate’s ambition is to be a high performing public health system that provides person-centred, safe and effective care.
ACT Health Directorate will need to work across health services to ensure integration of quality in the delivery of person-centred, safe, effective and high-quality care. It will achieve this by focusing on three strategic priorities in relation to quality:
Strategic Priority 1: Person-centred – Improve the experience of care
Person-centred care is a way of thinking and doing things that sees healthcare users as equal partners in planning, delivering and monitoring the improvement of safe, quality care that meets their needs. This means putting people and their families at the centre of decisions and seeing them as experts, working alongside health professionals to achieve the best outcomes.
Strategic Priority 2: Patient Safety – Proactively seek a reduction in patient harm
ACT Health Directorate’s first obligation is to ensure that by coming into any ACT healthcare service, every effort is made to keep patients safe and the risk of harm is reduced
Strategic Priority 3: Effective Care – Best evidence for every person, every time
An effective healthcare system is one that promotes and supports evidence-based, effective and reliable care provision. There should be no variation in the quality of care, which should be provided in an atmosphere of mutual trust where staff members can talk freely about safety problems and how to solve them.