Moving the needle on interoperability with the Digital Health Blueprint

The Australian Government’s Digital Health Blueprint represents a crucial step forward in driving a more connected healthcare system. The release of the blueprint followed the Strengthening Medicare Taskforce Report, which emphasised the importance of digital and data solutions and modernising healthcare systems in terms of healthcare stewardship.

“In the 2023-24 Budget, the Government invested about $1.1 billion in a range of modernisation programs, including modernising My Health Record and a FHIR accelerator program, Sparked,” Simon Cleverley, Assistant Secretary at Australian Government Department of Health, Disability and Ageing (DHDA), told HL7 Australia. “The investment and the roadmap that sits alongside the blueprint demonstrate the ongoing commitment to driving the transformation of how we deliver healthcare in Australia.”

One of the critical building blocks to that transformation, Simon noted, will be a digital health strategy that is enabled through a true partnership approach.

The question is, what will it take to achieve that transformation across all healthcare systems Australia-wide? Simon sat down with HL7 Australia to share his vision and perspective.

HL7 Australia: As you have noted, partnership is integral to achieving an integrated digital healthcare future. With that in mind, can you talk about the consortium striving to develop national data models and interactions using Sparked and the FHIR Accelerator?

Simon: I think it’s caught many people across the health sector by surprise that governments across Australia have translated their deepening understanding of the benefits of a community approach and been agile enough to move so quickly to leverage this approach to achieve those lofty goals through digital enablement. That’s come from lessons learned about how we all need to do business together to help people stay well for longer and to help those who are sick get the right, targeted treatment plan.

This consortium enables us to leverage the best knowledge, stakeholders and policy development expertise into a format that enables anyone to contribute to the way data is shared within the healthcare system. That includes our work on prioritised use cases such as an internationally aligned patient summary and Chronic Condition Management, which are key to driving scalable improvements across the health system by demonstrating how standards like FHIR can support better continuity of care.

And it’s not just getting noticed in Australia. We are getting a lot of people coming from international governments and bodies who are interested in the pathway and partnership approach we have taken and are asking us for advice on how they can do similar sorts of things in their country. It’s really that partnership approach that has been the key to the success we have had.

HL7 Australia: As the blueprint makes clear a key pillar of connected digital healthcare is My Health Record. What is envisioned with the modernisation of the platform through data standards, such as FHIR?

Simon: My Health Record has been on a really interesting journey from its establishment in the early 2010s, which has enabled real-time sharing of information to benefit the consumer, no matter where they are. It provides that authorising environment for healthcare professionals that allows them to access information about their patients, again, no matter where they are. But we do need to keep moving forward to provide a seamless access point for consumers to get information about their health and well-being journey. And the modernisation agenda, including FHIR programs, are really going to be the catalyst for that transformation.

The Australian Digital Health Agency has been undertaking early work to update My Health Record to be a FHIR enabled system. Over the coming year we will see work commence to update the platform to support alignment with the AU Core standard and AUCDI dataset produced under the Sparked program. This will begin a monumental shift away from the reliance of ‘PDF’ based information to support atomic data.

Modernisation is not just about My Health Record; it’s about all the clinical systems out there as well. One of the powerful things that has been enabled through the FHIR program and the journey we have embarked on with CSIRO, the Australian Digital Health Agency and HL7 Australia, is that we can drive that transformation in order to achieve the panacea of an interoperable future. Rather than throwing out what we have, we can make sure that what we have can be improved upon.

Our commitment to implementing use cases like Patient Summary and Chronic Condition Management is really where we start to see tangible benefits for clinicians and patients. These are real examples of how we can align system modernisation with policy goals around prevention, continuity of care, and supporting vulnerable populations. And, certainly, the government’s commitment to move to sharing pathology and diagnostic imaging reports by default to My Health Record – which has now been legislated demonstrates that core objective. That share-by-default principle then becomes especially powerful when applied to these use cases. This means that there would be a consistent FHIR-base core data set available at the point of care, especially during transitions or emergencies, ensuring that this data can be shared across any healthcare setting, at any time.

HL7 Australia: Can we pivot to talk a bit about the DHDA funding for the creation of the Australian FHIR Management Framework (AFMF) including the Australian FHIR Community Process (AFCP), and the establishment of the Australian FHIR Coordination Committee (AFCC).

Simon: The Sparked program was launched in August 2023, and we have seen significant progress over the past two years. That’s down to a strong partnership. What’s really crucial about the AFCC is ensuring we have scrutiny and appropriate open and broad views brought into the standards development process.

One of the things that I’m really focused on is having the appropriate governance to ensure that we can scale not only the standards at the core level but also springboard that to incorporate all the important use cases that drive that connected care agenda. From the AFCC’s perspective, it’s going to be really important that we do have that national viewpoint to assess where we are, where we are going and whether we have the right checks and balances in place. While I personally have stepped away from my seat in the AFCC, my Department remains strongly represented and deeply engaged in the direction and coordination of national standards governance. There’s a wealth of expertise to tap into, but we must also make sure we’re succession planning, not just around the AFCC itself, but around the standards community and around the industry and community more broadly to ensure we have the workforce of tomorrow to support all the use case work that’s going to have to happen once it’s developed.

HL7 Australia: What is your call to action for your peers not only at states and territories, but also other Commonwealth agencies and even other parts of DHDA with regards to involvement with Sparked and FHIR?

Simon: I feel there’s a groundswell now, and certainly within the events that I’m participating in around the FHIR accelerator, I’m seeing that enthusiasm to be part of these sorts of programs from states and across all parts of our delivery systems. I’m also seeing the calibre of people it’s drawing in.

The partnership, and the model that wraps around FHIR standards, including the role of HL7 Australia, demonstrates there’s really a sense that if you’re not there, you’re missing out on the opportunity to contribute to the future of modern healthcare delivery in Australia. That’s happening now, and we see that with the chief policy and information technology leads from states and territories turning up and participating and presenting in the forums being held; we see that through significant clinical involvement from right across the sector and from industry.

Over the next five years, we will see a significant increase in digital capabilities, but how we connect and use our national infrastructure — such as MyMedicare, the modernisation of My Health Record, broader development of SMART on FHIR apps, and our Healthcare Identifiers Framework – is going to need to be phased carefully in concert with the modernisation agendas happening across states and territories and in the private sector.

Probably my call to action is, if you’re not in it you won’t be able to shape it. Having said that, I would say we have significant buy-in from states and territories in a range of activities, including Healthcare Identifiers, including the My Health Record system, including the work to overcome information sharing barriers in legislation between states and territories, and the work that is happening with building and designing new EMRs for hospital systems that allows GPs to have access.

Ground zero, though, is making sure that we have nationally consistent and agreed standards for moving that information around the system, which can then be supported by those legislative and policy frameworks. This is the time to shape how those standards will operate into the future. As we have seen in the Strengthening Medicare Taskforce report and from what has been previously said by Minister Mark Butler, we are going to mandate these standards, not only to benefit information sharing, but also to address security and privacy concerns. The task before us is understanding what a phased implementation looks like, in practical terms, to support industry adoption and alignment.

HL7 Australia: Has your role been difficult in terms of getting momentum around these initiatives and gaining the necessary commitment to and enthusiasm for these programs?

Simon: What’s really difficult about digital and data technology capabilities, services and skills is people think you have to be a technical person to contribute to the conversation. And what has been shown through this work program is that that’s not the case. We need the clinicians, the consumers and those from all walks of the policy development lifecycle to play their role in making sure these systems support the clinical workflows and are simple for consumers to use. Certainly, there is a role for people that can actually translate the policy objectives into systems that allow us to move information around the healthcare environment. But it’s really about ensuring we have buy-in from all parts of the marketplace.

What is really difficult is ensuring we have a very clear understanding of the problems we are trying to solve, and what role digital and data systems can play in overcoming these problems. Those challenges include an inability for consumers to have a connected story across their health journey; lack of clinical insights at the point of care for clinicians wanting to provide more tailored, high-quality care; and inability to have real-time sharing of health information to support public health and planning at scale across our federated country. Having a strong community that is truly representative of the problems we are trying to solve will make it much clearer to governments around Australia as to why they are investing in foundational digital health capabilities and services.

We need plans to ensure we are clear about prioritising the delivery of these national capabilities. That’s why something like the Blueprint is so important. However, we also need a clearly defined set of objectives, which we expect to finalise shortly as part of our development of a National FHIR Roadmap. This roadmap aligns with our Blueprint, and is intended to guide industry on where to invest in FHIR use cases and show how these standards will be incorporated into our broader programs of work. The roadmap will show the Department’s intended investment in FHIR over the coming years and is due to be released in the 2025 calendar year. This will help provide a clear line of sight to all stakeholders about what we need to put in place to support Australia’s digital health transformation journey, and when.

We have to maintain and strengthen our partnership and the conversations we’re having with decision-makers. It’s really that ongoing collaboration and sharing what this means and making sure that we’ve got the right people in front of those conversations at the right time. The Federal Government showed confidence in the Sparked program with funding provided in the March 2025 Federal Budget to continue the work under Sparked, and in particular the development of standards to support the recording of reason for health encounter, consistent patient summary pathways, and the digitisation of chronic condition management plans. We have the right ingredients and I’m certain that over the next 12 months we will go back to the Commonwealth Government, state governments, and other investors with a clear position on what comes next, showing where we are going to take as a country, which will allow all stakeholders to invest with confidence. This is about building strong consistent foundations to enable reusable national infrastructure.

HL7 Australia: Is there a message for those stakeholders who are more reluctant to commit to standards?

Simon: I recognise, and our partners recognise, that we are stronger together. But, at the same time, we need to give visibility for the future of where we’re going and how we incentivise people to invest in moving a FHIR standard along as a baseline for how we move information around the system in Australia. We want to build and strengthen the community so everybody feels that they have a seat at the table and can contribute to the evolution of data and terminology standards in Australia.

I recognise that there is huge demand on organisations to do the things they are asked to do to comply with our changing regulatory frameworks, and to evolve their systems to improve user experience for their clients. We need to make it easy for people who are time poor to have the opportunity to become involved. I think the Sparked program strikes a good balance and offers opportunities to be involved. There have probably been some false starts in Australia when it comes to how we achieve a more connected health system but I would say to those who are still not sure if this is genuine to look at the signals. These include a national health interoperability plan that is being implemented with national oversight, Australia’s first FHIR accelerator program, and a Commonwealth Government leading and stewarding implementation of these initiatives. We must address challenges such as limited workforce capacity, a system that is dealing with more chronic disease, and a system that does not enable health information to move around in a systemic way. We must all commit to standardising our healthcare system.

For now, we are focused on making sure that we can get people together to create that dynamic partnership so that we can then make some decisions as a community about how we implement those standards.

The good news is we’re seeing more stakeholders who understand the role FHIR has within our ecosystem. We have also already seen some exciting developments in the industry, with several of our Sparked participants developing solutions based on the standards that Sparked is creating.

We know there’s a lot of work to be done but I think HL7 Australia is strong and I’m looking forward to continuing to work with HL7 Australia and all the other partners to drive the value proposition and achieve those national healthcare interoperability objectives.

HL7 Australia: How has working with HL7 Australia supported your agency’s goals in achieving seamless health information exchange?​

Working with HL7 Australia has been central to our approach to building a standards-based digital health ecosystem. What we’ve seen, particularly through Sparked, is that HL7 Australia brings the technical stewardship and the trusted relationships needed to align diverse interested behind our common goal of
achieving patient-centred connected care.

More broadly, HL7 Australia has played an important role in building capability and
engaging stakeholders all across the system. As we move forward towards mandating FHIR standards and implementing the national FHIR Roadmap, HL7 Australia will continue to be a key partner in ensuring these standards are implemented in a way that is robust, inclusive and scalable.

What is on the Department’s interoperability agenda in the next 6 – 12 months related to HL7 standards?

The coming 12 months will be focused on delivering tangible improvements to foundations that will progress us closer to real time health information sharing. Our focus across patient summary, reason for health encounter and chronic condition management is to develop FHIR standards that will enable multifaceted data pathways and reusable patterns to enliven interoperability. I strongly believe that the development and adoption of FHIR standards across these use cases will enable data portability and build a wealth of atomic data flows throughout the Australian healthcare ecosystem.

We will also continue to explore how we take these standards and start to drive adoption and implementation in systems. This will focus on investment drivers for both Government and industry including mandates and considering what is required to establish consistent governance and infrastructure that will enable adoption and support innovation in industry. This includes scaling up the use of FHIR and other standards in our health programs, and exploring tooling such as SMART on FHIR, Bulk FHIR, amongst other opportunities.