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A Journey Begins with but a Single Step” by Mr Laurie Hawkins
“A journey begins with but a single step”
by Mr Laurie Hawkins
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Laurie Hawkins, Chief Executive Officer (CEO) and Founder, AITIA Global.
The proverb that gives this article its title is ascribed to Lao Tzu, an ancient Chinese philosopher and writer, and teaches that even the longest and most difficult ventures have a starting point; something which begins with one first step. This is about my journey with AITIA Global, a start-up company I have founded to build on two national digital health initiatives that I have been responsible for in Australia. My goal is to leave a “legacy” that will improve healthcare across our planet. Following my success in 2011 in getting eight State and Territory Governments, the Federal Government and private healthcare stakeholders to adopt a “National Services Library” (called the National Health Services Directory or NHSD in Australia) for “health and social care services” (Yellowpages) combining public, private and not-for-profit organisations into a “single source of truth” I have wanted to “change the world” for the better. Having been successful in getting myriad healthcare stakeholders to share “data” (not patient data) and realising today “the world is all about data”, and seeing the many benefits it brings to strengthen health systems at a local, national and international perspective, so began my journey, which has taken “passion, persistence and perspiration” (true grit) and travels across the world to promote this concept. Now, more than ever, during this COVID-19 global pandemic, we need to “join the dots” by having a multi-agency collaboration across multiple countries using “data” on a single platform. Australia has created its global equivalent to assist the “world”, which is similar to “John Hopkins University”, but has more functionality including “spatial bars” and is based on the Advanced Data Analytics Platform, which is the second initiative for which I have been responsible.
What I have learned?
“Resilience, never give up”, they are just “bumps in the road” from whatever setbacks you have. Surround yourself with positive people and build professional networks, which for me includes 5,000 connections at very senior levels, predominately in the healthcare sector, but many other industry sectors, as well across more than 100 countries. This led me to a “mentor” of a large Global Health Alliance, who has encouraged me by providing the opportunities to present at major conferences including the European Union Health Conference hosted by Estonia during its Presidency in 2017. Other conferences include Beijing, China, Singapore and Boston. Not being a “digital native” (defined on Wikipedia as “generally somebody who was born after 1980 and thus raised with the internet”) in today’s connected world, and as Estonia is ranked as the
most digitally advanced country in the world, I became an e-resident of Estonia, so that I could trade across the EU, have an international bank account and register a company there – AITIA Estonia, all from Australia. Along the way, I have been lucky to find “amazing people” not only in “my own backyard” of Melbourne or Australia but across the world. People who have great digital health products and services aimed at a regional, state, country, or international perspective.
Why this Journey
Across the world, as countries struggle to balance rising consumer expectations, escalating demands on health systems, an ageing population, rising rates of chronic disease and increasing costs, there is a need to consider the foundation blocks of “digital health”, which act as a catalyst for other innovations to build upon, for example, secure messaging, telehealth, and tools such as data analytics. Having been successful in Victoria with this concept, it was adopted and launched nationally in Australia in July 2012 as the National Health Services Directory (known as the Health Services Library internationally). This is a repository of health and social care “services” which combines both operational data for Health and Human Services and provider data for transactional information to “provide better continuity of care” for health consumers throughout their life through better collaboration between health providers. At present, many hospitals, aged care, community care, and primary care settings independently maintain address books of local clinicians. These are used daily by doctors, nurses, and allied health professionals to aid the transfer and management of care. They range from simple lists to relatively sophisticated databases separate to, or embedded within, other systems. Few of these, however, are linked to a capacity for ehealth communication. For example, when a GP or hospital-based doctor is planning further care for a patient such as a renal patient with diabetes, they need to be able to: • access high-quality information about various service providers in the patient’s town or suburb; • find a podiatrist, physiotherapist, dietitian, pharmacist, etc.; • assure themselves of the identity, provider status, address, etc. of those providers; and • access electronic address information easily available to refer the patient for further care. Australia built the National Health Services Library (NHSD in Australia) on the back of the Victorian Health Services Directory (for which I was responsible), combining “service” and “provider” directories across state jurisdictions. It was in response to an increasing frustration initially from health professionals about the overlapping nature of finding information and the inconsistent type and quality. The shift toward ehealth and healthcare reform meant the greater integration of systems and a consumer group that expects greater access to information. Service and provider information must be available quickly, easily and with the highest possible degree of accuracy and reliability alongside the emerging identification, authentication, and messaging regimes if we are to use electronic communications effectively to support health services. For Australia, with a population of 25 million people, the NHSD:
covers the breadth and depth of Health and
Social Care Services across Australia (eight
State and Territory governments and a
Federal government); • is the “single source of truth” for ehealth from the “cloud”; and • handles over 10 million transactions per month (and growing as more national and state ehealth initiatives start to use the national secure messaging facilities). The NHSD is now the: • National Services Directory (400,000+
Services); • National Provider Directory (300,000+
Accredited Health Practitioners); and • National Telehealth Directory. It also underpins many Federal, State, and local health initiatives such as the National Nurse on Call, the National GP After Hours program, the National Pregnancy Birth and Baby website, the National My Aged Care website, and many other initiatives.
The NHSD is a shared piece of national infrastructure and allows many stakeholders to have varying degrees of control.
The NHSD in Australia is a shared piece of national infrastructure and allows many stakeholders to have varying degrees of control. Opening the NHSD infrastructure to be ubiquitously available, has built a community of positive support because of its utility and ease of availability. The NHSD is currently accessible via websites, mobile apps, and APIs, integrated into an increasing range of software products. With increasing demands on national and international health services, we urgently need to shift from primary and acute care to include “social care” (or community care). This has been a missing link in the context of “patients” healthcare throughout their lifetime, so we can build healthy communities through knowledgebased environmental preventative strategies and sustainable active living principles. This can be done here and now by making data readily available in a more effective context to policymakers, health planners, and researchers. An example of a software product integrating the NHSD is the National Healthmap data platform. This platform aims to help overcome the “islands of data” held across the health sector by combining the NHSD with a range of relevant health data sets, such as census demographics, disease prevalence, and health outcomes. The Healthmap demonstrates how the NHSD can be extended from its primary role as a foundation for national ehealth initiatives to a health data tool to support policymakers, health planners, and researchers in their broader roles of improving population health outcomes through evidence-based decision making. Visualisation of data is extremely effective in allowing complex datasets to be brought together to convey information in a simple geospatial (Google Maps) format. The National Healthmap uses data from the NHSD, from which we can introduce a wide range of national datasets (e.g., census) and local health datasets to support a greater focus on evidence-based planning and decision making. Now that key service information can be sourced (from an authoritative resource) and a greater focus on data governance rather than fragmented silos, data quality issues are reduced, and we have more data possibilities to the greater community as it allows greater and more widespread use of data. Service data can now be viewed by Health Focus Areas, for example by Cancer, Aged Care, or “Categories” or by “Programs by Organisations” such as – Access To “Allied Psychological Services Program” (ATAPS). The Health Services Library (HSL) can be replicated anywhere around the world. For
example, National Health Libraries linked together across the European Union (EU) to provide health consumers, health planners, research groups with a significant database of health and human services.
Data from Australia, Ireland, the UK, and the USA viewed all from the same platform.
This could empower citizens when they travel, for example, to see where doctor (General Practitioner) services are available after hours on the user’s smartphone, an excellent example of providing the right data at the right time at the right place. Barriers, such as cost, technology, and data quality, have arisen and continue to arise frequently. However, by demonstrating what is possible with the vast knowledge of health data coming from the “cloud”, and how effective it can be in health planning, evidence-based, policymaking, and empowering health consumers, these barriers are overcome more readily. Data quality is improved as we can now have national and international data standards quickly and easily, and an easy-to-use platform with a “Google Maps” front end. The National “Health Services Library” acts as a catalyst for ehealth, delivering greater access to relevant health sector data and providing a wealth of information resources to the health sector and consumers. * * * Laurie Hawkins is the Chief Executive Officer (CEO), Subject Matter Expert – Health Services Libraries, and Founder, AITIA Global. Contact Laurie at laurie.hawkins@ healthservicesdirectories.com Australian National Health Services Library: https://www.healthdirect.gov.au/australianhealth-services AITIA Global: https://www.aitiaglobal.com/ Australia’s global equivalent of the John Hopkins COVID-19: https://studio.healthmap. com.au/#/gNG Global Health Alliances: https://echalliance. com/ European Union Health Conference Presentation by the author, Tallinn, Estonia, October 2017: https://bit.ly/3eaxMNd Estonia as the most digitally advanced country: https://e-estonia.com/
