RANZCR: A Vision for Digital Health in Clinical Radiology in Australia

The Royal Australian and New Zealand College of Radiologists (RANZCR)

Inside News March 2020

Over the past decade, Australia has invested significant funds into attempting to harness and facilitate the adoption of digital healthcare. The commitment to this issue is outlined in the National Digital Health Strategy, created by the Australian Digital Health Agency, which states that every healthcare provider will be able to communicate via secure digital methods by 2022.

Work continues to ensure that a clear plan is in place to achieve this goal and the College is uniquely positioned to be a leader on this issue. The advanced technology used in clinical radiology means that our members have always embraced new developments and technologies to improve patient care and facilitate best-practice service delivery.

The College has been active in the digital health space for several years and has worked with governments and their agencies to improve outcomes for patients. For example, the College is leading the way in setting standards and ethical principles for AI. Most recently, we contributed to the Australian Digital Health Agency’s Interoperability Program consultation, and continue to share our vision for digital health with government ministers and other stakeholders, to name just a few initiatives.

Continuing to be a pioneer in digital health is a priority for the Faculty of Clinical Radiology Council in 2020. Our aim is to ensure that patients and doctors have access to all relevant healthcare information, to enhance patient safety and reduce duplication of imaging, waste and costs.

Digital health provides numerous opportunities for providing better informed, quality care and improving access, particularly for those in regional and remote areas. Better transfer of and access to digital information promises to ensure that timely and more clinically relevant information is available for the clinical radiologist providing the service, the treating medical practitioner and others subsequently involved in a patient’s care. Within clinical radiology there is also the potential to reduce unnecessary imaging where a patient’s previous images are not available due to imaging being completed in other jurisdictions or networks.

The College has a clear vision for how Australia can harness the benefits of digital technologies and improve the quality of care for patients who need radiology services. As depicted in the accompanying image, the College’s focus in digital health centres around five key priorities:

• the establishment of an eReferral system

• access to historic images

• standardised terminology

• development of imaging guidelines,

• the managed roll-out of artificial intelligence (AI).

The College strongly supports the adoption of eReferral in in clinical radiology to improve how clinical and administrative information is exchanged between healthcare providers. A repository model is preferred where a referral is automatically transmitted to a secure virtual database and is then accessible to any provider the patient chooses. Before getting started on a solid foundation, it is imperative that standardised terminology is developed and agreed upon. This will simplify referrals to radiology and create a stable foundation for other digital health priorities.

Healthcare providers need easy, secure and timely access to patient information, including images and reports. Currently independent data repositories across health care settings are poorly linked and not adequate to provide a seamless experience for patients who invariably attend for care across multiple settings. For example, patients frequently attend for care across public and private providers, community clinics and hospitals, and across jurisdictions.

The availability of historic images and reports would reduce duplicate imaging occurring because of the lack of interoperability in Australia’s healthcare system. Making historic images easily available and accessible across providers would also likely reduce out-of-pocket costs for patients.

Patient care would also benefit from the introduction of imaging guidelines. These guidelines would increase appropriateness of referrals, enhance patient safety, provide educational opportunities and feedback to referrers on the suitability of the selected imaging modality. To be effective, the College has recommended that clinical decision support (CDS) must be digitally integrated into the workflow of clinicians.

AI presents many opportunities for a more efficient and accessible healthcare system. While it may be some time until the technology is clinically appropriate and safe for patients, it is important for the College to continue positioning itself as a leading player in the application of AI in healthcare.

Last year, the College became the first professional peak body to develop Ethical Principles for AI in Medicine and we are currently in the closing stages of finalising a set of professional standards for the use of AI in clinical radiology and radiation oncology. We must continue to be pioneers in this space and work with stakeholders to help them recognise the potential and risk of AI and the integral role it could play as digital health and interoperability projects progress.

The College is stressing the need for an agreed vision for digital health in clinical radiology, as taking a project-specific approach will result in further interoperability challenges. It is also vital that due regard is given to data security, patient privacy, workability, and the needs of health practitioners using the system.

At its heart, digital health strives to connect healthcare providers and clinicians across all environments to provide a seamless experience and quality care for patients. As technology continues to advance at a rapid rate, it is vital that the digital health solution is properly considered and implemented effectively.

If you have further questions about digital health in clinical radiology please contact Melissa Doyle, Executive Officer at the College at melissa.doyle@ranzcr.edu.au