Connected CRM

Have you ever wondered why, in an age when you can transfer money across the world instantly, you still can’t easily share your own medical records between doctors or hospitals? In Connected Care: Digital Health in Australia, Richard Royle and David Hansen confront this paradox head-on, arguing that while medicine has been transformed by technological advances in diagnostics and treatment, its information systems remain painfully fragmented. They propose a bold vision: a connected, patient-centered digital health ecosystem that not only streamlines care and reduces costs but also empowers you to play an active role in your own health journey.

At its heart, the book contends that digital health isn’t about technology alone—it’s about reimagining how health data flows between patients, clinicians, hospitals, and governments. The authors, both long-standing leaders in Australia’s digital health movement, walk you through the country’s three-decade struggle to link its complex and often siloed healthcare system. They reveal that the ultimate goal isn’t just convenience—it’s sustainability and safety. Without better digital integration, Australia’s healthcare system will continue to strain under its own administrative weight.

The Promise and the Paradox

Royle and Hansen start with a thought experiment: imagine a world where all your data—from prescriptions and pathology results to home smartwatch readings—could be securely viewed by your GP, your specialist, and even you. This isn’t science fiction; it’s already happening in parts of Europe and the United States. So why not here? The authors trace the roots of Australia’s lag not to a lack of interest or innovation, but to what they call a “fragmented federation”: overlapping state and federal health responsibilities, diverse funding structures, and inconsistent digital standards.

The comparison to banking and travel systems is telling. In both industries, common standards (like SWIFT for banking and Amadeus for global flight reservations) allow seamless information exchange. Health care, by contrast, is mired in data silos and inconsistent systems that undermine the very safety it promises. The authors argue that digital health must follow a similar standardization path—a ‘network effect’ where interoperability becomes the default.

From Paper Trails to Digital Pathways

The journey toward connected health has been long. From the early days of computerised prescriptions in the 1990s, driven by pioneering GPs and software developers like Medical Director and Genie, to government-funded initiatives like the 2012 Personally Controlled Electronic Health Record (PCEHR), Australia has invested billions into digital infrastructure with mixed results. Royle himself chaired the 2013 national review that transformed the PCEHR into My Health Record, a now-ubiquitous database accessible to nearly every Australian.

Despite early resistance from clinicians wary of privacy issues and clunky software, the tide is turning. Most GPs now operate digitally, and state hospitals are rolling out large-scale electronic medical records (EMRs) from global providers like Cerner and Epic. Case studies such as St Stephens Hospital in Queensland—Australia’s first fully integrated digital hospital—show what’s possible when clinicians lead the change rather than resist it. Here, technology succeeded because doctors and nurses were co-designers, not bystanders.

The Systems that Bind It All

The technical backbone of digital health lies in standards and identifiers. Without them, sharing data reliably is impossible. The authors skillfully explain tools such as the Individual Healthcare Identifier (IHI), established under Australian law to uniquely tag every patient’s data, and coding systems like SNOMED CT, which standardize medical language across contexts (“fracture of wrist” always means the same thing everywhere). Combined with international data exchange frameworks like HL7 and FHIR (Fast Healthcare Interoperability Resources), these standards bring cohesion to chaos.

“Digital health is about getting the right information to the right person, at the right time, in a secure form,” the authors emphasize. “It is not a gadget—it’s a social infrastructure.”

From Connectivity to Transformation

The second half of the book moves beyond infrastructure to envision what digital health makes possible. With AI revolutionizing medical imaging and decision support, genomics offering customized treatment, and virtual care enabling clinicians to support patients from afar, digital health is crossing into the territory of personalized, predictive, and preventive care. The COVID-19 pandemic accelerated this shift by normalizing telehealth, e-prescriptions, and digital vaccinations—proof that necessity can fast-track systemic change.

Royle and Hansen don’t shy from challenges. Privacy breaches like the 2024 MediSecure hack show that cybersecurity must evolve alongside innovation. Meanwhile, underfunded aged care and Indigenous health systems risk being left behind if the “network effect” doesn’t extend beyond hospitals and clinics. Yet, their closing message is optimistic: sustained government investment, clinician involvement, and empowered citizens can finally make connected care a reality.

Why It Matters to You

This book matters because the quality of your healthcare increasingly depends on how well your data moves. Fragmented records lead to repeated tests, delayed treatments, and unnecessary risks. Imagine never again scribbling the same medication list on multiple forms or waiting weeks for your results to reach another specialist. Connected care promises a system where efficiency, safety, and transparency replace frustration and inefficiency. As Royle and Hansen conclude, the next decade will determine whether digital health in Australia becomes a global success story—or remains a cautionary tale.

Australia’s digital health journey reads like a decades-long relay race—each generation passing the baton of progress, sometimes dropping it, sometimes sprinting ahead. Royle and Hansen trace how the industry evolved from early computerised GP systems to nationally integrated networks powered by modern interoperability standards.

GPs Lead the Digital Charge

The story begins in the 1990s, when general practitioners—spurred by regulation changes and innovations from small tech firms like Medical Director—digitized their practice management. By linking prescriptions and patient histories, GPs rapidly achieved one of the world’s highest digital adoption rates. This early success, financed by the Australian government’s Practice Incentive Program, showcased the power of combining clinical leadership with targeted funding.

However, hospitals proved a tougher nut to crack. While pathology and radiology adopted electronic results via HL7 messaging, the rest of the system—hospitals, specialists, and aged care—remained digital laggards. The result was a patchwork: advanced data streams in some places, paper folders in others.

Failed Starts and Lessons Learned

In the early 2000s, major projects like HealthConnect and MediConnect sought to build a national health information network. Despite partial successes, both fell short of ambitions—partly due to overcentralization and weak clinician buy-in. From these experiments came valuable lessons: success requires interoperability, not monolithic “one-size-fits-all” systems.

Then the National E-Health Transition Authority (NEHTA), launched in 2005, standardized the system’s DNA—introducing the Individual Healthcare Identifier and adopting SNOMED CT, the clinical “language” used worldwide. NEHTA’s work would eventually lay the foundation for My Health Record.

Hospital EMRs and National Systems

Hospitals soon followed, with mixed results. Success stories—like the fully digital Cerner rollouts in Queensland’s Princess Alexandra and St Stephens Hospitals—stood in contrast to failures like Victoria’s costly HealthSmart project, which was criticized for poor leadership and lack of stakeholder engagement. Royle’s leadership at St Stephens marked a turning point; by involving clinicians from day one, the project sidestepped resistance and proved that the technology can serve medicine, not the other way around.

The transformation of the PCEHR into My Health Record in 2016 cemented digital health as a national priority. By switching from “opt-in” to “opt-out,” the system achieved over 98% population coverage. Yet, uptake by clinicians remained limited—until COVID-19 forced the system to mature in real time.

COVID-19: The Great Accelerator

The pandemic did for telehealth in three months what years of advocacy could not. More than 30 million virtual GP consultations occurred within six months, e-prescriptions were rolled out across the country, and vaccination records were updated automatically in digital systems. Suddenly, digital health was no longer a policy goal—it was a public necessity. The crisis solidified the case for permanent telehealth reimbursement and demonstrated that the public could adapt to digital health faster than bureaucracies assumed.

Royle and Hansen argue this period proved that once underlying technologies are in place—like the IHI, HL7 standards, and My Health Record—the network effect finally takes hold. These infrastructure pieces transform digital health from an individual initiative into a collective ecosystem.

If a patient’s blood test results can’t speak to their medication list, or a hospital discharge summary can’t talk to a GP’s system, then technology isn’t helping—it’s hindering. Royle and Hansen explain that interoperability—the ability of different systems to exchange and interpret shared data—is the lifeblood of digital health. Everything else depends on it.

From Acronyms to Action: HL7, FHIR, and SNOMED

The alphabet soup of digital health—HL7, FHIR, IHI, SNOMED—can seem opaque, but each represents a crucial building block. HL7 (Health Level Seven) revolutionized the way results moved between labs and clinics, while its next-generation cousin, FHIR (Fast Healthcare Interoperability Resources), embraces modern web technologies. Created in 2011 by Australian expert Grahame Grieve, FHIR allows data exchange through APIs—the same technology that powers apps like Apple Health or Google Fit.

SNOMED CT, meanwhile, acts as medicine’s universal translator—a clinical dictionary ensuring every diagnosis, procedure, and condition carries a single, consistent meaning. It’s the linguistic glue binding the digital health ecosystem.

The Power of Identifiers

Imagine trying to match a patient across multiple hospitals without a universal ID—it’s a recipe for confusion and error. The Individual Healthcare Identifier (IHI) solves this by assigning every patient a unique 16-digit code. Combined with identifiers for providers and organizations, IHIs make sure the right data follows the right person, enabling safe data use across platforms.

These technical foundations, while invisible to patients, are what make truly connected care possible. Without them, even the most advanced AI or telemedicine innovation collapses under data incompatibility.

Project Sparked and the National Core Data Set

The next frontier is unifying Australia around shared, modern standards. The Project Sparked initiative—launched by CSIRO in 2023 with partners like HL7 Australia and the Department of Health—embodies this effort. Drawing inspiration from the U.S. Project Argonaut, it aims to create a cohesive Australian Core Data Set for Interoperability (AuCDI). This standard ensures that essential patient data can move freely and meaningfully between systems, while also respecting Indigenous identity markers and national healthcare nuances.

Interoperability isn’t a technical luxury, the authors insist—it’s the moral backbone of a modern health system. Without it, digital health remains a collection of islands, not an archipelago of care.

Artificial intelligence, for Royle and Hansen, is no longer futuristic—it’s the next logical layer atop Australia’s maturing digital health foundation. With data now flowing more freely, AI can turn information into actionable insight. But the authors emphasize a crucial caveat: without trustworthy data and ethical design, AI risks compounding existing healthcare inequities rather than solving them.

AI in Diagnostics and Clinical Support

From breast cancer screening to retinal disease detection, AI algorithms are already matching—and sometimes outperforming—human specialists. For instance, AI-enabled mammography systems now assist radiologists as “second readers,” catching subtle indicators too easily missed during long shifts. In radiotherapy, AI plans treatments by segmenting organs accurately and predicting radiation effects, freeing human experts to focus on complex decisions.

Despite such promise, early failures of AI in medicine—due to biased data and poor validation—taught researchers that health-specific AI must meet rigorous regulatory standards. Many such tools qualify as “Software as a Medical Device” under Therapeutic Goods Administration rules, requiring oversight akin to pharmaceuticals. The growing field of ambient AI—exemplified by Australian pioneer Lyrebird Software—illustrates a safer use case. By listening in real time during consultations and drafting doctor’s notes automatically, it lightens the administrative load rather than replacing clinical judgment.

Generative AI and the Human Touch

The explosion of generative AI tools like ChatGPT introduces new opportunities and risks. Imagine AI-powered symptom checkers that interpret nuanced patient language and gently triage users toward appropriate care—a step beyond static question trees. Yet, Royle and Hansen warn that large language models must be paired with medical-grade oversight. Dialogue alone doesn’t equate to diagnosis.

AI also holds potential in non-clinical domains—resource scheduling, hospital logistics, and environmental impact reduction. The authors reference the UK National Health Service’s AI Lab as a model for coordinating trustworthy innovation. Australia’s own Australian Alliance for AI in Healthcare is taking similar steps with a national roadmap promoting ethics, interoperability, and patient safety.

AI will not replace doctors, they note—but doctors who use AI responsibly will replace those who ignore it.

For patients, this new reality means faster diagnoses, safer treatments, and less friction in daily health management. The catch? It all hinges on one thing: having clean, connected, and secure data to feed the learning machines.

Australia’s geography—a land of vast distances and sparse rural populations—makes virtual care not just a convenience but a necessity. Royle and Hansen illustrate how telehealth, once considered exotic, has evolved from a stopgap measure into an integral arm of healthcare delivery.

From Landline to Lifeline

The Western Australian Country Health Service’s Emergency Telehealth Service, which provides remote on-call emergency physicians to hospitals without 24-hour doctors, exemplifies the lifesaving potential of virtual connectivity. Meanwhile, CSIRO’s Remote-I platform connects urban eye specialists with remote communities to detect early eye disease—a breakthrough for Indigenous and rural populations. These aren’t pilot projects anymore; they are operational realities saving lives.

Mobile Health and the Democratization of Data

The rise of smartphones has given birth to “mobile health”—using apps to deliver continuous care. The CSIRO’s cardiac rehabilitation program, later spun into the company Cardihab, demonstrated that home-based digital recovery could outperform traditional rehab attendance. Similarly, the M♡THer app supported women with gestational diabetes by allowing real-time blood glucose monitoring from home, freeing hospital capacity and reducing risks for mothers and babies. (The program’s success has even led to expanded trials across Australian hospitals.)

Looking ahead, AI-enhanced chatbots could offer tailored coaching and alerts, creating a hybrid system where algorithms handle routine support while clinicians intervene for complexity. The authors see this “virtual-first” model as crucial to an overstretched workforce and an empowered patient community.

Telehealth, they argue, is not about replacing human interaction—it’s about reclaiming access and continuity in a system that has too often lost both.

Royle and Hansen stress that Australia will only achieve truly connected care when its most vulnerable populations—older adults, people with disability, and Indigenous Australians—share in the digital transformation. These communities historically face fragmented, underfunded, and analog systems, but digital tools are starting to close those gaps.

Reinventing Aged and Disability Care

Aged care facilities and disability providers have long operated outside the mainstream health data ecosystem. The Royal Commission into Aged Care Quality and Safety identified digital connectivity as a prerequisite for quality future care. Imagine a resident at an aged care home whose vital signs automatically link to their GP, pharmacist, and caregiver dashboard—that’s the reality the authors advocate for.

In practical terms, the CSIRO’s Smarter Safer Homes trial showed how sensors and AI could help older adults maintain independence longer, improving quality of life and reducing emergency transfers. Similarly, the 2022 AI-enabled Assistive Technologies Framework—developed with the National Disability Insurance Agency—guides ethical adoption of smart devices like fall detection tools and mobility aids.

Digital Bridges for Indigenous Health

For Indigenous communities, digital health solutions must start with co-design and cultural governance. Research cited by the authors identifies six principles for success—First Nations leadership, inclusivity, reciprocity, evidence-based approaches, and above all, respect. The KaraCare System, co-developed by CSIRO and Western Australia’s government, illustrates this ethos: it connects Aboriginal health providers across systems using FHIR technology, ensuring clinical data remains both useful and culturally safe.

In all three areas, the message is consistent: the value of digital care multiplies with connection. Each new link—be it a smart sensor, a telehealth portal, or a shared database—reduces the distance between care and community.

Ultimately, Connected Care ends where it began—with leadership and trust. Technology is necessary but insufficient; people and policy must align behind it. Royle and Hansen identify leadership as the missing ingredient in many failed health digitization efforts, and they challenge both government and clinicians to take ownership of the change ahead.

Governing for the Common Good

Australia’s federal structure—fragmented between state-run hospital systems and federally funded primary care—has long hampered unified action. But recent developments, such as the 2023 Digital Health Blueprint and Action Plan, aim to overcome those “rail gauge” differences. A record $951 million investment signals that Canberra finally recognizes digital health not as optional modernization, but essential infrastructure.

Trust in Data and Security

Cybersecurity breaches, such as the 2024 MediSecure leak, remind us that digital trust is easily lost. The authors applaud systems like My Health Record and Epic for their strong security design but note that small-scale GP and community providers must move to encrypted, cloud-based servers to ensure consistency. Encryption—both in storage and transmission—is no longer optional; it is the moral equivalent of informed consent.

The Human Factor

Consumers, they argue, are no longer passive recipients—they’re data collaborators. Surveys show most Australians now want to access and share their health information digitally, especially those managing chronic conditions. For clinicians, the call is similar: digital literacy is as critical as medical literacy. Programs like the Certified Health Informatician Australasia certification are cultivating a workforce fluent in both care and code.

Connected care will not only modernize health—it will democratize it, giving every Australian the tools to manage their health better, live longer, and trust the system again.

For Royle and Hansen, this is the ultimate payoff: technology that restores human connection, rather than replacing it. Once everyone—leaders, clinicians, and citizens—shares both the data and the mission, connected care will fulfill its promise of a healthier, more equitable nation.