Critical services

Digitising human services

Six technology and services experts discuss how to build on the rapid digitisation brought on by COVID-19 to deliver better human services

Overview

Author: Jarrod Ball, CEDA Chief Economist

The COVID-19 pandemic has necessitated rapid and fundamental shifts in how human services are delivered in Australia. The expansion of telehealth demonstrated that technology is readily available to deliver greater convenience and access to services for the community – where the will to change exists. A survey commissioned by NBN Co. found that almost half of Australians who visited their GP in the early phase of the pandemic did so virtually via telehealth services, and almost two thirds of respondents said they would continue using telehealth services into the future. 

Governments have no choice now but to use the COVID-19 moment to drive permanent changes to embed technology and data into human services. The critical imperative for governments is that those services meet community expectations of quality and that there is trust in the technology and data underpinning those services. Timely and convenient access to human services will also be critical in a recession that will entrench and exacerbate existing disadvantage and vulnerability for many in the community.  

The starting point must be more convenient and easier to access human services for all in the community, complementing and enhancing the ‘human touch’ rather than replacing it. The broader benefits will only be felt if the service meets community expectations. A relentless focus on fiscal savings or ensuring regulatory compliance often sees government digitisation efforts fail, building community scepticism and distrust.  

Each contribution to this report outlines how digitisation can provide the community with better human services in the most convenient setting at the right time. But there are broader enablers required to make this happen. 

The first is data. Providing better human services requires more sophisticated collection, storage, sharing and application of data. Governments are taking important steps to facilitate this, including through the Commonwealth Government’s forthcoming Data Availability and Transparency legislation. Incorporating more data in human services needs to meaningfully enhance these services, and the data needs to be collected, stored and applied in a transparent way to ensure community trust. Recent experiences demonstrate the value of data in a crisis – whether this is emergency responses to bushfires or contact tracing for COVID-19. But data cannot simply be switched on in a crisis – it must be part of business as usual for government service delivery.  

Secondly, digital inclusion remains problematic for Australia. It is not safe to assume everyone in the community has the same access to digital technology. At the start of the pandemic, research showed that 2.5 million Australians were not connected to the internet. A lack of digital literacy also means that even where there is the means to connect, not everyone will have the same ability to use hardware and applications to interact with the required services. Financial and technical support must be integrated into our policy settings. 

Third, we need better knowledge sharing and coordination across jurisdictions and sectors of human services. Despite renewed cooperation and coordination between levels of government as a result of COVID-19, it is apparent that many governments are continuing to digitise their human services without leveraging the knowledge and experience of other governments that are further ahead in this process. Doing this could enable better services and avoid mistakes that prove costly for taxpayers. 

Finally, we need to invest in and grow the human services sector. Human services are often seen as a cost or drain on the economy despite the value that the community places on them, as evident in the results of CEDA’s 2018 Community Pulse survey, which found government delivery of critical services and support in health and aged care were among the top priorities for Australians. They also deliver well-established long-term economic benefits to participation and productivity. But the economic importance of human services is also right in front of our eyes. Healthcare and social assistance employs around 1.8 million people, accounting for 14 per cent of the workforce. As Professor Elizabeth Hill recently demonstrated in CEDA’s Labour market policy after COVID-19, human services can also play an important role in Australia’s jobs recovery. 

The five human services explored here accounted for more than $150 billion of government expenditure last year. This expenditure should be seen as an investment in building the capacity of governments, the private sector, not-for-profits, cooperatives and mutuals to deliver human services that are constantly improving and delivering the best value for the community. 

Dr Rob Grenfell (CSIRO) begins our expert contributions with a short case study to describe how digital technology and systems can assist in every aspect of the caring economy. This includes the client being certain of the detailed care they will receive, carers having more time to properly connect with their clients as digitised systems reduce administration and governments having the data to understand the effectiveness of their programs in real-time and make adjustments as necessary. 

These outcomes are not achievable without better data and records, as Tim Kelsey (Analytics International HIMSS) highlights in his contribution on the digitisation of health. As he notes, the priority for Australian governments in developing a single, lifetime comprehensive record that follows the patient wherever they are treated is to agree on common data standards for clinical information. This would include the adoption of the Individual Health Identifier (IHI) as the primary identifier for all medical records. The IHI, a federal initiative, already provides a unique 16-digit number for all eligible residents in Australia and should be used by state and territory governments as well as private providers as the de facto standard for all health and care services.  

But joined up data and records alone will not drive the innovation and improvement necessary to deliver the best care possible. Jordan O’Reilly (HireUp) reminds us that just like other sectors of the economy, human services, such as disability care, need innovative risk-taking and the entry of new firms. O’Reilly suggests governments can play a market steward role by connecting entrepreneurs, facilitating the broader distribution of funding and investment in new models, building awareness of innovators and incentivising research and development. 

Where new firms, data and technology emerge to improve service delivery and outcomes for the community, it is important to share their benefits more broadly. As David Spriggs (InfoXchange) explains, this is beginning to occur in the provision of homelessness services. But there remains a compelling case for embedding proven systems across all jurisdictions and the housing continuum for safe and reliable access to shelter. This requires: 

  • Building on the New South Wales and Tasmanian approaches to implement a national approach to service coordination across the homelessness sector, so that services have a simple way to update and share bed vacancies, refer clients between services and with appropriate consent be able to view client information across services. 

  • Leveraging the Queensland approach to implement a client management system that is enabling a more person-centred, integrated approach across the housing continuum, including homelessness, social housing, affordable and private market rentals. 

In sectors such as justice that have long been dominated by paperwork and face-to-face proceedings, there is a need to build momentum for change, starting with high-volume and low complexity matters in the civil space. Sarah Kaur (Portable) proposes that governments invest in new processes and online tools for the most common disputes about residential tenancy, small consumer goods, fencing and traffic offences. 

The rise of mental health concerns during COVID-19 and the recent Productivity Commission report into mental health have built momentum for fundamental changes to the way mental health services are delivered in Australia. The provision of these services via telehealth has demonstrated the immediate opportunities to provide better access to these critical services. Professor Mary Foley (Telstra Health) notes that we must maintain the momentum and learn from countries that already have telehealth and virtual care embedded in their systems for mental health care. 

These contributions demonstrate that there is no shortage of ideas and enthusiasm for using technology and data to deliver better human services. It is now time to build on the momentum of the COVID-19 pandemic and use technology and data to deliver human services that meet community expectations and enhance the sector’s contribution to our economy and our society. 

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