Executive Summary

The key message from the consultations undertaken for this paper is that there is considerable latent demand for broadband services in the health sector in Australia. This observation is based on the transformational effects of a fully integrated system of health delivery as well as the potential of individual applications. This, combined with the specific technical requirements of reliability and synchronous transmission essential to the health sector, suggests that broadband is vital.

The major impediment to the more widespread use of broadband in the health sector was consistently identified as availability at an affordable price. Other impediments are discussed in some detail in the paper. While most of these other impediments are solvable, the availability and affordability impasse must be addressed to gain productivity benefits.

These productivity benefits are potentially significant, although difficult to quantify. In a sector that accounts for 8.5 per cent of Australia's GDP a productivity improvement of between 2.5 and 3 per cent, such as that envisaged in the UK, would yield significant economic benefits. Even more difficult to quantify are what are often described as 'social' benefits. While quality of life, and indeed life itself, is given a monetary value in a legal context, the reality is that wider use of online technologies will result in a reduction in human suffering and better health outcomes.

Health services in Australia are a significant part of the economy, and the costs are growing. Expenditure on health services in 1999-2000 was $53.7 billion. Australia's expenditure on health as a proportion of GDP increased from 5.2 per cent to 8.5 per cent between 1970 and 1999-2000 and is projected to rise further as the population ages. The Government's Intergenerational report explores the fiscal implications of the aging population. The productivity benefits to be gained from more widespread use of technology-based health services could be used to contain overall expenditure and to improve services.

A rapidly expanding range of technology-enabled health applications are currently in use or being developed, ranging from visions of the future such as remote surgery conducted using robotics, to a remote expert directing the functions in an emergency room, to remote training, to electronic patient records. There is also a core move to provide a greater opportunity for the consumer to take responsibility for wellness.

Security and privacy issues are paramount in health services and, with the advent of communications technology in health care, there has been concern about safeguarding personal information. Advances in privacy legislation, important work on standards and Public Key Infrastructure development being undertaken by the Health Insurance Commission are laying foundations for solutions to these issues. Funding through the Medical Benefits Schedule and medical legal issues need to be addressed, but are not insurmountable obstacles. Finally, cultural change in work practices by clinicians is essential to enable the effective use of new technologies leading to improved health outcomes.