Opinion: Broadband is needed, and needed now

As a starting point, we need to recognise that the health system is a complex ecosystem. The transformational power of the digital revolution is the way it enables networked operations, linking previously disconnected parts of the system. The network platforms enable information flows and it is access to information and better information exchanges that facilitates better health outcomes through changed operational processes.

Dr Terry Cutler. Credit: CSIRO

Seamless access to patient health records, medication data, and care plans makes the whole system more intelligent - and citizen access to online health information, triage services, and medical peer to peer consultations through all the forms of teleconferencing promote a more joined-up and collaborative framework for service delivery.

Professor Peter Brooks reminds us that "80 percent of diagnoses can be made by taking the patient history alone", which is why online consultation and triage has such potential to treat people outside our costly acute-care facilities. It also provides better service access for people in non-metropolitan areas. In Queensland, a Professor of Geriatrics runs the Geriatric Ward at Toowoomba Hospital, which is 130 kilometres from Brisbane, from his office at Brisbane's Princess Alexandra Hospital. There are numerous similar examples around the country.

But what if we could do the same thing with people in their own homes, particularly as more people become housebound? How much would become possible with a high definition Skype-like service and remote monitoring like the health equivalent of a smart energy grid? Think of the savings and convenience of ePresciptions and "call back" forms of care.

In addition, we can provide the tools to help people become more informed about health issues and better placed to manage their own well-being, not to mention the fact that preventative health measures and social inclusion will be enhanced through better communication linkages between family members and friends, especially for the housebound or isolated.

Ubiquity is important

Only two things hold us back from realising the potential. The first is that within health and community services we need to re-examine the current business models and incentive structures across the sector to facilitate different ways of doing things. Second, the example of eHealth has some important implications for the way we think about broadband infrastructure.

First, ubiquity is important. We can create institution-to-institution links now, but we need extensive household coverage to realise a truly citizen-centric and cost-effective health system. We also know from experience that networked solutions only take off when there is a tipping point in the level of penetration. The more people are linked in, the more beneficial the system becomes for everyone. That is why is it useful to focus on applications that can drive take-up and use.

Second, e-health and other like examples highlight the need for the high capacity symmetrical bandwidth that fibre links facilitate. Present copperwire and wireless-based solutions are predominantly built around an asymmetrical model where there is far greater download capacity than upload.

Finally, thinking about the uses we could make of broadband infrastructure reminds us that - to assess the benefits, and costs - we need to look at the value proposition across the whole service delivery architecture, not just the costly infrastructure platform.

The Australian Government is committed to broadband communications, it is committed to better health outcomes, it looks to better environmental management, and it is promoting more efficient energy systems. This provides an opportunity to join the public policy dots and to bring forward significant public benefit outcomes.

Dr Terry Cutler FTSE is an industry consultant and strategy adviser in the information and communication technology sector, Principal of Cutler & Company and Deputy Chairman of CSIRO.

This article first appeared in the December 2010 issue of Australian Academy of Technological Sciences and Engineering (ATSE) Focus. Reproduced with permission.