541 - Connected Care: Bridging Gaps in Modern Healthcare: The Future is on FHIR!

As healthcare systems around the globe grapple with rising demand and constrained resources, the push for improved data sharing and digital integration grows ever stronger. 

This episode of Talking HealthTech explores the evolving landscape of connected care in Australia. It focuses on how interoperability, fuelled by FHIR (Fast Healthcare Interoperability Resources), reshapes clinical and patient experiences and what it will take to make these changes stick.

This episode is part four of a 4-part series by Talking HealthTech in collaboration with Telstra Health and Smile Digital Health called Connected Care: Bridging Gaps in Modern Healthcare.

A Fragmented Ecosystem in Need of Connection

For decades, Australia’s healthcare sector has been characterised by tribal communities, each with its own digital systems, workflows, and priorities. Pathology, primary care, acute care, and government departments often operate in silos, making the smooth movement of information between settings a persistent challenge. Despite significant investment in digital infrastructure and a nationwide commitment to improving patient outcomes, the system remains burdened by legacy technology and inconsistent data practices.

“When you think about what you need to do to drive interoperability, it really needs a community,” says 🎶Marvin Malcolm , Head of Data and Integration Architecture at Telstra Health. “No organisation can do that in isolation. No organisation is an island that drives interoperability.”

This sense of collective purpose is beginning to take root, with industry bodies, government agencies, technology partners, and clinicians coalescing around initiatives designed to make genuinely interoperable care a reality. As Marvin puts it,

“We’ve talked about it for years. But when you actually say, ‘Okay, well, we’ve talked about it. Now let’s do it’, that’s when things start to happen.”

Why Interoperability Matters, and Why it’s Hard

Interoperability is essential for seamless, patient-centred care. It allows clinicians to access the information they need from pathology results to patient histories wherever and whenever required. Yet, the journey towards interoperability is as much about cultural and administrative hurdles as it is about technology.

One of the primary reasons for this complexity is that healthcare data is deeply nuanced. As Duncan Weatherston , CEO of Smile Digital Health, explains,

“Healthcare has a semantic problem. It has a structural problem. It has a legislative problem.”

Even basics like the way labs measure tests (molality for one, mass for another) or the codes they use to describe results can differ from one provider, state, or country to the next.

In practice, matching and merging data is no small feat. As Duncan puts it, “The ability to drive interoperability requires that you overcome each of those hurdles.”

From Islands of Information to Seamless Data Flow

Historically, health IT has prioritised applications over data. Hospitals, clinics, and labs have invested in a patchwork of specialised software - each optimised for its purpose, storing information according to its rules. This application-first mindset has created thriving islands of functionality and a digital archipelago, with vital patient data trapped in closed systems or requiring time-consuming manual re-entry to move between providers.

Keith Kranz , Manager ICT at SA Pathology , summarises the issue:

“We put in lots of applications. And to be quite honest, all that’s done is create islands of information in my mind. And we have to step out of that area because a lot of people are in their comfort zone when it's an application.”

The costs, both financial and clinical, are significant. Front-line staff may spend extra minutes (sometimes hours) each day transcribing information from paper or a PDF. Mistakes can creep in. Patients grow frustrated when they must repeat histories or chase down records that should flow freely. The stakes are even higher for health services serving both public and private patients across metropolitan, regional, and remote areas.

The Promise of FHIR and the Path to Standardisation

To break the cycle of fragmentation, the spotlight has shifted to FHIR, a modern health data exchange standard designed for the digital age. Developed by HL7, FHIR allows healthcare data, whether test results, care notes, or administrative details, to be packaged, exchanged, and interpreted consistently across systems.

For Keith, the move to FHIR at SA Pathology was about regaining control.

“You’re stuck in the vendor model where, at the end of the day, the vendor has you in control rather than the other way around. I’m not in control of anything because, invariably, vendors will lock the data up in their proprietary systems.”

FHIR’s appeal lies in its flexibility and granularity. Data can be broken down to an atomic level, meaning it’s not just exchanged but can be interpreted, queried, and aggregated for future uses such as AI-driven analytics, population health management, or clinical decision support.

“Once again, that’s one of the exciting things about My Health Record because My Health Record is stuck in a PDF world today with CDA format, and the reality is that data is not realisable like that. So, it needs to be turned into something else, and they’ve started on that journey,” Keith says.

Barriers to Data Quality and Legacy Systems

Standardisation isn’t just about agreeing on formats; it’s also about improving data quality. Much of the information in legacy healthcare systems is inconsistently structured or unvalidated. Fields designed for clinical shorthand, or paper records never intended for sharing, frustrate modern efforts to automate workflows or glean new insights.

“When you’re moving into this FHIR world, which to me is all about standards, at the end of the day, is ‘How do I fix some of the inherent issues that I’ve got currently in the system because I’m having to talk to those legacy systems?’” Keith observes. “And in that process, I want to improve the quality. Because if we are going to use things like AI and so forth in the future, you’ve got to do it off the back of good quality data.”

Bridging these gaps often means building interfaces that translate data from old formats, cleaning up inconsistencies, and digitising historical records. In some areas, such as digital pathology and genetics, this also involves managing an explosion of new information, with genomics generating data at petabytes annually.

Global Lessons, Local Challenges

Interoperability isn’t a uniquely Australian problem. Healthcare organisations worldwide, from North America to Europe and Asia, have faced similar barriers. Duncan notes,

“This is a global need… the use cases are specific to a particular clinical engagement or an administrative engagement, and then they’re different in each of the locations where you have these types of interactions.”

Yet, the Australian context presents its mix of challenges and opportunities. Its size and diversity make national collaboration both essential and logistically complex. Initiatives like the Sparked Symposium (which brings together hundreds of organisations to drive interoperability) reflect a growing appetite for progress and a recognition that shared effort is required.

Data for Better Outcomes, Not Just Better Processes

Better structured, interoperable data is not just about efficiency or cost control. The actual payoff lies in its ability to improve clinical decision-making and patient outcomes. Streamlining requests and results can be life-changing for a department like SA Pathology, which provides services to both the public and private sectors and underpins critical diagnoses.

“Traditionally, pathology has been about clinicians. That's the first thing. It's also been about ‘I get an order or a request form.’ So, most people will be aware the request form starts the pathology journey at the end of the day. That’s the order that you generate for tests, and then ‘I provide results’. And, traditionally, that’s been the pathology model, which is kind of like a very short journey. The future for pathology is how do you then value add to that process and do a lot more with that data?” Keith asks.

By atomising and standardising results, labs and clinicians can easily track trends over time, spot anomalies, or apply predictive models that help clinicians intervene earlier. Patients, too, benefit when they receive reports tailored for lay understanding, with meaningful commentary rather than bewildering tables of numbers.

Streamlining Workflows and Reducing Burden

Practical examples of interoperability in action abound. Take electronic requesting, where a GP orders a test directly from their system, the order flows seamlessly to the pathology provider, and results travel back without re-keying or duplication. This saves time for front-line staff, enhances accuracy, and reduces patient friction.

“If I add three or four minutes to each of those patients because I’m going to enter some data into a computer system, that ain’t good value because most people don’t want to wait. I certainly don’t want to wait. In fact, if it was me, I’d walk out of there and go somewhere else. And this is to me also about that customer experience and how we improve the customer experience,” Keith notes.

This means more room for clinicians to focus on interpretation, shared decision-making, and empathy, and less on wrangling systems or correcting data.

Clinical Automation, Computability, and the Role of Standards

A significant benefit of digital, interoperable platforms is the ability to compute across care journeys. Trend lines, alerts, and calculators can help clinicians spot subtle deterioration or respond to risks before they escalate.

“We need to be able to compute on the back of information. We need to be able to do a lot of the work on behalf of the clinician. We need to reduce the cognitive load… Computability is the win. Computability is how we’re going to take the load off of clinicians, how we’re going to help people adhere to best practices, how we’re going to take the science and make it real, and then how we’re going to take the reality and bring it back to science,” says Duncan.

Interoperable standards like FHIR, paired with structured terminologies such as SNOMED and LOINC, give organisations the foundational tools to organise, validate, and share information even at a national or population level. This opens the door to improved clinical care and research, health system planning, and real-time quality improvement.

Meeting the Needs of Patients and Clinicians Alike

As more patients access their results directly, sometimes even before their GP, it has become critical to tailor data for professional use, clarity and reassurance.

“When you’ve got that data, that rich amount of data, to deliver a table of numbers on a piece of paper to somebody as a consumer… that’s nice,” reflects Marvin. “We did some work a couple of years ago around interpretive comments. I think it would be nice if… the output to me as a consumer is more of a narrative or something that says, ‘By the way, your cholesterol is a little bit high right now. It’s been trending up for the past three years. You probably ought to, you know, take some action around that.’”

This philosophy shapes the broader shift towards citizen science and engaged self-management. People with chronic conditions can benefit from transparency and accessible data, helping to postpone, mitigate, or even avoid complications.

A Future-Proof Platform for Emerging Opportunities

Looking ahead, the scale and flexibility of interoperable platforms will prove critical. New diagnostic technologies, evolving models of care, AI-powered analytics, and the ever-increasing volume of data from sources like genomics all demand adaptable systems.

Marvin notes, “It’s a very scalable platform. I know some of the new work they’re doing around scaling data, which is really interesting. It’s a piece that people… It’s not sexy, but when you’re starting to collect lots and lots of data as we will need to do in the future, well, how do you ensure that the technology that you’re using can support that?”

Australian providers are now watching closely as platforms like Smile Digital Health's FHIR-based offerings are localised and expanded through partnerships (such as with Telstra Health), hoping to balance international best practice with the practical realities of local implementation.

Learning from the Past, Building for Tomorrow

For transformation leaders like Keith, it’s clear that change is not simply about technology but process, culture, and strategic vision.

“We’ve got to make things simple by design. I see constantly we put in place applications that require people to make multiple clicks, who need extensive training to find things, yet dropping through multiple tabs to see things, that’s a problem straight up because we’re not making it easy for people to do,” he says.

Others are quick to emphasise the need for ongoing collaboration and relentless focus on usability. Whether it’s codifying data so that it means the same thing in one place to another or engaging with community stakeholders to ensure all voices are heard, the work of digital transformation is never truly finished.

“The application is what drives the clinical use case… We need to separate out the data, make sure we’ve got a great data model, a great structure, and then we need to bring it back to the clinician in a way that’s usable by them and delivers all that value they’re not getting today because they’re not interoperable,” Duncan argues.

Delivering on the Dream: Why Interoperability Can’t Wait

Getting interoperability right will unlock clinical, financial, and human value at scale. As technology moves forward and patient expectations shift, those organisations that adopt open standards, focus on usability, and prioritise collaboration with peers and partners will be best placed to thrive.

The future of connected care in Australia and worldwide will be decided by those willing to bridge divides, share data, and turn information into actionable insights to benefit us all.

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Telstra Health

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