Dr Amandeep Hansra
Australia's digital health challenge is increasingly less about funding – and more about how value is defined and measured.
That was a central theme emerging from a recent HIMSS–Nous Group discussion on ROI-driven transformation, later captured in a joint report, and one echoed by Dr Amandeep Hansra, chief clinical adviser at the Australian Digital Health Agency.
Too often, she argues, ROI in healthcare is still narrowly defined through a financial lens – risking an incomplete view of the value digital transformation can deliver.
"In this ROI discussion, it is important to acknowledge several key factors," Dr Hansra said. "Australians are, on average, living longer and with more chronic disease… So when we talk about ROI, we must broaden the lens. It can't just be about short-term financial gain."
Instead, she points to a broader definition of value – one that includes outcomes, experience, and long-term sustainability.
"Digital health isn't just a cost centre, it is an enabler of better care and system transformation," she said. "We are already seeing measurable returns in reducing avoidable hospitalisations, improving care coordination, shifting care from hospitals into the community, and enhancing both patient and clinician experience."
From optional investment to national priority
This shift in thinking is increasingly reflected in national policy and reform efforts. Digital infrastructure is now being treated less as a discretionary investment and more as a foundational component of the health system.
Dr Hansra points to Australia's recent policy direction as evidence of this shift, including reforms under the Strengthening Medicare agenda and legislation such as Share by Default.
"There is a strong argument that Australia is already fully committed to this shift," she said.
Since the announcement of Share by Default in 2023, engagement with My Health Record has increased significantly, with sharp rises in clinician access to pathology and diagnostic imaging results, as well as increased consumer usage.
"This is beyond commitment," Dr Hansra said. "This is a comprehensive transformation of our health system."
Policy changes expanding the use of healthcare identifiers are also enabling more providers to participate in digital health infrastructure, supporting more coordinated, multidisciplinary care.
Why fragmentation remains
Despite this progress, fragmentation across the health system persists – a challenge widely recognised across the sector.
Australia's healthcare system has historically developed across primary, acute, and community settings, each with different workflows, incentives, and technologies.
"Fragmentation persists because healthcare hasn't historically been designed as a connected system," Dr Hansra said.
Reforms are underway to address this, including mandates for sharing pathology and diagnostic imaging data, alongside broader national agreements on interoperability.
Adoption is also increasing. In the past year, healthcare providers have accessed shared patient information millions of times through My Health Record, reflecting growing reliance on shared data in clinical decision-making.
But the next phase of transformation, Dr Hansra suggests, is less about building infrastructure and more about embedding it into routine care.
"We need to continue shifting from building infrastructure to embedding it in clinical workflows," she said. "That means making data sharing the default, ensuring systems are interoperable and easy to use at the point of care, and supporting clinicians to adopt digital tools as part of routine care delivery."
AI ambitions depend on strong foundations
As interest in AI accelerates, both the report and Dr Hansra's remarks emphasise the importance of strong digital foundations. Emerging technologies such as AI depend on interoperable systems and high-quality data to deliver meaningful value.
"AI is only as effective as the data and systems it sits on, so getting the foundations right is critical," she said.
National strategies are therefore focused on strengthening interoperability, improving data quality, and establishing governance frameworks to support the safe and effective use of AI.
Aligning a complex system
Australia's federated funding model adds complexity to digital transformation, with costs and benefits often distributed across different parts of the system – an issue frequently raised in national conversations on digital health.
Dr Hansra acknowledges this complexity but emphasises the level of national coordination already in place.
"Australia's federated system does create some complexity, but it's not simply a barrier," she said.
Frameworks such as the National Digital Health Strategy 2023–2028 provide a shared direction for data sharing, interoperability, and digital investment.
"To sustain progress, we need continued alignment between policy, funding, and outcomes so that investment across the system supports more connected care across the country."
Measuring what really matters
The HIMSS–Nous report highlights a shift from measuring implementation to measuring outcomes – particularly patient experience, clinician experience, and equity.
Dr Hansra sees this shift underway, though not yet complete.
"There is definitely a shift underway, from measuring activity to measuring impact, but we still have some way to go," she said.
She points to the concept of a "learning health system," where data is used continuously to improve care, inform policy, and guide investment decisions.
As digital infrastructure becomes more connected and comprehensive, the opportunity to measure meaningful outcomes – and use that insight to improve the system – continues to grow.
Redefining ROI for the next decade
Taken together, the message from both the HIMSS–Nous forum and Dr Hansra's perspective is consistent: ROI in digital health must extend beyond financial return.
"What's missed when we focus too narrowly on short-term ROI is the broader value," Hansra said. "Better outcomes, more equitable access, and a more sustainable health system over time."
In that sense, the real return on digital health investment is not just financial – it is reflected in how effectively the system delivers care, supports clinicians, and improves outcomes for patients.
