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Annual Report 2012 - 2013

Business Highlights

Creating new connections

Healthdirect Australia provides every Australian with access to healthcare

No matter where people live, what time of the day or night, they can talk to a doctor or nurse, and receive trusted online advice on the most appropriate care for their health issue.

At a glance 04

Overview 10

Our services 13

Enhanced capabilities 28

Governance 30

Board committees 32

Risk management 33

Clinical governance 34

Contents

At a glance

4 Healthdirect Australia 5 Annual Report 2012 - 2013

Healthdirect Australia has come a long way since developing the first Australia-wide 24-hour nurse triage helpline

Chair’s statementWelcome

Healthdirect Australia continues to make great strides since launching the first Australia-wide 24-hour nurse triage helpline.

Our focus will always remain the same: providing the most appropriate health related-information and advice for all Australians.

Healthdirect Australia is playing a key role in Australia’s changing healthcare landscape. We are providing online and telephone-based health information and advice, as well as linking state and federal government services with providers and partner organisations. Our services successfully fill vital gaps in the healthcare system, such as connecting patients with after hours care or providing trusted and credible sources of health information.

We have reached some important milestones this year, which highlight just how important our services are. Almost four million callers have been assisted and reassured by being able to speak with a nurse on the healthdirect Australia telephone service at any hour of the day and night. Furthermore this year more than 35,000 new and expectant mothers were supported by the Pregnancy, Birth and Baby helpline, while there were 117,000 visits to the new website.

As well as delivering on our continuing commitments from the last report, this year we developed significant new online and telephone services that will have an impact across both health and aged services. These include mindhealthconnect (launched 1 July 2012) and our new My Aged Care website and call centre (launched 1 July 2013). Already more than 1,000 Australians use the mindhealthconnect website every day to access information and support for mental health issues. To successfully integrate these services we have established a best practice strategic sourcing framework, and further enhanced our risk and clinical governance frameworks.

The company has continued to operate within budget this year, utilising funds held over from prior years. While this shows up as an operating deficit for the year, it simply reflects that we have used unexpended funds from previous years as new services are developed and rolled out over multi-year timeframes.

I would like to acknowledge the work of my fellow Board members, and of all our Board committees, who work tirelessly to improve access to our high quality health information services.

We will continue to focus on connecting Australians with the most appropriate health advice for their needs to ensure they make the most informed decisions for their care and treatment.

Bob Sendt, Chair

6 Healthdirect Australia

Over the last 12 months we have invested to create a national network of health information services to enhance Australians’ health literacy, empowering them to make informed choices and to navigate their way to the appropriate service for their health issue or enquiry. By linking our health information services with face-to-face primary care services, Healthdirect Australia creates an easier pathway to the appropriate health service, providing national support at a local level.

This year we changed the company’s name from the National Health Call Centre Network to Healthdirect Australia, reflecting our evolution from a single telephone helpline to a multiple health information services provider.

I would like to thank all our staff for this outstanding effort, bringing their different skills together to deliver projects on behalf of our stakeholders on time and on budget, and I would also like to recognise the support of our shareholders in bringing our vision to life.

Colin Seery, CEO

By the time you read this, healthdirect Australia will have reached a significant milestone, having received its four millionth call.

That is four million Australians who have been reassured by speaking with a registered nurse or GP to receive the information they need to make their next healthcare decision.

Following on from last year’s organisational change program, this year has seen the delivery and implementation of a number of key initiatives, enhancing our core services and the completion of new projects. This includes the development of the My Aged Care gateway, the launch of the mindhealthconnect portal, the integration of the Pregnancy, Birth and Baby helpline and website, enhancements to our core services including healthdirect Australia, the after hours GP helpline and the healthinsite website, as well as further development of the National Health Services Directory.

CEO’s introductionDelivering new connections for a healthy future

By the time you read this, healthdirect Australia will have reached a significant milestone having received its four millionth call

7 Annual Report 2012 - 2013

Susan brings more than 20 years’ experience in law, governance and human resources to the Board. She has held executive management roles in corporate treasury and professional services firms, and is a non-executive Director on the Boards of G8 Education Ltd, Gold Coast Parklands and Children’s Health Foundation Queensland and is Chair of the Oncore Group. In addition to her Board Directorships, Susan is the leader of strategy practice of Board Matters, a specialist governance consultancy, and is an assessor for the Australian Institute of Company Directors.

Member of the Finance, Risk Management and Audit Committee

Member of the Clinical Governance Advisory Group

Patricia is an experienced Chair and Director in the energy, government, health and not-for-profit sectors. She is a non-executive Director of APA Group, the largest energy infrastructure company in Australia, and of Macquarie Generation, a major electricity generator in NSW. Patricia was formerly Chair of Diabetes Australia Limited, a Director of Australian Energy Market Operator Limited, Chair of Sunnyfield Limited and CEO of Gas Market Company Limited.

Chair of the Finance, Risk Management and Audit Committee

Member of the Project Review and Work Health and Safety Advisory Committee

Ms Karen Dado, DirectorAppointed June 2012

Ms Susan Forrester, DirectorAppointed June 2012

Ms Patricia McKenzie, DirectorAppointed June 2012

Karen is a Principal with AFG Venture Group, a corporate advisory and consulting firm based in Asia and Australia, and previously spent 15 years with PricewaterhouseCoopers in their Management Consulting, Risk Management and Transactions Services practices. She has conducted numerous performance improvement and governance reviews in leading healthcare organisations, research institutes and life science companies.

Chair of the Project Review and Work Health and Safety Advisory Committee

Jim is Chair of Rural Health Workforce Australia, a Board Member of Cancer SA and Mary MacKillop Care SA and Ernst & Young’s Lead Partner in Health and Human Services for Asia Pacific. He is Deputy Chair of the Independent Hospital Pricing Authority and was previously Chair of the Australian Health Ministers’ Advisory Council, Director of the National E-Health Transition Authority and Chief Executive of the Department of Health in South Australia.


Anthony is a specialist Emergency Physician and Vice-President of the Australasian College for Emergency Medicine, and is a member of the Governing Council of the Tasmanian Health Organisation - South. He also has roles as Associate Professor in Health Services and Deputy Head of the School of Medicine at the University of Tasmania, a member of the Australian Medical Council’s Specialist Education Accreditation Committee, and the Director of Acute Health Services Planning and Design in Tasmania.

Chair of the Clinical Governance Advisory Group

Mr Bob Sendt, ChairAppointed Chair June 2012, Director from February 2008

Mr Jim Birch, DirectorAppointed February 2007

Associate Professor Anthony Lawler, DirectorAppointed June 2012

Bob is a company director and consultant. He is the Administrator of the National Health Funding Pool and the Chairman of Job Futures Ltd, and has been a Director of the New South Wales Cancer Council, the Accounting Professional and Ethical Standards Board, and the Australian Auditing and Assurance Standards Board. Bob was the Auditor General of New South Wales from 1999 to 2006.

Member of the Finance, Risk Management and Audit Committee

Our Board

8 9 Healthdirect Australia

Over the past five years, we have seen a significant increase in the role of technology in delivering healthcare services and information Julie is a General Practitioner with 25

years’ experience as a Director on a range of health-related boards at a local, regional, state and national level including community health, hospital, aged care and GP divisions. She also has broad experience in health service reform including mental health, chronic disease management and primary care.


Member of the Project Review and Work Health and Safety Advisory Committee

Dr Julie Thompson, DirectorAppointed June 2012

Image from left to right

(Top) Anthony Lawler, Karen Dado, Patricia McKenzie, Jim Birch

(Bottom) Julie Thompson, Bob Sendt, Susan Forrester


A trusted gateway to healthcare information and services

Healthdirect Australia provides all Australians with free access to health information and advice. No matter where people live, what time of the day or night, they can talk to a doctor or nurse, and receive trusted online advice on the most appropriate care for their health issue.

In a country as large as ours, this can be a lifeline for many Australians who would otherwise need to travel great distances to the nearest hospital or medical practitioner. However it is just as reassuring for those living in the suburbs seeking information on caring for an aged parent or a friend with a mental health concern.

Healthdirect Australia procures, develops and manages online and telephone health advice services on behalf of state and federal governments.

• We link Australians to information services to give access to help and guidance when and where they need it.

• We coordinate and integrate health advice phone lines for consumers, carers and healthcare professionals on behalf of governments.

• We develop and manage health information websites, including information about mental health, pregnancy and aged care.

• We implement governance structures for these services to be provided safely and efficiently.

• We manage specialist services for state governments, such as ambulance secondary triage in NSW and WA.

• We are able to establish emergency support helplines within hours.

Each service is delivered through the most appropriate channel, whether that is telephone counselling for new parents or online information and guidance for those concerned with general health enquiries.

Overview

The company

Healthdirect Australia was established, and is jointly funded, by the Australian Government and the governments of the Australian Capital Territory, New South Wales, Northern Territory, South Australia, Tasmania and Western Australia. It is a public company limited by shares, and is responsible for delivering services by contracting with service providers and managing ongoing operations.

Name change

In December we changed our trading name from National Health Call Centre Network to Healthdirect Australia. This was a first step in defining and creating a brand portfolio that will align our services under one brand to best meet the needs of consumers. Our new name reflects our evolution from a single telephone service to a multiple service information provider, and the integrated role of our telephone and online channels for these services.

healthdirect Australia 1800 022 222 www.healthdirect.org.au

after hours GP helpline 1800 022 222

mindhealthconnect www.mindhealthconnect.org.au

healthinsite www.healthinsite.gov.au

National Health Services Directory www.nhsd.com.au accessible as a smartphone app and through many government and Medicare Local websites throughout Australia

My Aged Care (commenced 1 July 2013) 1800 200 422 www.myagedcare.gov.au

Healthdirect Australia services


Pregnancy, Birth and Baby 1800 882 436 www.pregnancybirthbaby.org.au

General health advice and triage

Counselling and support for young families

Access to healthcare providers in the right location

Access to information and support for aged care

Access to the right services for mental health concerns


Our services

WA• healthdirect Australia• after hours GP helpline• Pregnancy, Birth and Baby • Medicines line• Non-occupational post exposure

prophylaxis helpline• Residential care line• Ambulance secondary triage• Country patient transport assistance• Outpatients direct

NT• healthdirect Australia• after hours GP helpline• Pregnancy, Birth and Baby • Medicines line

SA• healthdirect Australia• after hours GP helpline• Pregnancy, Birth and Baby• Medicines line• SA Parenting Helpline• Accident and incident manage

ment system• Non-occupational post exposure

prophylaxis helpline• Fast track to after hours GP helpline for

nurses in residential aged care settings

QLD• after hours GP helpline• Pregnancy, Birth and Baby

NSW• healthdirect Australia• after hours GP helpline• Pregnancy, Birth and Baby • Ambulance secondary triage• Medicines line• Fast track to after hours GP helpline for

nurses in residential aged care settings

ACT• healthdirect Australia• after hours GP helpline• Pregnancy, Birth and Baby• Medicines line

VIC• after hours GP helpline• Pregnancy, Birth and Baby

TAS• healthdirect Australia• Pregnancy, Birth and Baby• Medicines line• The Parent Line

Our telephone healthcare network

13 12 Healthdirect Australia Annual Report 2012 - 2013

healthdirect Australia

Callers can speak to a registered nurse at any time of the day or night, about any health concern or query.

Many callers can be assisted to manage their condition at home or until they see their GP. Otherwise, they are directed to their relevant local health service – and if the call is an emergency, they are transferred to Triple Zero (000). healthdirect Australia is available to people calling from the ACT, NSW, NT, SA, TAS and WA.

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When Kerin phoned healthdirect Australia in April, she thought she had the flu and expected to be told to rest. So she wondered if it was an over-reaction when the call operator insisted she had to go straight to hospital by ambulance.

“By that stage, I could barely do up my pyjama buttons, and I’d just crawled on my hands and knees into bed. When I described that weakness, the operator suspected something more serious.”

Just a few hours later, Kerin found herself in an intensive care unit, where she was diagnosed with Guillain-Barré Syndrome.

“I cried, I was so shocked. I hadn’t realised until then just how serious it was.

But by the time I got to Royal Adelaide Hospital I couldn’t stand up at all.”

Guillain-Barré Syndrome is a time-critical condition as paralysis can be quick – and in Kerin’s case it was. She needed medication to stop it from spreading and causing potential breathing problems.

Kerin spent two weeks in the hospital ward before being transferred to a rehabilitation centre, where she had to learn to walk again.

By late June, she was already back at work. “I still have some numbness, and my balance is not quite back to normal, but I felt well enough to go back to work and I’ve been longing for some normality.”

She had used healthdirect Australia before, to check minor complaints or medication for her children. “Thankfully I knew the telephone number off the top of my head, and thought to call them first as they are always so helpful.”

She says the operator who answered her call this time is her hero.

“I feel very lucky – if I’d just stayed home and rested, the outcome could have been quite different.”

healthdirect Australia caller

Kerin Matz

“I owe the healthdirect operator my life…”


Disease surveillance

Every day Healthdirect Australia submits data to the Office of Health Protection to enable specific disease outbreak monitoring and the capability to identify hot-spots for diseases such as influenza and gastroenteritis.

This included monitoring a widespread outbreak of gastroenteritis in NSW in 2012 from July through to October.

Ambulance Secondary Triage

Healthdirect Australia has formed partnerships with the Ambulance Services of WA and NSW to ensure that whether a caller telephones healthdirect Australia or Triple Zero (000), they will receive the appropriate level of care for their condition:

• If a healthdirect Australia nurse determines the call is an emergency they will ensure a safe and effective transfer to Triple Zero (000)

• If a Triple Zero (000) call handler determines the call isn’t a life threatening emergency, they will transfer the caller to healthdirect Australia



after hours GP helpline

The after hours GP helpline supports existing face-to-face after hours medical services. Callers to the nurse triage services provided by healthdirect Australia, NURSE-ON-CALL in Victoria and 13 HEALTH in Queensland in the after hours period have their condition triaged by a registered nurse and, if appropriate, are transferred to a telephone-based GP.

The GP will assess the caller’s condition and provide medical advice. If a caller needs to see a health professional immediately, they will be referred to the most appropriate local face-to-face after hours service. If the call is an emergency, it will be transferred to Triple Zero (000). In around 60% of cases, with assistance from the GP, the caller is able to manage their health issue at home.

All Australians have access to telephone health advice from registered and accredited GPs in the after hours period (Tasmanian callers have access via the GP Assist service).

after hours GP helpline caller

Catherine Mayfield

When her two-year-old daughter showed the distressing signs of croup, Catherine expected to have to make the long journey from her Western Australian farm to hospital.

Her child had had some nasty croup episodes before, each involving a 90-minute drive to a hospital that didn’t always have a doctor on site.

“We live in a remote location – right in the middle of Perth, Esperance and Kalgoorlie, on a 6,000ha property. And it was harvest, our busiest time of year. I was pregnant again, and we were both exhausted.”

So Catherine called healthdirect Australia first, to see what they suggested would be best for her daughter.

“She was very distressed, not breathing very well, and the coughing was awful. The nurse quickly put me through to a GP on the after hours GP helpline, Dr Tim, who asked me whether we had any medication in the house.”

That is when Catherine remembered she still had some left over from her last hospital visit.

“As soon as we gave her that, she was so much better. Dr Tim suggested we go to our local Silver Chain post the next day,

and make sure we kept a prescription of the medication on hand. It has certainly saved us a few more trips to the hospital – but thankfully that’s the worst case she’s ever had.”

Catherine says she is so grateful to the nurse and Dr. Tim “Living where we do, it’s pretty amazing to have access to that help, and such a relief to a scared parent in the middle of the night.”

“It was such a relief that we could stay at home, but help our daughter get better…”

How do we ensure our health information and advice is safe and of a high quality?

healthdirect Australia and the after hours GP helpline are staffed by registered nurses and GPs. All GPs and nurses hold unconditional registration with the Australian Health Practitioner Registration Authority and have at least three years’ experience, and GPs have unconditional registration with the Medical Board of Australia. Practitioners use evidence-based guidelines to triage the symptoms and recommend the best clinical course of action.

Clinical issue

1 Vomiting

2 Diarrhoea

3 Rash

4 Cough in a child

5 Vomiting by a child

Recommendation/Advice %Self care advice and see a doctor / health provider within normal operating hours

53.8%

See a GP immediately 27.0%

Self care at home 9.5%

Emergency department immediately 8.6%

Activate Triple Zero (000) 0.9%

Other 0.2%

Advice given Patient age and gender

Top five clinical issues


“Jean Hailes has enjoyed a long term partnership with healthinsite to ensure women in Australia are able to easily access quality health information and services.

Poppy Griffiths, Manager, Corporate Partnerships and Marketing, Jean Hailes for Women's Health

healthinsite

Relaunched in March 2013 with improved content and design, the healthinsite website offers a wide range of consumer health information.

The site is designed to be an entry point for people to learn about health topics before they drill down to more detailed information from trusted and reliable partner sources.

The site incorporates fact sheets and video content about more than 40 health subjects, with links to further reading from more than 100 health information partners. healthinsite is accessible on any internet browser, including smartphones and tablets. Anyone can instantly access relevant local health services via a direct link with the National Health Services Directory. There will be significant further enhancements to healthinsite during this next period.



When Kate was coming to the end of her pregnancy, she was worried about whether she was making the right decision to be induced.

“My mum passed away a few years ago, and I didn’t feel I could ask any of my friends about this. I live in a small mining town, nearly two hours inland from Rockhampton, and I just needed someone to talk to,” she says.

Her midwife suggested she call the Pregnancy, Birth and Baby helpline.

“I thought I’d have to go through an automated service, but I was put straight through to a lovely counsellor, and we had a bit of a chat.”

“It was so reassuring, at a time when I was feeling a bit panicked and worked up. It was the way she spoke to me, and how she talked me through what would happen during the induction that made everything seem OK. I just wanted to know I was making the right decision.”

Soon after the call, Kate was induced and delivered a healthy baby boy. She hasn’t

yet needed to use the Pregnancy, Birth and Baby helpline or website as a new mum, but is grateful to know it’s there.

“I would absolutely recommend this service to everyone and I’ll definitely use it again – the counsellor was just fantastic.”

“It was a fantastic reassurance, I really needed to understand what would happen…”

Pregnancy, Birth and Baby

Pregnancy, Birth and Baby is a 24-hour telephone helpline and online information service for Australians seeking advice about pregnancy, childbirth and parenting in their baby’s first year. High quality information is provided on topics such as maternal nutrition, breastfeeding, a baby’s development and sleeping habits.

If women (or their families) are facing challenges such as emotional distress or perinatal issues, or have questions about pregnancy options, they can call the helpline and be transferred to a qualified counsellor between 7am and midnight, seven days a week. Calls are often about issues such as grief and loss, depression, anxiety, stress, inability to conceive, unplanned pregnancy, relationship difficulties and even financial pressures.

The Pregnancy, Birth and Baby website was launched in January 2013 with 130 pages of content and 1,200 links to our partners’ content. The site is a helpful resource, in partnership with the telephone counselling service, for young families or those thinking of starting a family.

Pregnancy, Birth and Baby caller

Kate Collett


Pregnancy, Birth and Baby Contract Manager

Michelle Tan

Healthdirect Australia’s Michelle says, “When we set out to develop and integrate the new online portal with the existing telephone helpline we wanted to create something special for young mums and dads, or those about to become parents.”

“The clinical, digital, marketing and project teams all worked together to deliver the service.”

“The website provides reliable information, appropriate support services, and links visitors to appropriate groups such as the Breastfeeding Association,” says Michelle.

Michelle says she often recommends the service to her friends and family. “A good friend of mine recently had a baby, and she found the website very informative and the helpline an invaluable service. It gave her some comfort to be reassured about what is ‘normal’ when it comes to childbirth and the first year with a baby.”

“With a helpline and online portal, the Pregnancy, Birth and Baby service provides simple and trusted information and advice for all Australians.”

mindhealthconnect

mindhealthconnect was launched in July 2012 as part of the Australian Government’s e-Mental Health Strategy to provide access to trusted online resources for those concerned with their own or someone else’s mental health.

In its first year of operation the service focused on three common mental health issues affecting Australians – depression, stress and anxiety. The content will be expanded over time to cover a wider range of mental health issues including:

• Bipolar disorders

• Schizophrenia

• Eating disorders

• Post-natal depression

• Phobias

We are working with 23 partner organisations including beyondblue, Lifeline and the Black Dog Institute, as well as health departments, to provide high quality resources including online programs, fact sheets, video and audio stories and support communities. A guided search tool helps direct users to the most appropriate services and resources for their concerns.

“For many people, mindhealthconnect makes it easier to find the mental health service that is right for them.”Jonathan Nicholas, CEO, Inspire Foundation


National Health Services Directory

Launched in July 2012, the National Health Services Directory provides a comprehensive national directory of health and human services, and related provider information. Australians can quickly access their closest health service and its opening hours. The Directory includes GPs, hospitals, emergency departments and pharmacies, with additional health services including allied health and aged care providers being added this year. Healthcare providers can use the Directory for referrals for their patients.

The National Health Services Directory is also available as an app for mobile devices and through many government and Medicare Local websites throughout Australia.

We are further enhancing the National Health Services Directory in three key ways over the next year:

• Service listings will be expanded to include allied health professionals

• More government bodies, Medicare Locals and peak bodies will embed the directory on their websites, providing direct access to the data to meet their specific needs

• The directory will support secure messaging for the delivery of hospital discharge summaries by providing a central database for eHealth addresses.

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Planning tool

Healthdirect Australia provides a planning tool that brings together the National Health Services Directory and other health data sets from across the country. This assists policy makers, Medicare Locals and healthcare providers with service planning and delivery. Launched in August 2012, the planning tool helps to identify health service gaps by overlaying demographic and health data sets with service locations.

“SA Health is working in partnership with Healthdirect Australia to provide accurate and up-to-date health service and provider information to the public. The National Health Services Directory provides a viable long-term solution as a central health directory that will meet South Australia’s needs.” Susie Butler, Information Systems, Standards and Quality Unit, SA Health

24 Healthdirect Australia Annual Report 2012 - 2013

My Aged Care

In 2012 the Australian Government announced that, as part of its Living Longer, Living Better reforms, it would establish a user-friendly gateway for the aged care system.

The result was My Aged Care, an online portal and telephone helpline, providing up-to-date information about aged care, healthy and active living and the aged care services.

The Department of Health and Ageing contracted Healthdirect Australia in November, to procure and manage the contact centre, as well as develop the online portal.

My Aged Care was launched seven months later on July 1, 2013 – on time and on budget.

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“I am very proud of what the Department of Health and Ageing and ourselves have achieved with the development of My Aged Care,” says Chantelle Howarth, Business Analyst. “It has consolidated all information on the Australian aged care system and services into one central gateway, providing clear, consistent and reliable information for older Australians and their carers and practitioners.”

“It gives all Australians the tools to access and navigate information more easily and find what they are looking for.”

Chantelle says the look and feel of the online portal has had a very

positive response, especially the real-life scenarios used to help people understand what to do in certain situations. “People relate to people, and those stories cut through the complexity of navigating so much information on aged care.”

The timeframe was the biggest challenge for the project team. “That is why the Department of Health and Ageing selected us to apply our expertise to manage and deliver it.”

The next stage of the service will include more tools to allow Australians to estimate aged care costs, improve their

ability to find services and allow providers to access customised portals. “My Aged Care has shown that Healthdirect Australia can deliver a high quality, large scale project in a challenging timeframe – proving our capabilities in both online and telephone healthcare services.”

“The development of My Aged Care involved every aspect of Healthdirect Australia.”


My Aged Care Business Analyst

Chantelle Howarth


Much of Healthdirect Australia’s work this year has focused on enhancing current health information services, integrating our telephone and online services and developing new services. To do this effectively, the organisation has enhanced its organisational capabilities and

established a robust, secure and scalable infrastructure with a range of supporting policies and frameworks. Healthdirect Australia ensures consistency and assurance around clinical quality, technical compatibility, security compliance and content governance for all of our services.

Digital servicesHealthdirect Australia has developed sophisticated digital development capabilities as part of our strategy to ensure all Australians can access our services – whether they prefer to make a telephone call, visit a trusted website, access information on their smartphone or download a health fact sheet.

Healthdirect Australia has undertaken work to understand the needs of consumers and how they use digital technology to access health information and support. Usability testing includes an understanding of the patient’s journey, the services they need, and the ways design and technical implementation can support that.

By creating a standardised health platform, Healthdirect Australia can fast-track online development and provide greater cost efficiencies. Other healthcare organisations can also leverage this capability and easily integrate with our services.

In addition to delivering the new My Aged Care, mindhealthconnect and Pregnancy, Birth and Baby websites, the National Health Services Directory, and the relaunch of healthinsite, the digital services division has been working on:

• Planning and developing eHealth infrastructure, including the management of Endpoint Location Services

• Fostering partnerships with leading global organisations, including the National Health Service and NHS Choices in the UK for consumer health services, and the Trimbos Institute in the Netherlands for online mental health services.

Enhanced capabilities


Research and designHealthdirect Australia has a core capability in researching, planning and delivering multichannel services, and sourcing and coordinating external providers. My Aged Care provided an opportunity to implement this through a cross-functional approach to project delivery, and set a new benchmark in developing multiple services across multiple platforms.

Strategic Sourcing FrameworkBy linking market knowledge, procurement and contract management functions and systems into a continuous cycle of planning, analysis, sourcing, procurement and contract management, the Strategic Sourcing Framework ensures Healthdirect Australia provides value to our government shareholders and therefore the taxpaying public.

Contract managementOur service forecasts have achieved 99% accuracy throughout the year, ensuring resources are allocated most effectively without compromising the quality of service.

Improved IT uptimeThe organisation has developed a best-practice framework for IT delivery and service resilience across our online and telephone services, minimising the risk of service downtime as we continue to expand our online capacity.

Data security capabilitiesDelivering My Aged Care has improved the way we manage private data, prevent and detect security threats, and new policies, processes and practices have been implemented to handle sensitive information.

Awareness and education Market research was undertaken this year to improve the awareness and utilisation of our services among under-represented and marginalised groups. Through evidence-based service marketing, Healthdirect Australia aims to ensure that people understand how to access the health services they need. The awareness of key services in the general public is tracked every six months.

Project-based recruitmentWith the majority of Healthdirect Australia’s service functions procured and outsourced to third parties, the company maintains a core internal capability to recruit effectively and efficiently on a project-by-project basis. This includes coordinating the external providers and ensuring consistency and assurance around matters such as clinical quality, technical compatibility, security compliance, content governance, marketing and industry knowledge.

Future opportunities

Video consultations offer a unique opportunity for remote access to healthcare advice for all Australians. Healthdirect Australia has conducted a number of trials of video access to its clinical information services in residential aged care settings to assess this medium. A range of video technologies has been tested for wider scale consumer use, assessing patient experience and clinical and operational issues.

The goal is to ensure that in the near future, anyone with access to a computer or a mobile device will be able to speak to a GP, nurse or counsellor through a high quality, secure video session – without the need for special equipment.


Governance

In procuring publicly funded services on behalf of Australian governments, Healthdirect Australia has a responsibility to deliver safe, high quality and cost effective services.

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External GovernanceHealthdirect Australia is directly accountable to the federal, state and territory governments as both shareholders and customers. The Standing Committee and the Joint Customer Advisory Committee support this role.

The Standing Committee represents the interests of the federal, state and territory governments as shareholders. This committee is responsible for:

• Liaising with the Board and CEO to advance national health policy and priority issues

• Approving the company’s Strategic Plan

• Providing advice on the annual Corporate Plan

• Assessing business cases to improve existing services and develop new jointly funded services

• Reviewing the performance of Healthdirect Australia.

The Joint Customer Advisory Committee (JCAC) represents the interests of the federal, state and territory governments as customers.

JCAC is responsible for reviewing and monitoring the service and performance levels of operations, particularly in regards to:

• Increasing awareness and utilisation of Healthdirect Australia’s services among defined under-represented groups in Australia

• Reporting on service quality

• Overseeing a high quality and accurate national health service directory

• Ensuring that the health information offered is of a high quality.

JCAC meetings bring our customer representatives and the Healthdirect Australia management together. The committee meets quarterly.


“Thousands of Australians, particularly those living outside the major cities, rely on having a nurse or GP available on the phone.”

Jurisdictional representative for Western AustraliaSally Skevington


Sally Skevington is the Strategic System Support Manager with the Department of Health in WA, and has been part of JCAC since its inception.

She says JCAC was set up to monitor services provided by Healthdirect Australia, including the nurse triage service.

“Our focus is on whether the services are providing the right sort of care for people, are high quality and safe, and provided cost-effectively.”

“Healthdirect Australia has met and exceeded my expectations, I’m delighted with its progress,” she says. “The clinical governance processes and reporting are excellent, the assistance with issues of pricing of add-on services has been of great value and the innovation outstanding.

“Many people don’t know what to do or where to go when they need help, and that’s where these services can be a tremendous support. Thousands of people, particularly those living outside the major cities, rely on having a nurse or GP available on the phone, or direct access to a trusted source of online information.”

As well as being of great comfort to those people, Sally says these services have benefits for hospitals – “particularly small and rural ones where there is minimal overnight staffing and they need to focus on their patients rather than field calls”.

She says the priority for JCAC continues to be “The questions of efficiency, effectiveness, appropriateness and safety… we keep abreast of what is going on at a customer level, and continually ask ‘are the services helping the people who need help?’”

Board of Directors

Strategic level

Internal Governance

Operational level

Chief Executive Officer

Healthdirect Australiamanagement

Clinical Governance Advisory Group

Finance, Risk Management and Audit Commitee

Project Review and WHS Advisory Committee


Finance, Risk Management and Audit Committee

The Finance, Risk Management and Audit Committee (FRMAC) supports the Board in ensuring the accuracy of the company’s financial reporting, risk management processes and internal controls. It oversees the development and monitoring of Healthdirect Australia’s risk and compliance frameworks and coordinates the company’s internal and external audit processes.

Key activities in this financial year have included:

• Consolidation of the risk management framework with standardised risk tools and techniques rolled out across all new projects and initiatives, and a dedicated risk manager to ensure continuous improvement of risk management practices

• Stronger Information Security Management systems implemented across the company, bringing our IT security practices in line with Australian Government IT standards

• Internal auditing, including financial management and processes, and contract performance of the company’s major delivery partners

Clinical Governance Advisory Group

The Clinical Governance Advisory Group (CGAG) supports the Board in ensuring our telephone and online services are nationally consistent, high quality, equitable and sustainable. It advises the Board on clinical governance and clinical risk management, and has developed a clinical governance framework for quality control.

In addition to Board members, external members of CGAG include:

Dr Jenny Bartlett, an experienced clinician now consulting in clinical governance, healthcare improvement and medical management

Dr Leonie Katekar, Chief Rural Medical Practitioner, Remote Health Branch, Northern Territory

Dr Nick O’Connor, Clinical Director of North Shore Ryde Mental Health Service

Project Review and Work Health and Safety Advisory Committee

The Project Review and Work Health and Safety Advisory Committee (PROWAC) was developed this year with the key objectives of:

1. Overseeing and monitoring progress of key projects within the company’s project portfolio, and advising the Board on relevant matters

2. Delivering active leadership in work health and safety (WHS) matters, and monitoring the policies and practices of the company in respect to WHS compliance.

The committee advises the Board on project governance and portfolio risk and seeks endorsement for significant projects.

Board committees Risk management

Strengthening our project delivery

Healthdirect Australia has adopted a Project Approval Policy and Project Management Framework to provide clear guidelines and criteria for projects that require PROWAC governance, based on costs, risk profile and alignment to strategic objectives.

PROWAC plays a key role in ensuring successful project delivery by:

• Reviewing new project proposals, ensuring alignment to strategic objectives and priorities

• Monitoring and assuring compliance to our Project Management Framework and related organisational frameworks

• Ensuring adequate controls, planning and risk management have been established.


Healthdirect Australia proactively identifies and manages risk to ensure the provision of safe and high quality services to our customers. This allows us to consistently deliver projects and services within required timeframes and budgetary constraints.

Project development and procurement risks have become increasingly complex as our services have expanded. The risk management framework has been updated to be consistent with ISO31000.

The risk management frameworks include:

• Service development framework for systematic and accountable development of new services

• Procurement framework, ensuring regular assessment and evaluation to guide purchasing decisions

• Risk management framework, identifying and controlling potential clinical, project and business risks

• Fraud Control Plan and Risk Assessments to ensure the Company’s ‘Zero Tolerance’ policy on fraud remains in effect, including an annual internal fraud review consistent with Australian Government practices

• Financial management framework, aligning our funding and operational models

• Contract management framework, for a consistent and simplified approach to employee and supplier contracts.

This year Healthdirect Australia discharged its first three-year internal audit program. As a result of the organisation’s maturity in vendor management, the report recommended our core service providers could now shift from compliance audit to output audit.

32 Healthdirect Australia Annual Report 2012 - 2013

Healthdirect Australia’s clinical governance framework provides assurance that Healthdirect Australia’s services are safe, effective, consumer-focused and appropriate. All clinical governance activities are overseen by the Clinical Governance Advisory Group, which reports to the Board.

The clinical governance framework:

• Focuses on best practice clinical advice

• Sets governance and management principles and provides accountability

• Applies to both Healthdirect Australia and its service providers, encouraging the sharing of experiences

• Outlines the infrastructure needed for effective coordination, monitoring, evaluation and reporting of service quality

• Encourages continuous quality improvement for better delivery and outcomes.

Services Improvement and Development Committees are a key quality assurance mechanism for clinical governance and are implemented across all of Healthdirect Australia’s telephone and online services. These committees meet once a month to review performance and customer satisfaction results, share experiences and implement quality improvements.

Clinical governance

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Health Emergency Response Plan

A Health Emergency Response Plan has been developed for Healthdirect Australia’s role in the response to and recovery from health emergencies with a state, territory or national consequence.

This could include emerging infectious diseases, pandemic influenza, food or waterborne illness and chemical, biological or radiological incidents.

Healthdirect Australia provides inbound and outbound telephone helplines with a disease surveillance capability, as well as online information portals.

“About 30% of our calls come from hospital switchboards. In the past, those calls would have taken a nurse away from vital direct patient care.”

Clinical Governance ManagerCheryl Wallace

“healthdirect Australia gives all Australians access to experienced registered nurses, so they can make the right decision about the care they need. And with our evidence-based guidelines and processes, I can be confident that the service provides a safe and considered response,” says Cheryl Wallace, Clinical Governance Manager.

“There’s a lot of work behind the scenes to ensure the quality and safety of our advice and guidance,” she explains. “We’re helping all Australians make the right decision for their health needs. Sometimes callers may underestimate how serious their situation is. Or they may overestimate the care they need, and the nurse can provide advice on how to care for themselves at home.”

Cheryl says the partnerships with other health organisations are vital for sustainable long-term healthcare. “We’re working to coordinate a more integrated system for patients. In particular, we support that crucial after hours period – about 70% of our calls come in after hours.”

“Our end goal is better integration within the current healthcare system, so we can effectively support face-to-face clinicians such as emergency department nurses and paramedics.”

As a nurse, Cheryl understands the demands on hospital emergency services.

“About 30% of our calls come from hospital switchboards. In the past, those calls would have taken a nurse away from vital direct patient care – and in many cases, they would have to recommend that the caller come in. Now clinical nurses can be free to care for their patients. The after hours GP helpline offers a similar service to support the valuable work of GPs.”


Healthdirect Australia was established, and is jointly funded, by the Australian Government and the governments of the Australian Capital Territory, New South Wales, Northern Territory, South Australia, Tasmania and Western Australia. It is a public company limited by shares, and is responsible for delivering services by contracting with service providers and managing ongoing operations.

Our shareholders

Healthdirect Australia

Level 19 133 Castlereagh StreetSydney NSW 2000Phone: (02) 9263 9000Email: [email protected]

ABN 28 118 291 044

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