A digitally enabled health workforce for Australia

The current state

Healthcare is increasingly digitised, and with this change comes the need for a digitally enabled care workforce which is confident and capable of using digital technologies safely and effectively to deliver care.¹ We know what a digitally enabled care workforce should look like in Australia because we have multiple capability frameworks.^2,3 These describe what healthcare professionals should be able to do, as well as the skills of a new workforce specialising in the design, implementation, and safe deployment of new digital health technologies in practice. This case study paper aims to describe the complex factors that contribute to building a digitally enabled workforce,¹ and highlight the role of workforce education in that process.

Despite the need for a digitally enabled health workforce being identified more than a decade ago,^4–6 key hurdles remain in realising this vision. Overcoming these barriers remains a priority in Australia.⁷ The COVID-19 pandemic made these gaps much more visible. The health system response to the pandemic disrupted existing processes of care delivery and accelerated the adoption of digital technologies in healthcare.^8,9 This also made new models of care available.^10,11

The momentum in digital health technology adoption created by the pandemic may be slowing,^8–10 but it is important that the goal of a digitally enabled health system continues to enable benefits for all health stakeholders. Use of robust training initiatives to maintain and grow the skills of the workforce using digital technologies, and increasingly building these skills in the community,¹¹ are foundational to continue driving digital transformation in healthcare. The importance of education and training in safe and effective use of digital technologies in healthcare is increasingly being recognised, but realising this in practice has been slow.¹² This is concerning, particularly due to changing attitudes of the community regarding the use of digital health technologies in healthcare have changed.^13,14 People increasingly expect the health system to be connected, more patient-centred, and digital technologies to improve rather than diminish equitable access to care.¹⁵ Confidence and capability using these digital technologies is a known driver to their adoption by the health workforce,¹² so building workforce capacity in this area is key to ensure that the community sees the healthcare workforce as credible users of digital technologies.

The challenges that need to be overcome to realise a digitally enabled health workforce are complex (Box 1). In what follows, we draw on the discussion of an expert panel hosted by the Digital Health and Informatics Network at The University of Sydney in March 2023. The 40 min in-person panel had seven expert panellists, including two from industry, one from health services, two from government, two from academia, and chaired by an expert in health professions education and digital health. Structured prompts from the chair were used to guide discussion, followed by audience questions. The panel was audio recorded and the transcript subsequently reviewed by one researcher (AJ) to categorise key points and synthesise them into a summary of recommendations which was reviewed by all panellists and the chair, six of whom are authors on this publication (TS, AJ, MB, KQ, CI, PM).

Addressing key workforce challenges

We must first agree on the essential skills for a digitally enabled care workforce. Currently various frameworks exist touting similar but different capabilities,^4,19–21 making it challenging to develop a practical curriculum that teaches foundational skills for all experience levels in the care sector while distinguishing between the general and specialised workforce (Box 2). Investing in a digital health workforce may create new opportunities to attract talent to the health sector by creating opportunities for specialised digital health career pathways. It may also provide opportunities to support changes to the existing health workforce to adapt to increasing service demands by providing more efficient ways to support service delivery.^22,23

In our experience, we have seen many digital health implementations fail because of a lack of engagement. Digital health technologies should add value by improving the delivery of healthcare, but can instead produce unnecessary new time burdens, introduce new safety issues, or have other unintended consequences.²³ Improving collaboration between healthcare providers, digital health technology industry, government agencies, and academia could reduce the duplication of investment and effort.

Adaptive but clear governance of emerging digital health technologies would help to standardise what is expected in practice and could be built into training. Although there is policy prioritising workforce capacity building,^23,30–32 technology developments are outpacing the governance on their ethical, safe, and cost-effective use. While there are some examples of governance structures and mechanisms in place to support the safe design and implementation of digital health technologies, gaps in legislation remain in emerging areas such as use of artificial intelligence in healthcare.³³

Recommendations

We make three key recommendations to support the growth of a digitally enabled workforce. These include upskilling of senior leaders and management, developing digital transformation change champions, and creating agile, adaptive, and applied training offerings (Box 3).

Senior leaders in healthcare need to be more comfortable operating digitally, both by supporting digital innovation but also being innovative and engaged themselves. New diverse and inclusive pathways are needed for a digital health workforce with a breadth of perspectives. Specialised digital health roles need to be created to attract and retain talent to the sector. This is important as there is evidence to suggest a sizeable portion of this workforce are volunteers with the intention to stop volunteering their time in the next 5 years.³⁴

Change champions in the health system are those who are passionate and knowledgeable about the use of technology to support digital transformation. These individuals should play a role in workforce upskilling, particularly in areas where digital health capability frameworks have been developed less readily to date, such as primary and community care.³⁵ Academic institutions should invest more heavily in specialised postgraduate training. This approach would help provide structured training opportunities for the digital health workforce which currently relies heavily on informal professional development activities, mentorship, and networking to support career development.³⁴

Coupled with traditional educational vehicles, there is a need for new training opportunities that allow intensive and rapid upskilling such as micro- and nanocredentials.²² Digital health curriculums need to be more adaptive to respond to new digital technologies and changes in workforce needs.^12,22 Training also needs to be designed in a way in which general principles can be clearly applied by learners in clinical practice.

Conclusion

In summary, researchers have long examined the skills the health workforce needs to use digital technologies, but recent events have led to substantial growth in interest in this area. Numerous challenges must be addressed to create a digitally enabled healthcare workforce, and no single solution exists.

While several organisations support digital health workforce development, initiatives often operate in silos. There remains a reliance on traditional education methods, such as diplomas and degrees, with insufficient focus on agile, practical training for current health professionals. Enhancing connections among healthcare organisations, the digital health industry, and academia is essential. This will help to standardise the capabilities expected of the whole care workforce, expand the specialist digital health workforce, and help coordinate an ecosystem of short-course training opportunities nationally.

Ethics approval

Not applicable.