Can the AIDH finally grow some teeth? Ms Nikolic intends to make it the kind of organisation that holds policymakers to account and connects a disparate sector.
Anja Nikolic takes over as the new CEO of the Australian Institute of Digital Health on 25 March and she is looking forward to the challenge. Since the shock departure of previous CEO Louise Schaper in July of last year, the role has been filled for the interim by Mark Nevin.
Ms Nikolic is the current boss of the Australian Physiotherapy Association. She shares why she took the leap to the AIDH, and how allied health can help rescue the health sector.
You’re with the APA until March. What’s your current push there?
Advocacy on behalf of the profession and its patients, which largely centres around the premise that allied health can really rescue the health sector from its woes.
Think about how difficult it is to get an appointment with a GP or how inundated our emergency departments are. They’re all things that allied health can help with and particularly a profession with as wide a scope of practice as physiotherapy has.
Also, considering the growing burden of disease that’s associated with musculoskeletal health, there’s no sense in hampering access to physiotherapy, in fact, quite the opposite.
Lots of people are still under the misapprehension that you have to see a GP to get a referral for physiotherapy or other allied health. Medicare incentivises that model.
What we’re lobbying for is a break with that model. We’re advocating for first-contact funded physiotherapy, rather than Medicare only funding physiotherapy through a care plan that you get from your GP.
People are quite capable of triaging themselves into the right pathway. If a person has a musculoskeletal condition, and they know that the physio is the right person for them, then the money really should follow the sensible care pathway without creating unnecessary steps in the process that add no value whatsoever.
Hasn’t this conversation been happening ad nauseum?
The cogs of this wheel turn particularly slowly. Time will tell but what’s pleasing is that the APA now has a seat at the Strengthening Medicare Taskforce table.
The consultation that’s taking place is now more conscious of what allied health’s position might be. The Allied Health Professionals Australia are also represented – they’re like the peak body of peak bodies. So, there’s a pleasing move towards at least recognising that there’s value to be gained from having these voices at the consultation table.
Whether it bears fruit and whether it actually creates policy change – I think that’s possibly a 10-year timeframe that we’re looking at.
Is any of that fruit low-hanging?
What a wonderful segue into the world of digital health! It’s very sensible that a GP wants to be kept abreast of what’s going on with their patient but I don’t think the answer is to make the patient go back to see their GP to close that loop.
The sensible thing would be to have digital systems and data interoperability that enabled that communication between all care providers for a particular person.
This is not complex stuff. The technology is there but there doesn’t seem to be enough of a multidisciplinary thrust towards the sharing of this information.
What’s stopping that?
There is parochialism – everyone holding on to their own turf. For fear of what? I don’t know because it is clear that something needs to change – demand is outstripping supply in health and that gap is widening.
The result is that doctors aren’t missing out on patients but patients are missing out on care. That is the key thing that we need to wrap our heads around.
It’s a complex problem because you’re looking for solutions that encompass an entire health system. I think it’s sometimes seen as being in the too-hard basket. However, many of the answers to these questions do sit in digital health and so I’m looking forward to sinking my teeth into that area shortly.
Congratulations on your appointment to AIDH. What are you looking forward to?
Speaking with my APA hat on, I think the digital health sector needs a united, strong but independent voice about direction and strategy and purpose. Currently, that is a little lacking.
Physiotherapy has had so many false starts in digital health as a profession. We have tried to answer the questions inherent within that area so many times through our own effort and found that it’s a very lonely space.
Apart from health tech providers, in the private sector, there seems to be very few people to refer to for collaboration, discussion and co-creation of a solution.
The AIDH exists for that purpose – to unify those voices, to set a direction and to provide thought leadership in this space. So, I’m looking forward to what the AIDH can do with what will, hopefully, end up being good, strong leadership.
The AIDH is great at getting people together to explore digital health advances but that’s different from telling the government: “Hey, you’re barking up the wrong tree”
You can’t have thought leadership without first getting the sector together and collaborating to figure out what needs to be fixed. So, I’m not being at all disparaging of that.
However, what is missing is thought leadership and advocacy about what is required, to the powers that be, to the government, to policymakers and decision makers.
I think what the health sector has done reasonably well is pull together people for a conversation and thinking about issues. The sector, including the Australian Digital Health Agency, has also put together a few (strategy) blueprints. But then it all stalls.
What the sector needs is, essentially, thought leadership and a really good sense of direction and the holding to account those who can deliver it.
Is the AIDH board across your intentions?
I’d hate to speak on their behalf but certainly through the process of interviewing for the role, I was won over by their honesty and candidness about what the issues are, and a real willingness to tackle them.
They were very frank about wanting the AIDH to advocate more, to provide thought leadership, to be the party to whom the sector turns for those things. So, I’m really confident that they are very clear on what needs to happen. It was really that clarity that that made me think that the AIDH CEO role was a worthwhile pursuit.
I thought: “We’re on the same page here.”
What keeps you awake at night, apart excitement about this new role?
Privatisation of health but it is almost an inevitability if the government and health system don’t move with the times. This is almost a political statement, but I would not want us to go the way of America.
What’s needed is a fundamental shift in how we approach healthcare but the challenges in front of us are deeply complex and systemic. We’re essentially talking about a system built on Medicare, which is now quite aged, and we’re talking about more than tinkering with it.
So, what keeps me up at night is the fact that this is not a simple challenge, and it requires so many players to rise to the occasion and have a shared view. The size of that mountain to climb — sometimes it does feel a little insurmountable.
Wildcard question: What TV show would you like to live inside for a week?
I reckon it’s Friends – being good mates with Chandler Bing for a week.
I must have seen every Friends episode five or six times, and no one makes me laugh like Chandler Bing. The whole cast is really talented but and I always think, “God, I’d love to have someone like Chandler Bing in my real life”. So, if I was to live somewhere in TV Land for a week, I reckon it’ll be in Chandler Bing’s living room.
What do you think you’d be like at the end of the week?
Hopefully a really optimistic, mellow person; full of laughs and with the ability to lift others.