From fragmented records to connected care: Building an AI‑ready health system

We manage the most important parts of our lives from the palm of our hand. Our finances have evolved to securely and intuitively meet us where we are, adapting at scale to individual needs. Healthcare, however, hasn't kept pace. By rethinking care through a mobile-first lens, we have a real opportunity to make health and wellbeing more accessible and centred on people, rather than systems.

Right now, patients continue to encounter fragmented care journeys across Australia's healthcare system. Despite recent assessments or emergency visits, they are often asked to repeat their medical history, leading to inefficiencies and frustration. Clinicians, operating under time constraints and system pressures, must make decisions with incomplete information - resulting in consultations that lack continuity, clarity, and confidence.

This disjointed experience is the human cost of fragmented care - a reflection of systemic limitations in data sharing, workflow integration, and digital infrastructure. 

However, achieving interoperability in modern healthcare is no longer just about connecting systems; it's also about ensuring the safe use of intelligence applications. AI increases the stakes: fragmented data results in fragmented AI outputs, and without connected, high-quality data, AI models will always be limited and unreliable. 

Connecting care is complex. It requires sustained effort, shared commitment, and alignment across public and private sectors. Progress also depends on creating environments where information flows securely and reliably, enabling clinicians to deliver informed, timely and compassionate care.

The Australian Digital Health Agency has moved into execution of the National Digital Health Strategy 2023–2028, with its two‑year impact report showing 47% of initiatives completed and the rest underway. Amendments to the My Health Record Act, which mandate default sharing, have driven a 285% rise in weekly clinician pathology report views. The continued rollout of Provider Connect Australia is further streamlining provider data sharing.

These steps reflect a shift from planning to execution, strengthening the foundations of a connected, data-driven health system. The Productivity Commission estimates that better integration of digital technology could save over $5 billion annually - including up to $355 million through fewer duplicated tests - highlighting the economic and clinical value of interoperability.

To realise this potential, barriers to connectivity need to be identified, addressed, and overcome, while actively harnessing the enablers that are driving meaningful progress.

Barriers to Interoperability: Legacy Technology, Silos, and Security 

Legacy technology is a significant barrier to connected care. Many systems across the health ecosystem are outdated, closed, and incompatible – keeping data trapped in silos and limiting the ability to modernise. In many cases, clinicians still rely on paper-based referrals, printing letters for patients to carry between providers. This manual handoff introduces delays, risks information loss, and places the burden of continuity on patients. 

These outdated practices reflect deeper systemic challenges: entrenched workflows and the high cost and complexity of transitioning to modern, integrated platforms - all of which reinforce the cycle of fragmentation across the system.

As health providers explore AI-enabled triage, diagnostics and real-time decision support, these silos become more than operational barriers; they become sources of model bias, missing context and unreliable outputs.

Security and privacy add another layer of complexity. Healthcare providers must also navigate a web of regulations, from the Privacy Act of 1988 to the My Health Records Act and recent amendments, while ensuring that sensitive patient information remains protected across increasingly interconnected systems. Despite these regulatory guardrails, the healthcare sector remains the most frequently notified for data breaches, as reported by the OAIC. This demonstrates the delicate balance between sharing data for care and protecting it.

While interoperability is essential, it must be achieved with robust safeguards to maintain trust and compliance. The challenge lies in designing systems that are both secure and accessible - ensuring clinicians have the information they need, when they need it, without compromising patient privacy.

Accelerating Integration: People, Platforms, and Partnerships

Despite these obstacles, there are equally powerful opportunities for progress. Across Australia, we are seeing a quiet but determined shift – one that recognises that digital transformation in healthcare is not just about technology but about trust, collaboration, and system-wide alignment.

This shift is supported by initiatives that ensure modern digital foundations underpin a collaborative, standards-based health system. The My Health Record platform, for example, is shifting from legacy Clinical Document Architecture formats to FHIR® standards, helping to future-proof the nation's healthcare infrastructure as demand for the platform increases. 

Another key enabler is adopting a secure-by-design approach. This strategy embeds security practices into the DNA of every product, platform and workflow – from early ideation to clinical input. It brings together technology, clinical teams, risk managers, governance and audit functions from the outset, creating a foundation of trust that allows data to flow seamlessly while remaining protected.

True interoperability depends on collaboration. Governments, providers, clinicians, technologists, and communities must work together – after all, no single organisation can transform healthcare alone. By bringing together best-of-breed capabilities across diverse settings and varying levels of system maturity, partnerships can enable scalable, sustainable change. 

However, it is also important to recognise that the most well-designed partnerships and technologies will fall short without the right upskilling and ongoing support. Digital transformation must be matched by investment in learning and education. Providers need practical support to adapt their workflows, and patients need intuitive, accessible tools to engage with their care. 

With AI increasingly embedded into everyday clinical workflows, interoperability must now support not only data exchange but AI lifecycle management – from model training to monitoring to ensure safe clinician adoption.

The success of interoperability lies not just in systems, but in people: their skills, understanding, and willingness to embrace change.

Toward a Fully Connected Health Ecosystem

Sustainable progress relies on continuous learning, strategic approaches, and strong foundations. By fostering a culture of openness and accountability, we can unlock the full potential of connected care - where data and insights empower clinicians and communities alike.

Interoperability is not just a technical goal - it's a promise to every patient that their story will be heard, understood, and acted upon. By working together across sectors and disciplines, we can build a health system that is truly connected, compassionate, and AI-ready.