Digital transformation: a discussion with Professor Clair Sullivan

In November, Dr Tanusha Ramaloo, the PHN’s West Moreton GP Liaison Officer (GPLO), sat down with Professor Clair Sullivan to discuss digital transformation in primary care.

Professor Sullivan is an internationally recognised leading practising and academic clinical informatician who helps drive digital health transformation in Queensland and globally.

Professor Sullivan is the Director of the new Queensland Digital Health Centre within the Centre for Health Research at The University of Queensland.

A specialist endocrinologist, Professor Sullivan graduated with Honours in Medicine from The University of Queensland and earned a Research Doctorate in Medicine from the University of Leeds. In 2014, Professor Sullivan began a parallel career in the emerging field of digital health and has held significant leadership roles in digital health practice and governance across government and academia. Her work is regularly translated into practice and informs policy in Australia and globally.

Here’s what Professor Sullivan had to say:

How can primary care GPs achieve digital transformation in general practice?

“We talk about digital transformation having three horizons. The first horizon is actually making sure that you've got digital workflows. Most general practices are already using electronic medical records.

The second horizon is around capturing the data that you're collecting during routine care, aggregating it and looking at how you can be better utilise this data for population health.

The third horizon is around creating new models of care - using that digital workflow, using those data and analytics that you've created to create new models of care. An example for that might be rather than waiting for people to come in for their three-monthly diabetes reviews, we've got the ability to use artificial intelligence (AI) to predict who's going to run into trouble and intervening early before those problems occur, monitoring those outcomes, and continuously improving our processes.”

What are some of the educational opportunities for general practice, GPs and other health professionals working in primary care?

“Yeah, so I think there's a real gap. Certainly, when I started out in digital health, I looked around desperately trying to educate myself, couldn't find one and had to sort of clumsily self-educate. But the good news is now that that's evolved. We've set one up at University Queensland - we have a Graduate Certificate in Clinical Informatics and Digital Health. There are some fabulous GPs doing the course right now.”

And in terms of AI, is there a framework that is being planned for health with regards to consent and diagnosis?

“That's a very timely question. The Office of the Australian Information Commissioner put out some really wonderful guidelines in October 2024. They're really notes and guidelines around how to adopt commercially available AI solutions in healthcare, and it's great guidance.”

I also have heard that some general practices are using transcription - real time recording and synthesis of consults with consent. Are there any blind spots in using these services?

“Firstly, what a fabulous time saver. It really has the potential to save a lot of time and to take people away from the keyboard and to be able to look at the consumer. I think as well as consent, it'd just be worth making sure you know what happens with the data that's collected. Is it going to train other models? Is it going to pop up somewhere else? Is it stored onshore in Australia?

Those are all kind of important questions when you're selecting a provider to make sure that you go through. I don't want people to be afraid of taking them, but also just to know and make sure that you're getting the right one and that the data is safe.

Lastly, just to remind people about hallucinations. So generative AI has what we call ‘hallucinations’ where it will just insert random paragraphs sometimes. I saw this in a case recently where in the middle of a case note it said that the 65-year-old lady died, which was incorrect - it was just a frank hallucination. So, remember that although they're quite accurate and it's a wonderful tool to have, they do hallucinate, and you must always check the notes.”

Aside from the GP, should we be upskilling other key members in the workforce such as receptionists, practice nurses, etc.?

“Absolutely - digital health is a team sport, and it's not just about doctors. There's a wonderful opportunity for things like AI to streamline administrative tasks, scheduling and that type of stuff. To get the full benefit of AI, I think those backroom functions have a lot of potential to be automated, and we can't neglect that. It's also a nice place to start with AI because you're not interacting with patients - there's no sensitive health data. I think starting with corporate functions before clinical ones is not a bad way to go.”

Where do you see digital health in Australia moving towards? And are these funding models and models of care being explored currently?

“I think the future looks like that we have personalised advice and care for people from the time they're born to the time that they pass away, and that we do our very best to stop them from getting sick rather than fixing them when they do get sick. And so that will involve really understanding data and biometric data and the use of AI to risk stratifying and help with decision making.

I see us having a healthier future. I see us in our homes and communities a lot more than we're in hospitals. And that really will, I think, shift the power balance back to primary care. That's where we need to be focused and that's where I think our system will shift from break-fix to predict-prevent.”

Is there much happening within medical schools and nursing schools, for example, in training our future health professionals in the space?

I think it would be fair to say up until recently, no. However, I think the advent of generative AI has really put some fuel behind that effort. And so certainly here at University of Queensland, we are now incorporating digital health content into undergraduate nursing, medicine and pharmacy, and hopefully more to come. “

What is the vision for the Queensland Digital Health Centre?

This is a new science at University of Queensland Digital Health - the idea is to deliver on the quintuple aim of healthcare. So better clinical outcomes, better efficiency, better provider experience, better consumer experience, and equity using data technology. So, it's not about the data technology, it's about delivering on those quintuple aims of healthcare. We do that in many ways across those three horizons. And we have fabulous people like data scientists, mathematicians, and economists all working together on this wicked problem, and it's a lot of fun.”

Is there anything else that you'd like to share with our GPs and readers?

“I just think it's exciting and it's a great time to be in primary care. I think there's the opportunity to really make primary care the focus of predict-prevent. There's an opportunity for primary care to really grab the data revolution and to try to stratify resources to make smart decisions and to continuously monitoring outcomes. And that opportunity has not been there before. So, I'd say go for it.”