Connecting for care: Q&A with Robert Hardie from NBN Co
nbn co.’s new Executive Manager Health and Agriculture, Robert Hardie, discusses telehealth, internet connection speeds, freak snowstorms, and Australia’s digital health future.
VISIONFLEX: Congratulations on your appointment to the role of Executive Manager Health and Agriculture. Please tell us a little bit about yourself and your new role.
Robert Hardie: I’ve been at nbn for two and a half years, and I was previously Executive Manager for Agriculture. In June this year, I took on responsibility for health alongside agriculture.
I have a background in public policy, and I was a political advisor for a long time based at Parliament House in Canberra. Later, I worked in the agriculture sector for the NSW Farmers’ Association, working in the grains and horticulture spaces, and looking after chemicals and biosecurity issues.
At nbn, our chief purpose is to help lift digital capability in regional Australia. It’s about raising awareness of what the nbn network can do for people living in regional areas and what is available to them; as well as listening to organisations about their needs and feeding those insights back to our engineers and product experts to ensure we constantly improve to meet the digital needs of people across Australia.
We know that people living in rural and remote parts of regional Australia have a greater reliance on telehealth because of the distances that often exist between themselves and their primary health network or specialists.
The challenge is, how can we make sure that people, no matter where they are located, can get equity of access through telecommunications to the health services that they need.
Similarly, how do we make sure that the platforms, devices and other sorts of technology that are being developed to support telehealth, can work over a nbn satellite network connection.
What does Australia’s digital future look like for both health providers and their patients?
What I would like is a future where we have removed the barriers and impediments that are holding back the availability of telehealth.
Circumstances during the pandemic demanded the rapid implementation of telehealth and we jumped ahead by leaps and bounds. Now, we need to go back and more soberly reflect on the circumstances when telehealth is or isn’t appropriate to the provision of care. It’s now about how we harness and utilise technology to provide the best medical care and support to Australians, according to the circumstances they’re facing.
If the doctor wants to undertake a consultation virtually because that is going to meet the clinical needs of the patient, then let’s make sure the network infrastructure is in place so a patient at home can connect seamlessly to their medical professional. Let’s ensure it’s a good user experience for both patient and provider, and that the systems and platforms work well regardless of whether somebody is relying on a satellite connection, or they have a fibre-to-the-premises connection because they happen to live in a very large city.
What role does reliable broadband have in achieving this vision for Australia’s digital future?
It is critical that we have the infrastructure in place to support people’s telehealth engagements.
People sometimes say to us that the nbn network is not capable of supporting telehealth. Well, because of the work that we’ve done with companies like Visionflex and with others, we know that our satellite network is, right now, supporting people with telehealth in some of the remotest parts of Australia. They are using diagnostic equipment that is enabling a place-based clinician and a remotely located clinician to examine a patient.
From time to time when weather events impact a community – for example major disasters like floods and bushfires, or shorter events like very heavy downpours – there can be some temporary impact on the quality of the service. All satellite services face challenges with weather. What we try to do with our own network is constantly look for ways to improve the end-user experience. We can probably never get rid of weather-related dropouts, but we can try and minimise their impact on the way people are using their service.
For example, a few weeks ago, there was a snowstorm that passed over southern Tasmania, where one of our satellite base stations is located. Because of the way the satellite network operates there were people in tropical parts of Australia that noticed a temporary degradation in the service because the satellite dish in Tasmania had six inches of snow on it. The team was out there clearing the snow in order to bring back the full quality experience.
How has the COVID-19 pandemic, and the expectation that access to virtual care is always an option, shaped NBN’s health plans and goals?
Statistics made available by the Commonwealth Government tell us that almost 20 million telehealth consultations took place in the past two and a half years, and around 95 percent of these were conducted via telephone. Only around five percent were conducted in a virtual and visual sense.
As I mentioned earlier, our goal is to remove barriers to ensure clinics are well connected and the consumer is equally capable of connecting to the network. There’s also work to be done to continue the digital capability uplift to make people feel confident when they’re utilising a device, or they have someone who can assist, if required.
But certainly, the key opportunity going forward is to see more and more telehealth being performed via video call.
How has the COVID-19 pandemic, and the expectation that access to virtual care is always an option, shaped NBN’s health plans and goals?
But certainly, the key opportunity going forward is to see more and more telehealth being performed via video call.
So, it sounds as if this future depends equally on technology advancements and also educating consumers.
That’s correct. It’s about addressing the knowledge gap of our technology mix. Just because one provider may not sell a particular type of technology access to the nbn network, there are other providers out there who will make it available via satellite, fixed wireless, or fixed line capability. You might need to do a bit of investigating, but if ever in doubt, visit our website, which will outline what connectivity technology is available to support your digital needs.
And what about promoting digital capability uplift?
It’s all well and good saying we’re going to undertake things on a particular digital platform, but it would be helpful if the doctor was confident enough in not only using the platform, but also in potentially showing their patient, ‘this is how we’re going to communicate’.
So, when a patient comes in for an initial face-to-face consultation, the doctor can say, ‘bring your iPad or your smartphone or whatever device you might be using, and I’ll show you how we’re going to communicate when we do our next virtual catch-up’. That’s about lifting capability. The doctor has a very important and specific skill set and they’re not necessarily there to be computer technicians, but if they’re willing to bring their patients along with them, and explain how technology can benefit the patient, then the patient can respond by taking advantage of this alternate means of engagement.
There is great opportunity here for the medical profession. We know that colleges of medicine are looking at how they can continue to improve the digital capability skills of the workforce. I was recently in conversation with some organisations that indicated that younger health providers coming into the system now are much more digitally and tech savvy and they are bringing those skills with them.
If you are interested, we also have a product called OSCAR – Online Skills Check and Resources – that enables people to measure and then improve their digital capability. For example, how to better utilise a device, understanding digital and online safety, and even how to communicate online.
Returning to the present day: How is NBN Co currently making a difference in the health sector?
The network currently touches more than 17 million people every day, and it is constantly evolving as we help keep communities, businesses and all areas of society connected, and our nation productive. We are working with Visionflex to support remote Indigenous communities to get connected, which will enable them to access the medical help they need, when they need it.
We’re also working with state health bureaucracies on supporting place-based connectivity when a clinician goes out to undertake a mobile consultation, making sure they’re able to be connected so they can access health records and upload information, and also supporting connectivity to bricks-and-mortar facilities where people can attend a consultation out of hours.
Australia is a sparsely populated country and there are areas where patients cannot access telehealth video conference services due to slow internet speeds. How is NBN Co approaching this issue across rural and remote Australia?
Australia is the only continent on Earth to have access to a continent-wide, fast broadband network. A fast broadband network is defined as having speeds of 25/5 – that’s 25 megabytes per second download, and 5 megabytes per second upload.
These speeds support video calling on common-use platforms such as Zoom or Teams. The encouragement I give to anybody who says they can’t get the nbn, or the nbn isn’t available, is to look at our website because we have completed the build of the network. There are now more than 12 million premises that can connect to the nbn network. I encourage people to look at our website to find out what options might be available to them.
NBN Co’s Reconciliation Action Plan (RAP) touches on providing innovative health solutions for First Peoples. Can you please tell me a little bit about some of the work you are doing in this area?
We’ve been working closely with Visionflex on a project on Elcho Island in the Northern Territory to connect a community of around 250 people at Gawa, using our satellite network. It’s a very isolated, very remote community. The Visionflex system that is being deployed enables the community to access healthcare. This system is something that is being piloted through a project with Simbani Research and the Cooperative Research Centre for Developing Northern Australia (CRCNA).
There are opportunities in other parts of Australia where there is potential to roll out opportunities like this.
At nbn we are firmly committed to our RAP. In November 2020, we released our fourth RAP, with a strong emphasis on connecting more communities, increasing our engagement with First Peoples cultures and delivered customised offerings and educational programs to lift digital literacy. It’s presently being reviewed, and a new and updated version will be released next year that will continue our longstanding commitment to ensuring our Indigenous communities are not left behind and we continue to narrow the gap between capability in those communities and access to the network.
