Can Telstra have a significant impact in eHealth when so many others have failed

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Everyone in Australia recognises Telstra as the previously Government-owned telecommunications monopoly that was privatised a little over a decade ago, while being opened to competition. However it has still remained the dominant provider of fixed line, internet and mobile services while at the same time expanding its reach as a provider of cloud services and also increasing its role as a provider of support services to the National Broadband Network (NBN) for a very considerable sum. It is presently one of Australia’s largest companies with a market capitalisation of more than $75 billion and annual turnover of more than $33 billion writes Dr David More.

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Much less well known is that in the last 2-3 years Telstra has been steadily developing a presence in the eHealth space. At the time of writing (mid-April 2015) Telstra had made over 15 investments in eHealth related companies - many of which have been purchased outright - and has formed a separate operating unit termed Telstra Health.
You can read all about Telstra Health from this link: www.telstra.com.au/telstra-health
What is interesting recently is that Telstra Health has, as it has made these acquisitions and formed its various partnerships, has begun to much more clearly articulate a business strategy and some business objectives. As a listed company we can be sure Telstra’s motives are financial; not charitable.
They identify what they describe as a six-point strategy;
Our six-point strategy
We’re focusing on key health segments and building an eHealth ecosystem to address six of the biggest challenges facing the Australian healthcare system.

• Consumer Control - Providing people with greater control of their health and wellness


• Connectivity - Increasing access to healthcare regardless of location


• Admissions - Reducing hospital and aged care admissions


• Integration - Improving integration of health information


• Pharmacy - Creating a safer, efficient and more convenient pharmacy system


• Efficiency - Improving efficiency and productivity across the system

With these in mind there does emerge a pretty clear and logical rationale for the various acquisitions that have been made - although I would have to say some have a much clearer basis than others. The good thing is that many of the acquisitions have been successful in their own right in delivering relevant and useful clinical and other support services and that many of the developers have been very much engaged in and understanding of the health sector at large. Sadly, in some ways, their size, and financial capability, has allowed them to ‘pick the eyes’ out of the best available in Australia which outcome might just stifle innovation in the future.
As an observer of the eHealth space for now over thirty years I have seen all sorts of entities attempt to develop an engagement with the health sector and make a sustained and profitable (from their perspective) venture within the sector. It would be fair to say, I believe, that when considered over years, most organisations have run both hot and cold on the possibilities for them in the sector with very few, if any, being able to develop clearly sustainable and long term businesses, indeed before this present initiative Telstra has itself had different forms of engagement with the health sector over the last two or so decades. It is notable that the current push has considerable commitment at the level of the soon to retire CEO (David Thodey) who has mentioned eHealth frequently over the years as a significant growth engine for the company - with suggestions that the goal is to build a health / eHealth business with annual revenues of $1 Billion over the next five years. Clearly it is only at this scale could the goal of making a significant commercial difference be achieved. With that said it is clear Telstra has not been afraid to invest for growth in the sector with the announced venture / acquisitions clearly amounting to many tens of millions.
The key issue that flows from all this is just how they will be able to generate the sort of returns on investment and margins that a commercial entity requires. They clearly recognise - from these three paragraphs - that there may be some considerable challenges.
“We’ve seen what the digital technology revolution has done to meet challenges in other industries. We believe Australia’s healthcare system can benefit significantly from a successfully implemented, connected eHealth system, reducing the reliance on multiple face-to-face interactions and removing an often siloed approach to care.
It’s a huge job, so we’re working with government, providers, patients and healthcare funds to deliver a connected future with improved productivity, safety, convenience, and quality control.
It’s not about selling products, rather working with you to understand your challenges and develop solutions that will create brilliant new opportunities for Australia’s health system. Our products are our capabilities and it’s how we connect them, and the various parts of the system, that will make us truly successful.”
Here is the link:
www.telstra.com.au/telstra-health/about/system-strategy-and-values
Many before them have noticed this potential opportunity and challenge but very few have succeeded!
If they are to succeed they will really need to develop deep expertise and relationships with the sector and be patient, while at the same time realising that success will only come from establishing truly stable and worthwhile revenue streams by offering services that are sufficiently differentiated and worthwhile that they will be valued. Initially I suspect they will be met with considerable scepticism and that their ‘big business’ character may be a barrier to successful engagement.
I noticed that in the recent announcement of the successful tenderers for the replacement of the Medicare Locals that Telstra Health was involved in the successful bid for the Brisbane North Metro Network. (Note eHealth is one focus of the new Primary Health Networks). Is this a pointer to at least part of how Telstra is seeking engagement (and revenue)?
Another pointer to the underlying strategic direction is the recent announcement of MyCare Manager. This application is an eHealth solution for the aged and community care and disability sectors that includes a self-service portal and telehealth monitoring platform for clients. Here Telstra deploys both its network capacities as well as specific health functionality in a total solution package for a target market.
Read all about it here: www.australianageingagenda.com.au/2015/04/17/integrated-home-caresolution-launched/
Another possibility to consider is that Telstra may be using Australia as a test bed for a range of Asian eHealth initiatives. If this is the case the complexity will rise but so also may the opportunity increase very considerably!
There is an interesting recent article from the leader of the initiative found here: ehealthspace.org/news/telstra-s-shanesolomon-potential-ehealth
To me the jury is still out as to just how successful this initiative might be in the future but with Telstra’s scale and reach anything is possible, think maybe the PCEHR (ed: now re-launched as MyHealth) being run in the cloud on Telstra’s network, Telstra taking over provision of basic eHealth infrastructure services, provision of GP and/or hospital computing as a service or even taking over NEHTA. Some such outcomes are possible and I am sure can’t be ruled out! I will certainly watching with interest.

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“We believe Australia’s healthcare system can benefit significantly from a successfully implemented, connected eHealth system, reducing the reliance on multiple face-to-face interactions and removing an often siloed approach to care.”

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Dr David More
Health IT Consultant
Dr David More is a Health IT consultant with more than 20 years’ experience in the e-Health area. His blog can be found at aushealthit.blogspot.com and covers all matters e-Health. He may be contacted via the links provided on the blog.