Stuart Gibbon, Executive General Manager – Digital and Data, WA Primary Health Alliance
Across Australia, Primary Health Networks (PHNs) are responsible for understanding and supporting the health needs of their communities and addressing them by planning, designing and procuring (or ‘commissioning’) services and enhancing provider capabilities. This includes identifying where existing services aren’t fully meeting identified needs, where access to primary care may be uneven, and where people experiencing barriers to access are at greatest risk of poor health outcomes.
That work, funded and overseen under the Australian Government PHN Grant Program, relies on bringing together and analysing deidentified data from general practices and commissioned service providers. PHNs analyse that data to generate insights that drive decisions about where, how, and for whom services should be delivered, and to assist in evaluating who receives what services from whom at what cost and with what effect (i.e. the Leginski questions).
In practice, this means PHNs must operate as data-informed organisations, using tools and platforms to manage, analyse and use data in secure and effective ways. With 29 PHN organisations nationally, there’s a high risk this work becomes fragmented – with varying approaches and levels of capability, limited opportunities to learn from and collaborate with each other, and minimal ability to support a coherent national view.
Primary Health Insights (PHI) plays a central role in mitigating this risk by enabling greater consistency and more effective data collaboration across and between PHNs, as well as with key government and health industry stakeholders. Use of PHI has expanded and matured in recent years, and there is an imperative to communicate to our sector a clear understanding of what PHI is, why it was developed, how it works, and its value and impact in supporting the primary health care sector and improving broader health system integration.
So, what is Primary Health Insights – and how does it work in practice?
As stated on its website, PHI is a secure national data and analytics platform that hosts de-identified data collected by most of the PHNs across Australia from general practices and commissioned service providers delivering mental health, chronic conditions, aged care and alcohol and drug services. But what does that really mean?
To understand PHI more fully, it’s helpful to clarify how it’s designed and operates in practice, and to clarify certain things that it’s not.
Firstly, PHI is not a “data lake”. Data lakes are a concept first popularised around 2010 that refer to a consolidated location for storing large amounts of mostly unstructured data. By contrast, PHI is a federated platform that contains a separate, independently secured environment for each PHN – called a ‘lockbox’ – which contains both traditional databases as well as file storage for less structured data sets. The security and access controls that are an intrinsic part of the PHI design mean all data stored by a PHN in their lockbox is neither visible nor accessible to anyone from any other organisation.
Secondly, PHI is not a physical system located in one state, but is a fully cloud-based platform. While it is managed and supported by an organisation based in WA (WA Primary Health Alliance, as the operator of the state’s three PHNs, acts as the Lead PHN for and on behalf of all other participating PHNs), PHI and all data stored in lockboxes is fully hosted in Microsoft Azure data centres in Sydney and Melbourne, geo-locked to remain in Australia.
Thirdly, PHI is not custom-built software – it’s a platform built by configuring commercial services such as Microsoft Azure, Microsoft 365, and GitHub. That means data is stored using services like Azure SQL and Storage Accounts, that data engineering and analytics are performed using services like Synapse and Power BI, and administration is done using services like Purview and the Azure Management Portal.
When, why and how was PHI developed?
PHI exists to support PHNs in meeting the purposes of the PHN Grant Program as set by the Department of Health, Disability and Ageing (DHDA). In 2017, to support the objectives of the Australian Government, PHN CEOs agreed to work together to develop a common national data infrastructure.
A DHDA grant to coordinate, deliver and manage the platform on behalf of all PHNs was provided to WAPHA as Lead PHN. DHDA set strict requirements around data governance, security and increases in the level of PHN collaboration and consistency for data and reporting.
Following an open tender process, WAPHA engaged a consulting firm in late 2019 to support the program, and a separate specialist analytics vendor was engaged to build the system with support from Microsoft. The resulting platform was named “Primary Health Insights”.
PHI went live for pilot PHNs in late 2020, and then in 2023 the Australian Institute of Health & Welfare (AIHW) became the only non-PHN organisation to get its own lockbox in order to assist their ongoing collaborative data work with PHNs. By mid-2024, all PHNs in Australia had completed the onboarding data governance audit and commenced using PHI.
What do PHNs use PHI for?
PHNs use PHI to support and manage core functions and responsibilities relating to data collection, management, analysis and reporting. Even if PHI didn’t exist, all PHNs would still be required to do the same things they currently do by leveraging PHI, but they’d have to do this individually, and therefore less consistently and efficiently.
As a condition of funding, DHDA required PHI to meet stringent security standards, consistent with the later requirement for all PHNs to achieve ISO 27001 certification.
By using PHI, the PHNs, AIHW and DHDA have benefited from financial efficiencies as well as significant increases in collaboration and integrated effort. Communities of Practice, online tools, and joint project spaces in PHI have allowed PHNs to share knowledge, skills, methods and data securely, reliably, and effectively among themselves as well as with the AIHW and DHDA. A lot of this work supports the AIHW’s mandate to create a National Primary Health Care Data Collection.
Therefore, PHI is fundamentally about primary health care data.
Under the PHN Grant Program, PHNs are required to collect and store deidentified data from general practices and commissioned service providers. Security and privacy are at the core of PHI’s design and are reviewed regularly through external and internal penetration tests and independent security assessments.
In line with the Australian Privacy Principles, PHNs don’t hold data without having a valid use for it. The tools provided through PHI are used extensively to report on practice quality improvement, identify key at-risk patient cohorts, monitor commissioned activities and performance, identify priority service locations, and create health needs assessments – among many other use cases.
PHI enables PHNs to meet their data responsibilities more effectively, more securely, more collaboratively, and at a lower overall cost than any other available alternative. It acts as a capability and capacity multiplier, supporting consistency and re-use across the country, and simplifies the journey toward national data collections and standards.
So, where next for PHI?
All participating PHNs recently re-affirmed their commitment to PHI for the next three years. The next phases in the strategic direction for PHI will support DHDA’s stewardship of the national primary health data landscape, with PHNs working collaboratively alongside DHDA and AIHW to strengthen coordination, consistency and shared priorities. PHNs will continue to benefit from the platform’s evolving tools, technologies and services.
And that’s the value and impact of PHI
Primary Health Insights harnesses the collective power of PHNs to undertake targeted and impactful data analytics. And that, ultimately, benefits everyone who receives, plans and delivers primary care services across Australia.