my health Application

Chamonix has been delivering solutions within digital health for the past 12 years. In 2011, Chamonix was engaged by the Australian Digital Health Agency to deliver a middleware product for the healthcare industry (HIPS) to connect to the national My Health Record. The Australian Digital Health Agency (the Agency) is a corporate Commonwealth entity established by the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016. When the Agency sought a partner to help them produce a mobile application to access the My Health Record, Chamonix was well positioned to provide the expertise they needed. In 2021, Chamonix was awarded the contract to develop and manage the Australian Digital Health Agency’s mobile channel, My Health and in February 2023, the My Health consumer app was launched to help everyday Australians better managed their healthcare via the My Health Record.

Key Challenges

Consumer and provider education is a key focus for the Agency and they were seeking to leverage technology to facilitate better access to health information, thus freeing up time for both patient and healthcare provider through quick and easy access to government services for clinicians and consumers alike. The Agency also sought to achieve cohesion through common technology across all states and territories.

Considerations:
In developing this new portal, the Agency sought to provide secure and convenient access to My Health Record for everyday Australians. By developing my health as a mobile application the Agency could provide a secure and convenient way to access My Health Record, essentially empowering users with ‘health in the palm of their hands’. In order to place this technology in the hands of the maximum number of users, the following aspects needed to be considered:

• The application needed to be universally obtainable, from both the Apple App Store and Google Play Store
• Data from the My Health Record needed to be readily accessible for ‘real time’ updates
• The application needed to be secure to protect user privacy when accessing medical records
• Flexible and scalable infrastructure was needed to accommodate growth and enhancement of the application, without the need for major investment to scale resources as necessary
• The application resources and associated data needed to be accessible remotely to facilitate better collaboration

Background

Under the backdrop of COVID-19, digital health has seen exponential growth in relevance and importance, making it more pertinent than ever for all Australians and healthcare providers. The Australian Digital Health Agency’s vision is to create a healthier future for Australians through connected healthcare and their mission, to create a collaborative environment to accelerate adoption and use of innovative digital services and technologies.

Solution

The hallmark of a modern health system”, my health allows users to view key health information that they, their healthcare providers or representatives have uploaded to My Health Record. It is fast, easy, and secure – and can be accessed and shared from the palm of the user’s hand. my health enables users to view their medical history; check pathology results including Covid-19; manage vaccinations and immunisations; track allergies and reactions; view hospital discharge summaries; keep track of care planning documents; view multiple family records; view medicine information; view medical conditions and find and book a health service and symptom checker through integration with HealthDirect Australia.

Providing secure access via the cloud has allowed for a scalable solution as adoption of the technology increases, and provides scope to hold more data as adoption of the my health app continues to increase. Using cloud technologies provides ability to scale resources as needed to accommodate growth without the need for major investments in infrastructure.

Cloud technologies have also enabled the Agency to reduce their upfront capital expenditures and shift to a more predictable pay-as-you-go model, resulting in cost savings as well as the flexibility to access the application and associated data remotely to facilitate better collaboration. Through our engagement, Chamonix also introduced DevOps to the Agency, positioning the internal team well for future innovation and faster release of new features. As additional features are added to my health, the Agency is well positioned to innovate rapidly without the need for significant upfront investment. This affords greater agility for the Agency to respond quickly to user feedback and customer demands as well as changing conditions within the healthcare industry and broader landscape. With consumer views of My Health Record increasing by 292% in the last financial year, the app continues to make it more convenient for Australians to access key health information securely and instantly in My Health Record.

Azure Infrastructure
The my health app uses Azure exclusively for its delivery and runtime infrastructure, and delivery of both the app itself and its runtime infrastructure is automated via Azure DevOps:

• Azure Boards and Test Plans are used to plan and manage the work and testing of all app features.
• Azure Repos are used to manage all source code in Git-based repositories. Branch policies enforce delivery quality gates including code review and build pipeline validation.
• Azure Pipelines are used to build and release the app through Apple and Google Stores and to deploy the app’s runtime infrastructure into Azure using Bicep and Azure Resource Manager. Pipelines support critical aspects of Chamonix’s secure software development lifecycle including peer review, approval gates, static code analysis, static application security testing, software composition analysis, software bill of materials, and code obfuscation.

The app’s runtime infrastructure also resides within Azure:

• Azure App Configuration supplies dynamic configuration and feature flagging to the app.
• Azure Storage supplies dynamic app content.
• Azure Notification Hubs supplies mobile device push notifications to users.
• Azure Monitor and Application Insights ingests
  app telemetry and supports detailed reporting and diagnostics

The My Health Record Mobile Gateway that supplies the app with access to consumer’s My Health Record data is also hosted within Azure.

Leveraging the Microsoft Stack
my health was built almost exclusively using the Microsoft stack, and the application infrastructure, including configuration, notifications, blob storage, application insights and various other elements, are all hosted in Azure. Leveraging Azure cloud has allowed access to data from disparate locations and allows ‘real time’ updates which is highly useful in the context of healthcare data where there are multiple providers.

All infrastructure in Azure is automatically deployed from the pipelines using Bicep templates that define what the infrastructure should look like, and it can then be deployed for multiple environments. The tech stack and affiliated processes have been optimised for rapid release with the branching strategy and pipelines set up for CI/CD, which translates to getting updates into the hands of users sooner. Visual Studio IDE was used to build the app with the tooling within IDE allowing for rapid development across multiple environments including development, testing, production and disaster recovery.

In June 2024 the development team successfully migrated the my health app from using Xamarin.Forms which was reaching end-of-life in terms of Microsoft support to the latest code base,  .NET Maui. Maui provides a cross-platform framework for building across Android and iOS, which allowed our development team to use .NET to share logic across both platforms. This eliminated duplication and created efficiencies that allowed us to progress faster without the need for two disparate teams and we were able to deploy XAML to build a cross-platform user interface. Throughout the project, Azure DevOps was used extensively for backlog, sprint management, repo, automated pipeline, unit testing, security scanning and release management. Further efficiencies were realised by all communication with the Chamonix development team and the Agency’s team going via the Azure DevOps forum, including individual bugs and PBI’s. This provided greater transparency and consolidation as all history was traceable and linked to the repo. The Wiki feature was also utilised extensively throughout the project, with all onboarding and technical information and processes recorded. This meant that new members to the team was able to get up and running very quickly due to consolidated baseline information availability, allowing the remaining developers to focus solely on their workloads. Following the release, a my health hotline was established for users to provide their feedback directly where it is the prioritised for development. This is an example of how the team is converting customer feedback into a direct response.

Business Benefits

• Scalable solution with the ability to hold more data as adoption of the app continues to increase
• Agility to respond quickly to user feedback and changing conditions within the healthcare industry and broader landscape
• Rapid innovation without the need for significant upfront investment
• Fast, easy, and secure access to key health information from the palm of the user’s hand
• Ability to view a comprehensive series of dashboards details various aspects of individual’s medical history and records
• Increased convenience for Australians to access key health information securely and instantly in My Health Record

Solutions & Services

• .NET MAUIAzure Active Directory
• Azure Storage Accounts
• Azure App Configuration
• Azure Notification Hubs
• Azure Monitor, Application Insights
• Azure Functions
• Azure Logic Apps
• Azure Service Bus
• Azure API Management
• Azure Kubernetes Service
• Azure App Service
• Azure SQL Database
• Azure Resource Manager
• Azure Policy
• Azure Application Gateway