Don’t waste the EMR moment – it’s a once-in-a-generation opportunity for system reform

Western Australia is investing in a state-wide electronic medical record (EMR). For many, this is a cause for celebration - a long-awaited step toward digitising a system still reliant on fragmented platforms and, until recently, paper records. But let’s be clear: an EMR is not a digital silver bullet. It’s a major disruption. Like all disruptions, it carries both risk and opportunity. The real question is: Will WA use this moment to truly modernise its system?

Too often, EMRs are treated as IT projects rather than system change programs. The result? A shiny interface layered over outdated workflows and misaligned responsibilities. We’ve seen this play out across Australia. In public and private rollouts, resistance arose when platforms mirrored inefficient processes or under-resourced workflows. Clinicians faced more clicks, not more clarity. Data was captured but not used. Paper persisted because change wasn’t designed with real-world practice in mind.

WA has the benefit of hindsight and learning from the other states acting as guinea pigs We can, and must, do better. This is our chance to rethink how information flows, how care is delivered, and how decisions are made. To their credit, the WA EMR Program is asking the right questions:

• Which critical clinical workflows must we harmonise to reduce variation and risk?
• How can we meaningfully streamline processes to enable clinicians to spend more time with patients?
• What governance will ensure data privacy, quality and accountability?
• How do we build in interoperability, not just within hospitals, but across the whole health ecosystem?

Major digital health programs are inherently disruptive. They force us to define processes, make hard governance decisions, and challenge the status quo. That discomfort can be constructive, if we seize the moment.

At Nous, we’ve seen how disruption can be turned into direction. We helped design the whole-of-government transformation program for myGov from the ground up, defining the strategy, building the case for change, and aligning cross-government stakeholders bring about a $200 million commitment to transforming myGov’s customer experience and digital service delivery. 

In healthcare, we supported St Vincent’s Health Australia to build an enterprise architecture strategy that simplified a landscape of over 750 applications and now drives long-term digital investment aligned to its vision for connected care.

In WA, the stakes are high. The state’s health services cover the largest geographic footprint in the country and reach some of its most remote communities. Getting this right is more than a technology challenge: it’s a strategic imperative.

Consider some of our system’s longstanding challenges:

• Fragmented care across regions and providers
• Limited visibility of patient history, leading to duplication and delays
• Manual workarounds that exhaust staff and introduce risk
• Inconsistent clinical documentation that limits quality improvement

An EMR alone won’t solve these. But it can force the system to fix them, if we frame the program as a catalyst for deep and enduring reform.

Let’s be clear: the EMR isn’t the goal. Safer, smarter, more coordinated care is, which means we need to talk less about platforms and more about outcomes. How will the EMR help reduce avoidable hospital admissions? How will it support integrated care for people with chronic conditions or comorbidities? How will it enable clinicians to spend more time with patients and less time at the computer? The EMR is a tool – albeit an amazing one – but we can’t forget to get clarity on the problem, then use people and processes to maximise that tool’s utility.

To get there, we need to use the EMR rollout as a catalyst to harmonise workflows across the system and ensure coordinated, equitable care. We also need co-design (not just consultation) with clinicians and consumers, clear governance that enables timely, transparent progress, and investment in leadership, digital literacy, and change resilience, not just EMR training. These aren’t “nice to haves”. They’re conditions for success.

At Nous, we saw this firsthand through our role in implementing the Parkville Precinct EMR, where four Melbourne hospitals came together to implement a shared system. The project showed that success depends on far more than a technology solution. It needs deep, committed clinical leadership, true cross-organisational collaboration, effective governance, and a shared commitment to change management at all levels. Because better care doesn’t come from technology: it comes from the people who use it well. This way, the partnership ensured its technology remained contemporary, sustainable and focused on better outcomes for staff and patients.

System reform is hard. Funding silos, workforce pressure, and political cycles make statewide change difficult. But this EMR program gives WA Health a rare window: a mandate, a budget, and a shared sense of urgency. This moment creates permission to align public health services around shared digital and clinical standards, streamline care pathways across metropolitan and regional settings, and strengthen shared accountability for outcomes, not just activity. 

It also lays the foundations for a connected health system, with a digital backbone that supports virtual care, advanced analytics, population health, and meaningful patient engagement. Crucially, it enables WA Health to accelerate programs that rely on a strong digital infrastructure, such as the State Health Operations Centre (SHOC) and Community Health in a Virtual Environment (Co-HIVE), ensuring these investments are integrated, scalable, and sustainable.

The good news is that WA is already off to a strong start. The WA EMR Program has taken a thoughtful, staged approach, embedding clinical leadership, investing in engagement, and recognising that successful implementation hinges on more than technology. These foundations are both critical and commendable.

Now, the challenge is to stay the course and extend that mindset system-wide. WA Health leaders across the Department, health service providers, and clinical teams need to approach the EMR program not as an IT rollout, but as a strategic transformation initiative.

That means continuing to:

• Embed change leadership at every level – not just project managers, but visible clinical and operational champions who own the change.
• Prioritise user experience – not only for clinicians, but for patients and carers
• Measure success not in go-live dates, but in improvements to safety, experience, and efficiency

And it means staying focused on what matters: building a health system that works better for the people who use it, and the people who keep it running.

A few more ideas worth holding onto:

• Be relentless about simplification, reducing duplication and design for clarity.
• Use the EMR as a tool for health equity, ensuring underserved populations benefit, not just high-resource settings.
• Think beyond the hospitals, considering instead how the system will integrate with care delivered in the community. Truly joined-up care is the goal.
• Keep listening, especially when it’s uncomfortable. Resistance is often insight in disguise.

Finally, it is critical to remember that we only get one shot at this. Let’s not confuse deploying an EMR with delivering reform. This is our chance to build something much bigger than an IT system. It’s about creating a connected, future-ready health system that delivers better care for all Western Australians, regardless of who they are and where they live.

Get in touch to discuss the future of digital health.

Connect with Bec Johnson and Cristina Cañiz Pérez on LinkedIn.