How the hidden cost of disconnected care falls on women

In Australia, women perform nine more hours of unpaid work and care every week than men. Globally, they carry up to three times the unpaid care load: coordinating appointments, managing health records, navigating fragmented services for children, partners, and ageing parents. Women also comprise 91 per cent of Australia's "sandwich generation" carers simultaneously caring for both children and ageing parents. While these figures appear regularly in policy reports, what they fail to capture is what that work actually looks like.

It's waiting on hold to chase a referral that should have arrived digitally. It's re-explaining a parent's medication history to a third provider in as many weeks because the records did not transfer. It's going back to a GP because that paper pathology request accidentally went out with the rest of the recycling. This is the work created by the stubbornly persistent technology gaps in our health system. And it falls, disproportionately, to women.

This International Women's Day, the UN theme Balance the Scales calls on us to dismantle the structural barriers that quietly hold women back – in law, in institutions, in the rhythms of daily life. While conversation about balance in the workplace and pay remain as important as ever, I want to make the case for adding health system design to that list.

When a health system is fragmented, the work does not disappear. It simply shifts to the patient, or to the women around them. Either way, a woman typically becomes the connective tissue of a system that was never properly joined up. Yet a mother managing a child's chronic condition should not need to repeat the same clinical history at every point of care. A daughter supporting an elderly parent should not be responsible for reconciling medication lists across handwritten notes, patient portals, and paper discharge summaries. A woman navigating her own specialist care should not fear that critical details will be lost between systems that were never designed to communicate. These are the daily realities for millions of Australian families, and the research consistently shows who absorbs that load.

The technology solution that rarely enters the gender equity conversation is interoperability: the capacity of health systems to share information securely, accurately, and in a timely way. This tends to be discussed as a clinical efficiency issue, an infrastructure problem, a question for procurement teams. It is all those things, yet it is also a care burden issue, thus a gender issue.

When a referral is transmitted digitally, a carer does not need to phone around after it. When a pathology result flows automatically to the relevant clinician, a family member does not need to chase it. When a patient's record follows them from one provider to the next, nobody needs to re-narrate a history they have already told six times. For a woman managing her own health alongside that of children and ageing parents simultaneously, this means hours of her life returned and cognitive load removed.

The barriers to interoperability are real: legacy infrastructure, inconsistent standards, and commercial incentives that have historically worked against openness. But the good news is progress is being made. We have worked with HL7 Australia to develop a new standard for digital referral platforms to replace paper-based request workflows that have persisted, largely unchanged, for decades. Electronic bookings are reducing hospital admission processes that currently put extra burden on patients and their families. AI-assisted automation is beginning to surface relevant patient history at the point of care, reducing the need for carers to reconstruct it from memory. We are proud to be helping to bring these advances into active development and deployment across the Australian health system, but the pace of change needs to match the scale of what is at stake.

The downstream effects reach further than healthcare. When women spend hours each week navigating a system that should function without their intervention, that time comes from careers, from professional development, from rest and recovery. Research consistently links disproportionate unpaid care responsibilities to reduced workforce participation, lower lifetime earnings, and a wider superannuation gap at retirement. Fixing the structural conditions that create invisible labour is not just sensible health policy, but an economic imperative.

We can't keep asking individuals to compensate indefinitely for structural failures. A connected health system where information flows reliably between providers is one of the most practical interventions available to reduce the extra care burden that women disproportionately carry. It will not resolve every inequity. But every minute returned to a woman who has been quietly holding the system together is a minute towards balancing the scales.