There’s a hive of activity occurring in the west, as Curtin University – one of Digital Health CRC’s university participants – proceeds apace with numerous projects to help deliver digital benefits to the healthcare system and health consumers, writes Patrick Daley.
It may seem ironic that the topic of hamburgers crops up in a conversation about digital health, but to Professor Suzanne Robinson from Curtin University there is an obvious link.
“Drive around the newer suburbs of any city and there’s often a fast food restaurant already in place – or at least a plot of land for one – before many houses have been built and before health services have been considered” she says.
“Commercial organisations are using data analytics to drive their planning and business strategy – but the health system, on the other hand, is a slow mover when it comes to planning future services, and digital health uptake is a case in point.”
“While our health system is starting to embrace the use of big data and its benefits, uptake has been slower compared with other sectors.”
“You only need to look at social media to understand how data analytics and AI is being used to maximum effect in some sectors, and how far ahead of the health sector that is.”
Professor Robinson adds there are numerous reasons for this, including professional boundaries, funding arrangements and other health system structures.
“While analysts in the health system have to work within these boundaries, it is important we identify ways to innovate and collect high quality data in different ways.”
“There’s a lot more we can be doing in digital health, including with health consumers.”
“For example, everyone’s wearing smart watches and other pieces of equipment these days, but we don’t really know how we could use these in an effective manner to help inform healthcare delivery and clinical management of healthcare consumers. There is also an opportunity to understand how digital technology can be used to support individuals and communities to make healthy choices.”
“At Curtin, we are really trying to drive the use of digital health into the cutting edge of healthcare provision.”
Curtin Health Research and Data Analytics Hub
Curtin’s new Health Research and Data Analytics Hub is an innovative hub bringing together three key research groups – the Centre of Clinical Research and Education (CCRE), Health Systems and Health Economics (HSHE) and the Centre for Data Linkage (CDL).
The Hub is led by Professor Chris Reid (CCRE), Professor Robinson (HSHE) and Associate Professor Anna Ferrante (CDL). An overarching aim of the Hub is to show how the health system can analyse big data to better understand patient pathways, reduce inefficient use of resources, and ultimately improve population health outcomes.
With more than 20 full-time employees and 35 PhD candidates, the Hub’s research covers many areas including health systems, health economics, clinical trials, data linkage, population health and education, with the aim of analysing big data to better understand patient pathways and improve health outcomes.
The Hub is involved in innovate research projects funded by Australia’s prestigious funding organisations (including the National Health and Medical Research Council and Australian Research Council), demonstrating a high level of academic success and recognition.
Specific expertise includes the analysis of large administrative datasets (led by A/Prof Rachael Moorin); exploration of choices and preferences (led by A/Prof Richard Norman); analysis of costs and outcomes to inform policymakers (led by Dr Delia Hendrie); and clinical trials activity around new cardiovascular technologies and drugs (led by Professor Chris Reid and his team).
The Hub is also undertaking research in smaller technologies like health apps and dashboards that can enable health providers to access patient information in ways that could never be done before.
The tentacles of the Hub reach right across the university into a substantial number of non-health disciplines, from Curtin’s Institute for Computation to its Future of Work Institute. The Institute for Computation is providing world-leading expertise and technical support in computational modelling, data analytics and visualisation, while Curtin’s Future of Work Institute is focused on how society can thrive in the digital age.
“We know that many different areas contribute to better outcomes in health, so factoring in the social determinants of health is a must” Professor Robinson says.
“For example, where there’s crime there’s often other things going on, including a lack of education and poor housing. Using technology and data analytics more widely can really help us to understand problems that are beyond just the healthcare silo. Combining evidence from health and non-health data sets could help us focus on the right type of early interventions that reduce pressure on the health system and make a difference to people’s health and well-being.”
“The research and development focus of the Hub is about uniting data analytics and expertise across the various areas with broader health services and systems issues. Producing evidence that is timely and fit for purpose for policy makers and clinicians – who are often making decisions under considerable uncertainty – is a significant and growing challenge.”
“The Hub is a game-changer in that it is bringing clinicians, public health specialists and data analysts together on projects, and we are all getting skilled in each other’s areas of expertise.”
“It has really helped us understand how we can better integrate our skills and discipline expertise across each area’s needs, and this can deliver enormous benefits to the health system.”
Using data to optimise patient care
One focus of the Hub’s research is the use of digital health in optimising patient care.
“Our aim is to develop technology that provides real-time benefits to clinicians and patients” Professor Robinson says.
“Data linkage can bring together patient data from a range of care settings, including visits to the Emergency Department and your general practice. It could be used to set up a data activity profile for individual patients and could link in with pathology data, Medicare data and prescriptions data, so clinicians and researchers can more clearly see key factors around diagnosis and prescription drug use.”
“This kind of information gives us a much better idea of what happens to patients across the healthcare system and across their pathway of care.”
“It also gives us better information around patient risks – for example, we know there’s an association with cardiovascular and kidney disease, so being able to look back at a patient’s health profile would be extremely useful in pinpointing health concerns and ideally taking preventative action.”
“Linking data with other non-health data such as education, housing and other social determinants of health also makes it a very powerful tool in improving health outcomes. We have to acknowledge that people’s lives are complex and that their health status is influenced by a lot of factors. We need to take those factors into account when doing research.”
The use of linked data offers significant potential benefits, but it also requires excellent technical skills to do the linkage, and the ability to collaborate with the multiple data custodians who may hold concerns about how their data would be used.
To help address these concerns, the world-leading Curtin data linkage team has developed innovative, privacy-preserving linkage methods that are being implemented nationally and internationally. The technology makes it possible to link records without revealing the identity of the individual concerned. This new approach protects privacy and makes it possible for organisations to participate in research that otherwise would not have been possible.
“When data is linked for research it is done using strict protocols around privacy and data governance – researchers only work with de-identified data” Professor Robinson says.
“These practices protect the privacy of individual citizens while giving researchers the opportunity to use electronic heath data and other linked data to support decision-making in the health sector.”
“Curtin is currently trialling the benefit of data linkage for clinicians – and working with clinicians to explore what information and data would be really useful to them in a clinical setting. This type of work can complement the use of data at the population and policy level.”
“For example, the Curtin team is currently working on an NHMRC-funded project that uses de-identified linked data to predict how many times a patient with a chronic illness should visit a GP to get maximum benefit. Our Hub’s researchers are also supporting clinicians with analysis of real-time information and exploring how clinicians can use information to optimally treat a patient.”
Another area of research is the collection and use of patient-reported outcomes (PROMs) in the health system.
“Much of the data produced in the healthcare system relates to activity and reimbursement” Professor Robinson says.
“We know what was done and by who, but we have a much less clear picture of the effect of a service on the patient. Embedding questions on outcomes and/or patient experience in routine practice is a device for producing a positive feedback loop – if the system can identify the aspects of care that matter and that patients value, then future service configuration can be undertaken based on a strong evidence base.”
A practical research focus
Professor Robinson says Digital Health CRC’s collaborative research model works well with Curtin’s strategic focus around industry-driven research and development.
“The approach that Curtin has taken in this area is to engage in partnerships with industry, using academic rigour to address the policy questions being asked by those in the field.”
“In particular, Curtin’s Health Research and Data Analytics industry partnership model involves embedding post-doctoral researchers and PhD students within health organisations and selected clinical settings, with these students and staff members spending time at both the university and health sector sites and receiving training and guidance on both academic and policy questions.”
“Their role is to support data analytics, evaluation and research, to produce findings in a timely way and have the most impact on policy direction. Researchers are supported by our senior academics and industry partners to deliver research outputs that are relevant to industry and academia.”
“It’s a really good model that is starting to build momentum in WA.”
Curtin’s research has a strong foundation in practical outcomes, and this has been underpinned by a long-term partnership with the WA Primary Health Alliance (WAPHA) which is responsible for the three WA Primary Health Networks. This partnership has been successful over a sustained period of time due to the shared vision of Curtin and WAPHA.
WAPHA, as a state-wide organisation, has the opportunity to improve value at each point in the care continuum. This includes maximising the benefit of clinician-patient interactions, helping clinician teams to work together in a way that is efficient and tailored to specific patient needs, identifying ways the system can be more responsive to the needs of the broader community, and ensuring alignment between different parts of the healthcare system and beyond. Professor Robinson and her team have been integral to building capability in these areas, applying rigour to learning and supporting evidence-based commissioning.
“Through our partnership, Curtin has supported WAPHA in its vision to drive the delivery of the right high quality care, at the right time and in the right place – and it’s clear that digital health has a major role to play in the realisation of this vision” Professor Robinson says.
“For example, there is potentially lots of data available to clinicians, but there is also the time restriction imposed by short consultations – so Curtin and WAPHA staff are working with WA clinicians to try to understand what can be done in terms of data visualisation, to give the clinician the key pieces of data that will assist them in making an accurate diagnosis or providing the best care.”
Other key industry partners are the WA Country Health Service (WACHS), WA State Health and St John of God Health Care, which have a strong focus on evidence-based policy and practice and are also key participants in DHCRC – with WACHS leading the way in rural and remote digital health innovation.
“Our industry model is an excellent way of developing capacity for industry and academic employees, and it helps each organisation to understand the other’s world. From an academic perspective, it’s very rewarding work that enables impact and translation” Professor Robinson says.
Data security and protecting sensitive information is of key importance to organisations, and of particular importance to those working in the digital health research space.
“Our partners and data owners need to be able to trust that their information is protected from threats that could compromise the confidentiality, integrity or availability of data” Professor Robinson says.
“Curtin takes data security and governance very seriously and, to this end, our Hub has set up a secure environment with ISO 27001 certification.”
Looking to the future
Over the next decade, the Hub is looking to expand its geographical scope and influence in Australia through its work with rural and remote communities, embracing opportunities around digital health and how this can transform health access and service provision.
The Hub is also looking to further expand its scope across the Asia Pacific, with opportunities to strengthen data analytics in the region and support Australia’s neighbours in the utilisation of data analytics to improve health outcomes and system sustainability.
“It’s a really exciting era for healthcare, and an equally exciting role that Curtin is playing” Professor Robinson says.
For more information on Curtin’s Health Research and Data Analytics hub, visit curtin.edu/healthanalyticshub.
Email Professor Suzanne Harrison at [email protected].
Photo (top) – The Hub’s leadership team, including Professor Robinson (front row, right), Professor Chris Reid, Associate Professor Anna Ferrante and Professor James Boyd.
Photo (middle) – The WA CRC partners, including senior members of the Curtin University team.