Presentation on theme: "Australian e-Health Research Centre Anthony Maeder Professor in Health Informatics University of Western Sydney Health Services – a major focus for e-Health."— Presentation transcript:
Australian e-Health Research Centre Anthony Maeder Professor in Health Informatics University of Western Sydney Health Services – a major focus for e-Health research
Australian e-Health Research Centre Australian Healthcare “Vital Statistics” 2003/04 $78.6 billion which is 9.7% GDP Governments fund 68% of this spend Health employs 570,000 people Chronic workforce shortages Health sector growing at 5.5% per year Hospital admissions up 9% (public), 30% (private) in 5 years Prescriptions up 41% in 10 years
Australian e-Health Research Centre Important Drivers in Healthcare Rapidly ageing population: over 65s will double Chronic diseases: cancer and multiple co-morbidities Diabetes and obesity: dramatic increases population-wide New technologies increase costs: gene, stem cell, nanotech… Maintaining “hope and trust” on which all health care is based Increased consumer expectations Deployment of new models of care Transforming data into knowledge
Australian e-Health Research Centre Government Information Economy Strategy A connected and responsive government Meeting users needs Establishing connected service delivery Achieving value for money Enhancing public sector capability Issues for health Privacy and security are paramount Choice of service delivery models Interoperability and data utilization More informed consumers Innovative technologies Safety, Quality, Efficiency Governance and accountability
Australian e-Health Research Centre COAG Initiatives National Health & Hospital Reform Commission 1.The Commission will provide advice on the framework for the next Australian Health Care Agreements, including robust performance benchmarks in areas such as elective surgery, aged and transition care and quality of care. 2.The Commission will report on a long-term health reform plan to provide sustainable improvements in the performance of the health system.
Australian e-Health Research Centre COAG National Health Reform Plan Focus Areas a.Reduce inefficiencies generated by cost-shifting, blame-shifting and buck passing b.Better integrate and coordinate care across all aspects of the health sector, particularly between primary care and hospital services around key measurable outputs for health c.Bring a greater focus on prevention to the health system d.Better integrate acute services and aged care services and improve the transition between hospital and aged care e.Improve frontline care to better promote health lifestyles and prevent and intervene early in chronic illness f.Improve the provision of health services in rural areas g.Improve Indigenous health outcomes h.Provide a well qualified and sustainable health workforce into the future
Australian e-Health Research Centre NeHTA Over 3 – 5 years will implement: National patient and provider identifiers Snomed CT – global terminology for health data Structured privacy framework Shared e-health record system Therefore new services will be needed for hospitals, doctors, state and federal health systems
Australian e-Health Research Centre What is needed for Quality Healthcare? Healthcare Quality is defined by several dimensions… Safety Appropriateness Access Consumer centredness Effectiveness Efficiency Health professionals need to have appropriate competencies to support this agenda How does e-Health support this agenda?
Australian e-Health Research Centre Health Services Approach e-Health must help us deliver (as a minimum): Shared e-health records Decision support tools Forecasting of patient flows Ability to review pathways and compliance with guidelines Modelling new service delivery processes and structures Analysis of disease patterns and treatment responses
Australian e-Health Research Centre Australian e-Health Research Strategic Areas Large scale data integration (e.g. federated databases) Web services to facilitate data aggregation and analysis Privacy / security / trusted storage and communications
Australian e-Health Research Centre Extracting Meaning from Data - Cancer Staging HISTORY Left upper lobe and partial chest wall. MACROSCOPIC One specimen received.The specimen is labelled "left upper lobe and partial chest wall" and consists of a left upper lobe measuring 155 x 100 x 45 mm. On the lateral aspect of the lung there is attached chest wall and ribs measuring 60 x 60 mm. Deep to this on sectioning, there is a white sclerotic mass measuring 45 x 42 x 40 mm. Surrounding the tumour there is obstructive pneumonitis. No other lesions are identified on sectioning of the lung. The chest wall will be decalcified and a further report will be issued. MICROSCOPIC Sections show a poorly differentiated adenocarcinoma which in most areas comprises sheets of large cells with vesicular nuclei, prominent nucleoli and moderate amounts of eosinophilic cytoplasm. Focally within the tumour there is a cribriform architecture and occasional cells contain mucin vacuoles. Areas of necrosis are present. Tumour invades the overlying thickened pleura and foci of lymphatic permeation are noted within this pleural tissue. Lymphatic invasion is also noted within pulmonary parenchyma. However no metastases are found in peribronchial lymph nodes. No vascular invasion is seen, although thrombus is noted within a vascular space towards the inferior aspect of the tumour. Tumour does not appear to extend up to chest wall structures, but a further report will follow when sections of these are examined. Distant lung parenchyma shows mild centriacinar emphysema. Pathology Report Staging Guidelines
Australian e-Health Research Centre Enhancing Data - SNOMED CT Usage
Australian e-Health Research Centre Alzheimer’s Disease PIB-PET Study Cohort of 200 patients (age > 60 years) 40 patients with Mild AD 40 patients with Mild Cognitive Impairment (MCI) 120 normal elderly controls (NC) Clinical neuropsychological evaluation Mini Mental State Examination (MMSE) Clinical Dementia Rating (CDR) PET scans PIB PET FDG PET Blood sampling for A measurement MRI scans 3D high resolution data Anatomical information Diffusion weighted imaging MRI T1-weightedMRI T2-weighted C11-PIB PET FDG PET
Australian e-Health Research Centre Australian e-Health Research Strategic Areas Large scale data integration (e.g. federated databases) Web services to facilitate data aggregation and analysis Privacy / security / trusted storage and communications Telemedicine tools Skills training tools Machine learning tools
Australian e-Health Research Centre Building Cases from CT images From 3D CT…. …. to colon model
Australian e-Health Research Centre Comparison of real and simulated colonoscopy Real colonoscopy CSIRO simulated colonoscopy
Australian e-Health Research Centre Integration of Haptic Device into Simulator
Australian e-Health Research Centre Australian e-Health Research Strategic Areas Large scale data integration (e.g. federated databases) Web services to facilitate data aggregation and analysis Privacy / security / trusted storage and communications Telemedicine tools Skills training tools Machine learning tools Image analysis Sensor enabled environments In depth skills in maths, stats, visual analytics etc. for Healthcare system modeling and prediction
Australian e-Health Research Centre Efficient Management of Inpatient Beds Inpatient beds = elective admissions + acute care episodes Project premise: EDs may seem chaotic, but admissions are predictable.
Australian e-Health Research Centre Analysing ED Presentations Toowoomba: (Pop Growth 1.3%) Gold Coast: (Pop Growth 3.3%)
Australian e-Health Research Centre
Comparison to Existing Prediction Modelling Existing Predictions vs New Model Modelling for Periods% Error with Existing Predictions %Error with New Model 12/7/06 – 20/5/07 (n=171 days) 20.5%11.1% 12/7/06 – 9/9/07 (n=261 days) 19.1%11.1% 12/7/06 – 20/1/08 (n=335 days) 30.4% (effect of opening new ED wing) 11.8%