contexts to the Australian healthcare environment Prof. Nilmini - - PowerPoint PPT Presentation

▶
contexts to the australian healthcare environment
SMART_READER_LITE
LIVE PREVIEW

contexts to the Australian healthcare environment Prof. Nilmini - - PowerPoint PPT Presentation

Nov 29, 2022 235 likes •466 views

Translating developed technology oncology platforms from other healthcare contexts to the Australian healthcare environment Prof. Nilmini Wickramasinghe A/Prof. Paul Cooper Dr Muhammad Nadeem Shuakat Ms Cassandra Schultz Deakin University

slide-1
SLIDE 1

Deakin University CRICOS Provider Code: 00113B

Translating developed technology oncology platforms from other healthcare contexts to the Australian healthcare environment

  • Prof. Nilmini Wickramasinghe

A/Prof. Paul Cooper Dr Muhammad Nadeem Shuakat Ms Cassandra Schultz

slide-2
SLIDE 2

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Agenda

  • Background
  • What is an Oncology Platform
  • Benefits sought
  • The study
  • The Australian/Victorian context
  • Socio-technical lens
  • Initial findings
  • Next steps

2

slide-3
SLIDE 3

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Incidence of cancer continues to impact the health system

3

AIHW: In 2013-14 there were around 936,000 cancer-related hospitalisations - an increase of 44% from 2001–02, when there were around 649,000 cancer-related hospitalisations. Over the same period, the age- standardised cancer-related hospitalisation rate increased by 8.9% from 337 per 10,000 population to 367 per 10,000. The top five most common reasons for cancer-related hospitalisations accounted for 96% of all hospitalisations where the principal diagnosis was a cancer-related treatment or service.

With aging population, cancer has stretched developed countries’ health care systems in terms of financial, manpower and staff required to look after and manage treatment for cancer patients.

slide-4
SLIDE 4

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

How an OIS can help

  • Managing treatment plans, dose planning, image based decision.
  • Improving accuracy of treatment
  • Accessing data from multiple sites, reducing paper based data,
  • nline image reviewing in 2D and 3D, transferring data to external

sites.

  • Giving access to patient for making appointments, getting

knowledge about before and after treatments, joining support groups

  • Reduction in cost by eliminating clerical staff, reducing paper/film

usage, delays in results transfer and reduces patient waiting time

  • Giving patients access to their treatment summary, disease

specific knowledge related to side,-late effects, health monitoring and support services along with managing appointments and print

  • r fill questionnaires or forms before appointment.

4

slide-5
SLIDE 5

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Benefits sought for Oncology Platforms

Improved quality of care eg by connecting electronic records to enable sharing of clinical data together with genomic data, registry data and patient self-reported data on a large scale. More appropriate and tailored therapeutic protocol to be developed for each patient More rapid diagnosis and treatment eg linked systems Improved integrated care e.g. through shared records and collaborative working tools Improved efficiency eg through reduced clerical staff Lower costs e.g. through dashboards which give insights into expensive, possibly avoidable treatments 5 Monitoring the progress

  • f patients in their

treatment, to enable more informed and improved decisions about patient care

slide-6
SLIDE 6

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Major functions of OIS

  • Integration of radiation oncology, particle therapy and medical
  • ncology patient data in a single database
  • Accessibility of patient data for multi-disciplinary teams from

multiple locations with second by second data update

  • Seamless connectivity to any linear accelerator & treatment

planning system

  • Evaluation of diagnosis-specific data to compare acute

responses to treatment and long-term clinical outcomes

  • Development of disease-specific clinical protocols to facilitate a

standard, consistent quality of care

  • Monitoring radiation dose and reviewing treatment images to

determine if plan changes are required

  • Calculating medication doses for entire treatment based on

pre-defined dosing rules specific for each pathway

6

slide-7
SLIDE 7

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

What our study is aiming to examine

Phase One of the project reports on a systematic literature review

  • f three international platforms that have the potential to deliver

high-value patient centred care to cancer patients in an Australian context and examines a range of factors including functionality, usability, and translation of such platforms to the Australian healthcare context.

7

slide-8
SLIDE 8

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

The Australian/Victorian context - strategic intents of Digital Health (DHHS Vic)

8

Source: DHHS (Vic)

slide-9
SLIDE 9

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

The Victorian Digital Health Landscape (DHHS Vic)

9

slide-10
SLIDE 10

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Victorian Digital Health Guiding Principles

  • Clinical engagement – clinicians must be actively involved in

championing health technologies, realising expected benefits and efficiencies.

  • Information and analytics – information should be available across

the full, unified continuum of carers/researchers to enable demand management and personalised healthcare.

  • Adherence to agreed standards and interoperability – explicit

adoption of greed standards facilitates information flow and advances interoperability and quality of technology solutions.

  • Robust and transparent governance
  • Value-for-money and Business-driven – decision making should

be made by and for business reasons rather than be driven by the technology.

10

slide-11
SLIDE 11

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

National Strategic Principles

  • Putting users at the centre
  • Ensuring privacy and security
  • Fostering agile collaboration
  • Driving a culture of safety and quality
  • Improving equity of access
  • Leveraging existing assets and capabilities
  • Judicious use of taxpayer money - ensure that investments

are assessed on the basis of delivering the best health and care outcomes for all Australians.

11

slide-12
SLIDE 12

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Using Activity Theory to inform our comparison (the LENS):

Enables the understanding of interactions between human activities and various work practices (Leont'ev)

12

slide-13
SLIDE 13

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Activity Theory Elements

Element Area Subject Oncologists & Nurses Object Cancer patients & Family Tool Cancer Platform

13

slide-14
SLIDE 14

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Our Overall Comparative Lens

14

Clinician led and patient-centric: enabling high levels of clinical engagement, while being patient-centric. Putting users at the centre & fostering agile collaboration Information and analytics – information needs to be available across the full, unified continuum of care and be available for research to enable demand management and personalised healthcare Adherence to agreed Internationa and Australian standards and interoperability & leveraging existing assets and capabilities Robust privacy and security Value-for-money – the selected digital technology solution must provide value for money Safety and Quality

slide-15
SLIDE 15

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

OIS - Compared via the LENS

15 System A System B System C

Multiple therapies [AT: Tools and Division of Labour]

  • Support for medical and

radiation oncology (including proton therapy)

  • Centralization of radiation
  • ncology, particle therapy and

medical oncology patient data in a single database

  • Actionable oncology decision

support tools leverage a multi- institutional data set composed of demographic, clinical, genomic, treatment, and patient outcome data. Billing [AT: Rules]

  • Billing & cancer registry
  • Missed-procedure billing

advisories

  • Export billed items to your choice
  • f HL7-compliant billing software
  • Billing and other third-party

systems

  • Claims and billing data from

financial systems Image management [AT: Tools]

  • Comprehensive review of clinical

images

  • Optimized image-guided

treatment techniques

  • Review images remotely and

send set-up instructions to the treatment machine

  • Review dosimetric images for

IMRT pre-treatment quality assurance

  • Compare images using

automatic, manual or fiducial marker-matching algorithms

  • Attach images, files or patient

photographs to documents

  • Sophisticated image

visualization & distribution

  • 3D viewers: RTP, XVI, & iView

GT™ integration, adding and synchronizing tools, 2D image registration, volume image viewing

  • External image registration
  • Stereoscopic & volume image

registration

  • Setup details, immobilization

devices and reference images entered into treatment chart

  • Present complex, personalized

analytics on individual patients based on clinical, molecular, and

  • ther relevant data in a clinically

actionable format

slide-16
SLIDE 16

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

16

System A System B System C

Clinician led and patient-centric (configurable, adaptable, suitable for co-design) – strong workflow support [From Comparative lens]

  • Appointment scheduling,

review images remotely, customisable data collection forms and questionnaires

  • Electronic patient

management allows users to achieve a paperless, filmless working environment; treatment setup workflow management

  • Configure CARE reports to

contain personalized analytic content and historical patient content formatted to your institution’s & clinician’s specific needs Information and analytics [From Comparative lens] Pain scoring to identify trends Trend analysis Integration, aggregation & personalized analytics on highly complex, disparate, multi-institutional data sources Adherence to agreed standards and interoperability & leveraging existing assets and capabilities [From Comparative lens]

  • Facilitates compliance

with the Work Health and Safety (WHS) Act Seamless connectivity to virtually any linear accelerator & treatment planning system from any vendor, providing unmatched integration, freedom and flexibility

OIS - Compared via the LENS

slide-17
SLIDE 17

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

17

System A System B System C

PBS [AT: Rules]

  • Robust privacy, security and data

protection [From Comparative lens]

  • Built-in EDI (electronic data

interchange) for secure online claim submissions

  • High Availability and Rapid

Recovery Protection (HARRP) continuous data protection and ensures minimal data loss and immediate recovery

  • Eliminate error-prone work

through tight integration that enables the seamless transition of data between tools

  • Safety and Quality

[From Comparative lens]

  • Windows 2000 and 2003
  • Manual, barcode and

biometric patient identification and verification

  • ptions provide multilevel

safety checkpoints low cost, minimal impact to your IT team, data and network security resulting in very fast time-to-value. Comparison of cost, complications, toxicity and practice [AT: community of practice]

  • System C gives comparison of

Cost, complications, toxicity and even between different practice centres or clinics.

OIS - Compared via the LENS

slide-18
SLIDE 18

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Initial findings

  • Importance of being easy to use for both clinicians and

patients

  • Need to be patient centred
  • Need to fit Australian/Victorian healthcare system some

unique aspects eg VMOs

  • Integration with doctor office/consulting rooms
  • Access to Portal in exchange of patient recovery /treatment

protocols

  • Need to support efficient and effective care delivery

18

slide-19
SLIDE 19

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Specific steps in Australian Suitability

· ICD-10-AM, · AMT3, · eVIQ, · TNM Staging, · NCI Common Toxicity Criteria, · NSW and Queensland Clinical Cancer Data Dictionary · Australian Pharmaceutical Benefits Scheme and Medicare Schedule.

19

Adherence to standards that are specific to Australia, support for PBS and MBS etc

slide-20
SLIDE 20

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

Phases of Research

  • Mapping of system functionality and user needs (clinician and

patient) and then gap analysis

  • Expansion to include current Australian OIS
  • Development of rubric for ensuring systems are fit for purpose

in the Australian healthcare environment

  • Assessment of the impact of these solutions to support and

enable high value, patient centred care

20

slide-21
SLIDE 21

Deakin University CRICOS Provider Code: 00113B

DEAKIN MEDICAL SCHOOL

Oncology Platform

  • Prof. Nilmini Wickramasinghe , A/Prof. Paul Cooper et al.

n.wickramasinghe@deakin.edu.au p.cooper@deakin.edu.au

Contact details:

21