Translating data to make a measurable impact on clinical care: - - PowerPoint PPT Presentation

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Dec 15, 2022 164 likes •302 views

Translating data to make a measurable impact on clinical care: Clinicians working to effect system change Professor Chris Bain MBBS, Master Info.Tech., PhD (Info. Sys.), MACS, AFCHSM, FACHI Professor of Practice Digital Health FIT

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Professor Chris Bain MBBS, Master Info.Tech., PhD (Info. Sys.), MACS, AFCHSM, FACHI

Professor of Practice – Digital Health – FIT Professor (Adjunct) – FMNHS Digital Health Lead – Monash University Acting Director – HELIX, Monash University

HISA HDA Event 2018 – Tuesday 22/10/2018

Translating data to make a measurable impact on clinical care: Clinicians working to effect system change

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Starting assumption is ….. this is a good thing (of course !!)
Getting there in a SYSTEMATIC fashion will be a surprisingly

tough journey though I’d argue ….

What are the biggest challenges …and why ?
How do we overcome them ?

OVERVIEW

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HEALTH RECORDS IN AUSTRALIA 1

Seropian R, Reynolds BM. Computer analysis in surgical investigation facilitated by

ptically scanned input. Am J Surg. Dec;

120(6):710-3 ….. Year ??????

1970 !!!!!!

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HEALTH RECORDS IN AUSTRALIA 2

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HEALTH RECORDS IN AUSTRALIA 3

SO WHERE ARE WE AT IN AUSTRALIA ?
GP computerisation is above 90 %
But overall - successful technology “penetration” into healthcare in

Australia is WILDLY VARIABLE ….. in a range of ways …..

Uptake of accepted / known technologies – eg – EMRs
HIMSS EMRAM L6 (0-7) – Aus – 3 hospitals
Vs US – Q3 2017- 32.7% of n=5,480 (1792 hospitals !!!!)
Acceptance of new technologies
Footprint size and profile (often a $ issue)
Relative maturity of different types of technologies (eg – SMR vs AI) ….

but this is not unique to healthcare

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NOVEL END USER DEVICES

The REHEARSE-AF Study at the ESC congress

2 groups x 500 older

adults

1 year
Routine care vs

2 x ECGs per week

4 times better at

picking up AF

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CHANGING CARE PARADIGMS

“Monitoring of the central blood pressure waveform via a conformal ultrasonic device” – published in Nature Biomedical Engineering – 11/9/2018 by Wang et al …

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USER / “TRAINEE” VARIABILITY

“A clinician isn’t a clinician isn’t a clinician”

Disciplines across health (Nursing, Med etc)
Variation within disciplines (eg – ICU / Anaesthesia often involved

in IT /data ….. vs psychiatry)

Anecdote … Cardiologist doing his own ML !!
Exposure as part of their formal education (UG /PG)
Age bands
Interest

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“FLOATING THE BOATS” 1 ……

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“FLOATING THE BOATS” 2 ……

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THEN THERE’S STILL ….

Workplace culture
Evidence and logic vs politics
Enabling the staff to make the right decisions and changes –

support structures (eg - policies / governance as blockers)

Data ownership as a power base = politics
Historic delay between evidence and translation into care (? 17 yrs)
Ongoing upskilling and uptooling !!!!
Finding the patient / family a place in this (NB - Open Notes / SPM)

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So an exciting future that we MUST cautiously explore … and a challenge in harnessing and using all that data to the stated end … THANK –YOU. chris.a.bain@monash.edu @monashdigital