Here in the southern hemisphere, the sun is shining, the weather is warm, and research from the NHMRC Partnership Centre for Health System Sustainability (PCHSS) is hot off the press! We reflect on the latest research findings and recommendations made by PCHSS investigators and partners, and on our achievements and events.
What is the PCHSS?
The PCHSS is a $10.75M, five-year collaboration involving 17 lead investigators, 20 expert advisors, and over 40 system implementation partners from around Australia. Our vision is that our research findings significantly influence the development of a more resilient health care system – one that is affordable, cost effective, and delivers improved health outcomes for all Australians.
To celebrate the six years that PCHSS investigators and partners have invested in improving the sustainability of healthcare systems, we are holding a research showcase, entitled:
Future proofing healthcare: What evidence tells us about creating sustainable healthcare systems
The day will include presentations by world-renowned researchers and an interactive simulation of healthcare systems. The presentations will cover areas of PCHSS research, such as improving patient safety, incorporating digital health technologies into health systems, reducing wasteful and low-value care, improving health services using health economics, and developing learning healthcare systems as well as discussions on decarbonising healthcare systems. In the interactive simulation, the audience will be challenged to think outside the box and generate new ideas to improve the healthcare system.
This will be a hybrid event. You are welcome to join us in-person at Macquarie University or online.
Register here: https://PCHSS_Showcase_2023.eventbrite.com.au
We look forward to seeing you there!
Implementation Science Interest Group Seminar
The Implementation Science Interest Group (ISIG), formed by researchers at the Australian Institute of Health Innovation (AIHI), is an interactive forum that aims to share knowledge and skills across a diverse group of people interested in implementation science.
The ISIG have organised for Dr Matthew Chinman to present directly from the USA on the Consolidated Framework for Implementation Research (CFIR) Outcomes Addendum, which aims to guide researchers in the use of implementation outcomes in their work.
The event will be held on Monday, 27 March 2023 at 12:30pm – 1:30pm AEDST.
More details are to be released! For more information on ISIG and contact details, click here.
AWARDS AND RECOGNITION
Congratulations to Professor Johanna Westbrook and Professor Shlomo Berkovsky on their awards at Research Australia’s 19th Annual Health and Medical Research Awards.
Professor Westbrook received the prestigious Health Services Research Award, which recognised her achievements and leadership in evaluating the effects of information and communication technology in health care. Professor Berkovsky was presented a commendation award in the Data Innovation category for his contribution to research on privacy issues with mobile health apps. Well done to both of you for this fantastic achievement!
Professor Westbrook was also conferred the Distinguished Senior Investigator Award by the Health Services Research Association of Australia and New Zealand. This recognised Professor Westbrook’s significant contributions and leadership to the health services research field and health policy in Australia and New Zealand. Congratulations again, Johanna!
Since our last newsletter, PCHSS investigators published more than 25 papers, abstracts, reports, and other research works. These, and our papers, are available on the Our Publications page on our website. Notable recent examples of our publications include:
- A new study that examined the changes in telehealth activity during the COVID-19 pandemic after Medicare policy changes. The authors found that while additional government funding for telehealth services increased GP telehealth activity, this increase was not sustained over time. It appears that telehealth service use is impacted by more than funding. (De Guzman KR, Snoswell CL, Smith AC. The impact of telehealth policy changes on general practitioner consultation activity in Australia: a time series analysis. Australian Health Review)
- A systematic review of health outcomes associated with different available coronary interventions for older, frail patients with acute coronary syndrome. The primary health outcome measures used in the reviewed papers included major bleeding, mortality, death, myocardial infarction, and readmission, which were used to evaluate multiple interventions. For example, using percutaneous coronary intervention (PCI) in frail older patients led to reductions in mortality risk across three papers. (van Wyk GW, Berkovsky S, Fraile Navarro D, Coiera E. Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review. European Geriatric Medicine)
- A published case study that evaluated a university-based general practice to understand ways of improving care delivery using the learning health system framework. While use of informatic tools and financial incentives could be better enforced, the general practice excelled as a learning health system through its culture and patient-clinician partnerships. (Dammery G, Ellis LA, Churruca K, Mahadeva J, Lopez F, Carrigan A, Halim N, Willcock S, Braithwaite J. The journey to a learning health system in primary care: a qualitative case study utilising an embedded research approach. BMC Primary Care)
- A study that investigated the risk factors and protective factors associated with medical negligence claims in Australia. The authors found that doctors who experienced increased job demands, lower life satisfaction and recent serious personal injury or illness were more likely to have medical negligence claims against them. (Bradfield OM, Bismark M, Scott A, Spittal M. Vocational and psychosocial predictors of medical negligence claims among Australian doctors: a prospective cohort analysis of the MABEL survey. BMJ Open)
- Research on prostate cancer screening decision aids for general practitioners, focusing specifically on the inclusion of information on overdiagnosis. The authors found that most decision aids included information about overdiagnosis, but information regarding the prevalence of undiagnosed prostate cancer and competing risks of mortality should be more readily available. (Pathirana TI, Pickles K, Riikonen JM, Tikkinen KAO, Bell KJL, Glasziou P. Including information on overdiagnosis in shared decision making: A review of prostate cancer screening decision aids. MDM Policy & Practice.)
- A paper that evaluated the economic impacts of government-funded testing for COVID-19. The authors found that funding both PCR and rapid antigen tests (RATs) had economic benefits. However, at the time of the analysis (July 2022), Australia had high vaccination rates and few public health measures in place, therefore funding RATs for all and reducing funding for PCRs could generate higher benefits to costs ratios. (Karnon J, Afzali HHA, Bonevski B. An economic evaluation of government-funded COVID-19 testing in Australia. Applied Health Economics and Health Policy)
- A randomised clinical trial to evaluate the effectiveness of audit and feedback interventions in reducing musculoskeletal imaging requests by Australian general practitioners. The interventions were found to lead to significant reductions in imaging requests over 12 months. (O’Connor DA, Glasziou P, Maher CG, McCaffery K, Schram D, Maguire B, Ma R, Billot L, Gorelik A, Traeger AC, Albarqouni L, Checketts J, Vyas P, Clark B, Buchbinder R. Effect of an individualized audit and feedback intervention on rates of musculoskeletal diagnostic imaging requests by Australian general practitioners: A cluster randomized clinical trial. JAMA)
Since our last newsletter, there have been more than 15 popular press stories covering PCHSS research.
Here is a sample of news stories from the past few months:
- More businesses are offering online medical certificates and telehealth prescriptions. What are the pros and cons? (Snoswell C, Smith A, De Guzman K, The Conversation, 28 November 2022)
- From eight billion to four billion – how to save our planet (Braithwaite J, Croakey Health Media, 15 November 2022)
- Is private health insurance really worth it? What the Medibank hack means for the industry (Zhang Y, SBS News, 16 November 2022)
- ‘Catastrophic’ decision to defund healthcare advice organisation leaves Australians at risk, experts say (Glasziou P, The Guardian, 8 November 2022)
- Seven practical steps to build a culture of safety and human reliability (Braithwaite J, Quality Digest, 21 November 2022)
- General practice still making healthy profits: report (Scott A, Australian Doctor, 13 October 2022)
- Can digital health help curb sector’s climate impact? (Coiera E, Medical Republic, 16 January 2023)
PCHSS lead investigator Professor Enrico Coiera and Professor Farah Magrabi recently edited a focus issue of the Journal of the American Medical Informatics Association (JAMIA) that provides a blueprint for action to mitigate the impacts of climate change on human health, primarily focusing on informatics. Given the current, future, and large-scale impacts of climate change on humans and the healthcare system, this special issue provides critical pieces of research that could help reduce the current climate crisis.
Other PCHSS researchers also contributed to this edition. These articles included:
- A scoping review of the digital health interventions that have been used to reduce the impact of climate change. While publications have increased recently and highlight the potential of digital health to reduce impacts from greenhouse gas emissions, real-world evaluation of interventions needs to be addressed in future research. (Rahimi-Ardabili H, Magrabi F, Coiera E. Digital health for climate change mitigation and response: a scoping review. JAMIA)
- A paper that discussed the key tools and methods that can be used to combine economic, environmental, and healthcare data, such as Life Cycle Assessments and use of carbon calculators. Challenges to collecting and monitoring this data are also considered. (Smith CL, Zurynski Y, Braithwaite J. We can’t mitigate what we don’t monitor: using informatics to measure and improve healthcare systems’ climate impact and environmental footprint. JAMIA)
NEW LEVERAGED FUNDING
PCHSS’ researchers won over $5,786,000 in new funding and contracts in the last quarter. Examples of some of the new projects include:
- Research conducted by Professor Rachelle Buchbinder and colleagues that examines consumer-focused opportunities for reducing low-value care for arthritis. This project is being funded by Arthritis Australia.
- Research conducted by Professor Westbrook, Professor Braithwaite and colleagues that focuses on using virtual care and infrastructure innovation in Australian healthcare facilities. This is being funded as an NHMRC Partnership Project.
- The Australia and New Zealand Musculoskeletal Clinical Trial Network (ANZMUSC), which is an NHMRC Centre of Research Excellence chaired by Professor Buchbinder.
Transitions to Green Care
On 31 October 2023, PCHSS and the Implementation Science Interest Group (ISIG) from the Australian Institute of Health Innovation hosted international guest Dr Hans Ossebaard who spoke about ‘Transitions to Green Care’. Dr Ossebaard works at the Dutch national Health Care Institute as a strategic advisor on sustainable healthcare innovation. His talk focused on the integration of sustainability into healthcare, including the reduction of healthcare’s ecological footprint. It was a privilege to host such a knowledgeable and engaging speaker, and it was great to hear about what options there are for implementation of sustainable healthcare.
Follow us on Twitter @PCHSS_AIHI for notifications of upcoming events and registration links.
Videos of other past events are available on our YouTube Channel.