News

Welcome to the NHMRC Partnership Centre for Health System Sustainability’s (PCHSS’s) (southern hemisphere) summer newsletter! As the Omicron wave of COVID-19 begins to recede in Australia, we pause to reflect on the latest research findings by PCHSS investigators on developing and implementing more resilient and robust health systems.

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.

NEW AWARDS AND RECOGNITION

The PCHSS received the Macquarie University Excellence in Research: Five Future-shaping Research Priorities – Healthy People award at the 2021 Research Excellence Awards ceremony on 30 November. This award recognises exceptional research collaborations that have made a material impact on healthcare in Australia.

Professor Jeffrey Braithwaite (pictured top right) was presented with the 2021 Sidney Sax Medal to recognise his contribution to health services and systems research. The Sidney Sax Medal is sponsored by the Australian Healthcare and Hospitals Association (AHHA) and is awarded to an individual who has made an outstanding contribution to the development and improvement of the Australian healthcare system.

Professor Enrico Coiera (pictured middle right) was named the top researcher in medical informatics and Professor Paul Glasziou (pictured bottom right) was named the country’s top researcher in epidemiology by The Australian. The Australian’s Research Magazine 2021 names the top researcher and top research institution in each field of research based on the number of citations for papers published in the top 20 journals in each field over the past five years. Congratulations Paul and Enrico!

NEW PUBLICATIONS

Since our (southern hemisphere) spring newsletter, PCHSS investigators published over 50 papers, abstracts, reports, and other research works. These and all our papers are available on the Our Publications page on our website. Notable recent examples of our publications include:

• In this systematic review, PCHSS researchers revealed that social norm nudge interventions (ones that inform individuals of others’ behaviour) can reduce inappropriate antibiotic prescribing by general practitioners. (Raban M, Gonzalez G, Nguyen A, Li L, Newell B, Westbrook J. Reducing antibiotic prescribing using nudges: a systematic review of interventions in primary care. Infection, Disease & Health)

• By analysing data from telehealth outpatient consults in Queensland, Australia from July 2017 to June 2018, PCHSS researchers found that when healthcare is provided using telehealth instead of in person, there are likely to be productivity benefits for both the patients and society. (Snoswell CL, Smith AC, Page M, Scuffham P, Caffery LJ. Quantifying the societal benefits from telehealth: productivity and reduced travel. Value in Health Regional Issues)

• PCHSS researchers developed a thematic framework based on a systematic review of the literature to understand the consequences of disease diagnosis for individuals, families, carers, and the health system. The new framework consists of five themes, which can be used to evaluate the impact of changes in disease definitions. (Sims R, Michaleff ZA, Glasziou P, Thomas R. Consequences of a diagnostic label: a systematic scoping review and thematic framework. Frontiers in Public Health)

• This pragmatic review examined interventions to prevent inpatient hypoglycaemia. Positive evidence was found for many types of models of care. Local context was revealed to be a critical factor in success. Local decision-makers can use this review to identify interventions relevant to their specific context. (Gray J, Roseleur J, Edney L, Karnon J, the Southern Adelaide Local Health Network’s Hypoglycaemia Clinical Working Group. Pragmatic review of interventions to prevent inpatient hypoglycaemia. Diabetic Medicine)

• The use of electronic mental health (e-mental health) programs and services has increased dramatically since the start of the COVID-19 pandemic. This review assessed key characteristics and evidence gaps in the e-mental health literature. Five factors (system, service, technology, provider, and patient factors) need to be overcome for the application of e-mental health to be successful. (Ellis LA, Meulenbroeks I, Churruca K, Pomare C, Hatem S, Harrison R, Zurynski Y, Braithwaite J.The application of e-mental health in response to COVID-19: scoping review and bibliometric analysis. JMIR Mental Health)

MEDIA ENGAGEMENTS

Since our last newsletter, there have been more than 40 popular press stories covering PCHSS research.

Here is a sampling of news stories from the past few months:

• The Hippocratic Oath and what happens in the real world (Rachelle Buchbinder, ABC Health Report, 11 October 2021)

• Why greater private sector participation has not improved aged care performance (Tony Scott, Croakey Health Media, 25 October 2021)

• Press Release: Prof Jeffrey Braithwaite recognised as outstanding health leader (Jeffrey Braithwaite, Get the word out, 28 October 2021)

• Health leaders urged to empower the sector on climate action (Yvonne Zurynski, Croakey Health Media, 15 November 2021)

• What could the hospital of the future look like? (Farah Magrabi, The Lighthouse, 16 November 2021)

• Climate change, human health, and health care systems (Jeffrey Braithwaite, Yvonne Zurynski, K-lynn Smith, MJA Insight+, 19 November 2021)

• Research shows free RATs ‘highly likely’ to benefit economy (Jon Karnon, 9News, 7 January 2022)

OTHER NEWS

NEW LEVERAGED FUNDING

PCHSS’s researchers won over $1,722,263 in new funding and contracts in the past quarter. Below is a brief description of some of the new projects:

• Professor Johanna Westbrook and colleagues received a new contract to evaluate the usability and effectiveness of the neonatal intensive care unit (NICU)/pediatric intensive care unit (PICU) version of the eHealth NSW electronic Record for Intensive Care (eRIC). The eRIC is a clinical information system designed to improve the quality and safety of care for patients in critical care units.

• Professor Enrico Coiera’s new postdoctoral fellow, Dr Nazim Uddin Sheikh, received a Macquarie University COVID Recovery Fellowship. He plans to develop a privacy enhancing COVID-19 symptom classification tool.

• Although every patient is different, unwarranted clinical variation (differences in treatment not based on medical need or patient preferences) can lead to waste in clinical practice. Professors Paul Glasziou, Rachelle Buchbinder and collaborators received a NSW Agency for Clinical Innovation (ACI) Unwarranted Clinical Variation Grant. They will undertake a structured implementation approach to reduce unwarranted clinical variations.

• In October 2021, a group of philanthropists began the Million Dollar Vax lottery to increase vaccination rates in Australia. People who got their COVID-19 shot before the closing date could enter to win a $1,000 gift card or, for one lucky person, $1 million in cash. The program received over 2.7 million entries. But what were the impacts of the lottery? Professor Tony Scott and Dr Dajung Jun received a contract from the Summer Foundation (one of the campaign’s promoters) to find out.

• A hospital is more than just a building and health services shouldn’t exist in isolation. Through a NSW Health Infrastructure grant, Professor Braithwaite and colleagues have undertaken the Rouse Hill Development project, which is creating an innovative, far-reaching research-based solution for the local community within the planned new hospital.

• What impact has the COVID-19 pandemic, and responses to it, had on the Victorian economy? Professor Tony Scott and his collaborators won a new contract from the Department of Treasury and Finance, Victorian Government to answer this pressing question.

• Professor Jon Karnon and colleagues received funding for five research activities related to health system sustainability. These grants will help understand patient’s experiences with a hospital-in-the-home program; explore how to use patient reported outcome measures to improve elective surgery; and undertake economic evaluations of two healthcare programs. They will also aim to answer the questions: Would the business case for business cases in Australian healthcare be funded? •

• Professor Suzanne Robinson from Curtin University received a WA Health Implementation Science Fellowship 2021. She will be working closely with Associate Professor Yvonne Zurnyski and other collaborators to support the development of the new WA Country Health Service (WACHS) Operations Centre.

PAST EVENTS

PCHSS 2020-2021 webinar series

Exploring the Nexus of Climate Change, Human Health, and Healthcare System Sustainability

On 2 December 2021, PCHSS researchers were joined by a panel of global experts for an online workshop on the intersection of climate change and human health. The session involved discussions about the unique challenges presented by climate change and how these challenges impact human health. They also discussed the health systems’ carbon footprint and how wasteful care contributes to the problem. The presenters then explored solutions to improve human health and create more resilient healthcare systems.

Following the presentations, there were two panel discussions moderated by ABC national medical reporter Sophie Scott.

Before the event, we published a preview article in the MJA Insight+, Climate change, human health, and health care systems, drawing on the recent events of the 2021 COP26 conference in Glasgow, Scotland and highlighting the health co-benefits of addressing climate change. In their article, Health leaders urged to empower the sector on climate action, Croakey News Media interviewed many of the panellists about what health professionals and health systems can and are doing to address climate change.

Croakey Health Media also covered the event on Twitter through the @WePublicHealth account. As summary of the Twitter discussion is available here.

Videos of this and all our events are available on our YouTube channel.

Follow us on Twitter @PCHSS_AIHI for notifications of upcoming events and registration links.