News

Welcome to the NHMRC Partnership Centre for Health System Sustainability’s (PCHSS’s) winter newsletter! We hope you are staying safe and healthy, whether you are locked down or enjoying some freedom. With the ongoing COVID-19 outbreaks and continuing vaccination rollouts, there’s a growing need for research on how to develop and implement more resilient and robust health systems. In this winter edition of the newsletter, we feature some of our investigators’ and system partners’ recent work on health system sustainability.

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

UPCOMING EVENTS

Perspectives on Social Prescribing (28 September, 2-3:30 pm (AEST))

We are continuing our 2020-2021 webinar series with a session on social prescribing. Social prescribing is the practice of linking patients to social services and community-based programs (such as exercise classes, art appreciation and nature activities) to address the social determinants of ill health. This webinar will include presentations from James Sanderson (Director of Personalised Care at the NHS, England), Carolyn Dew (Head of the Cultural Pharmacy) and Professor Mark Morgan (Professor of General Practice at Bond University and Chair, RACGP Expert Committee – Quality Care) and Associate Professor Yvonne Zurynski (Associate Professor in Health System Sustainability, PCHSS and Australian Institute of Health Innovation, Macquarie University) and others working in this topical area, followed by a lively panel discussion. The event will be held on 28 September. Check our website for registration details.

If you missed any of our webinars, you can watch them on our YouTube channel. Follow us on Twitter @PCHSS_AIHI for notifications of upcoming events and registration links.

NEW PUBLICATIONS

Since our autumn newsletter, PCHSS investigators published over 25 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:

Funding research translation: how we got here and what to do next. Zurynski Y, Smith CL, Knaggs G, Meulenbroeks I, Braithwaite J. Australian and New Zealand Journal of Public Health.

• This commentary explains that efforts to increase translational research have not had the desired effect. Too much funding still goes to basic research instead of health services and public health research, where translation is more likely to happen. The authors suggest that funders can support research translation by balancing funding allocations and “embedding robust translation plans into research grant schemes; rewarding partnerships and collaborations that support translation; enhancing transparency in funding allocations; and monitoring the impacts of research investment on practice, health outcomes and policy in the long term.”

Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues. Churruca K, Pomare C, Ellis LA, Long J, Henderson S, Murphy L, Leahy C, Braithwaite J. Health Expectations.

• This review synthesised data on patient-reported outcome measures (PROMs), which are standardised questionnaires that are used to collect information on patient health outcomes. The authors found that one of the key challenges to using PROMs is that there are hundreds of tools available, making it difficult to select the optimal, and reliable and valid, tool. 

Management of patients presenting with low back pain to a private hospital emergency department in Melbourne, Australia. Buchbinder R, Bourne A, Staples M, Liu C, Walker K, Ben-Meir M, Gorelik A, Blecher G. Emergency Medicine Australasia.

• This study examined the characteristics and management of patients with lower back pain who presented to the emergency department of a private hospital. The authors found that these patients underwent more laboratory tests and imaging and were more likely to be admitted than patients presenting to a public hospital. Medication prescribing rates were comparable to public hospitals. The authors highlight the need to locally adapt and evaluate new models of care to reduce low-value care and improve outcomes for patients.

Replication studies in the clinical decision support literature–frequency, fidelity, and impact. Coiera E, Ly Tong H. Journal of the American Medical Informatics Association.

• Many researchers do not repeat previously published studies because the repeat studies are difficult to publish, even if they contradict the previous work. This is concerning because potentially 50% of research across various fields is not replicable. This study aimed to determine the frequency and impact of replication studies in the clinical decision support system (CDSS) literature. The authors found that from more than 4,000 studies, only 12 (0.3%) were replications. Understanding which CDSS principles require replication and ensuring such studies are clearly identified can improve effectiveness of CDSS and potentially avoid patient harms.

MEDIA ENGAGEMENTS

Since our last newsletter, there have been more than 33 popular press stories covering PCHSS research.

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

• It’s more than the money: Getting GPs to go to rural areas (Scott A, Pursuit, 10 May 2021)
• AI in healthcare has a PR problem (Coiera E, The Brilliant, 20 June 2021)
• How well do COVID vaccines work in the real world? (Glasziou P, The Conversation, 2 July 2021)
• Don’t blame aged care workers for not getting vaccinated (Westbrook J, The Sydney Morning Herald, 6 July 2021)
• Involve staff when designing aged care tech, researchers say (Gray L, Australian Ageing Agenda, 14 July 2021)

OTHER NEWS

New leveraged funding and awards

PCHSS’s researchers won over AU$3.5 million in new funding in the past quarter. Below is a brief description of some of the new projects:

• Associate Professor Yvonne Zurynski, Professor Jeffrey Braithwaite, and their colleagues received funding from the Juvenile Diabetes Research Foundation to aid in the development, implementation, and evaluation of models of care for Type 1 Diabetes (Davis E, Jones T, Bloom D, Zoungas S, Zurynski Y, Braithwaite J, Couper J, Huynh T. Improving clinical outcomes in young people with T1D – getting evidence and treatments into practice).
• Professor Rachelle Buchbinder, Professor Jon Karnon, and their collaborators received funding from HCF to study alternative models of care for post-operative rehabilitation following total hip and knee replacement surgeries in private hospitals (Buchbinder R, O’Connor D, Gearon E, Gorelik A, Young K, Zayontz S, Risbey P, Naylor J, Harris I, Karnon J. Wiser Rehabilitation following primary, elective total hip and knee replacement surgery at a private hospital).
• Associate Professor Yvonne Zurynski and her colleagues received funding from the Commonwealth Department of Health for the RArEST project, which will develop and deliver rare disease resources, education and training for people living with a rare disease, their families and carers, health professionals and the wider population (Jaffe A, Farrar MA, Palmer E, Millis N, Baynam G, Zurynski Y, RArEST: Rare disease, awareness, education support and training).

•  Our investigators also received significant recognition for their contribution to research and society. Professor Paul Glasziou AO became an Officer of the Order of Australia for distinguished service to medical education and standards, and to evidence-based medical research.
• Professor Helena Teede AM was awarded Member of the Order of Australia for significant service to medical education and research, to endocrinology, and to women’s health. Read more about their accomplishments on our website.

PAST EVENTS

Special webinar on Creating a value-based, integrated health system for Australia

On 3 June 2021, PCHSS hosted a two-part webinar with researchers and system partners (including representatives from NSW Health (George Leipnik) and WA Health (Dr Audrey Koay)). The presentations examined the challenges to and opportunities for developing and implementing a health system that is based on providing value to patients. The session included presentations by

• Professor Jeffrey Braithwaite and Associate Professor Annette Schmiede (How do we create value-based, integrated health systems?)
• Professor Paul Glasziou AO (Reducing overdiagnosis & overtreatment: Roles of health professionals and consumers)
• Professor Tony Scott (Incentivising value: What payment models are needed?),
• Professor Enrico Coiera (How replicable is digital health research and why does that matter?)
• Professor Johanna Westbrook (Better use of electric health record data in aged care to monitor quality)
• George Leipnik (A vision for value-based care.) [Video not available]
• Dr Audrey Koay (Value based healthcare: A systems approach)

Followed by a panel discussion with the speakers.

The second half of the webinar focussed on how integrated care can contribute to a value-based system. The presenters drew on examples from some successfully implemented programs (such as the Kids GPS program with the Sydney Children’s Hospitals Network) and discussed how to determine which health services should be scaled up (and which should be scaled down). The session included presentations by

• Leanne Wells (An introduction to integrated care)
• Professor Rachelle Buchbinder AO (Hospital in the Home, what does the evidence say?)
• Professor Jon Karnon & Mr Andrew Partington (Facilitating Local Economic Analysis (FLEA))
• Associate Professor Yvonne Zurynski (Increasing value through integrated care)
• Associate Professor Liam Caffery (Telehealth, creating care continuity when there are more ways to access care)

Followed by a panel discussion with the speakers.

Videos of the presentations and the two panel discussions are available on our YouTube channel.

PCHSS 2020-2021 webinar series

The PCHSS hosted another webinar in its 2020-2021 Health System Sustainability series.

Creating a Sustainable Health System through Collaboration was moderated by Associate Professor Yvonne Zurynski (PCHSS and Macquarie University) on 6 July 2021. In this webinar, our speakers discussed the importance of co-designing health services through collaborations of researchers, health professionals, and health consumers to create a resilient health system that serves the needs of the community. Leanne Wells (Consumer Health Forum of Australia (CHF)) discussed the challenges to the sustainability of Australia’s health system, and highlighted the need for consumer voices, leadership, and insights at all levels of the health system, including research, policy, and service design. Watch the video of the webinar on the PCHSS YouTube channel here.