National digital health research centre to set up IT critical incident database

Macquarie University's Australian Institute of Health Innovation (AIHI) and a consortium of partner organisations have been awarded $2.5 million by the National Health and Medical Research Council (NHMRC) to set up a Centre for Research Excellence (CRE) in Digital Healthcare, which will undertake a number of programs including developing an automated IT critical incident database.

The CRE will be led by renowned health informatician Enrico Coiera, director of the Centre for Health Informatics at AIHI, and it brings together for the first time all the major Australian academic centres of health informatics research, including Bond University, the University of South Australia, the CSIRO Australian e-Health Research Centre, and the universities of Sydney, Melbourne and New South Wales.

It has also received the support of the Australian Digital Health Agency (ADHA) and the Australasian College of Health Informatics (ACHI), which will both work with the centre on a number of programs.

Professor Coiera said digital health was seen as a critical tool to improve the quality, safety and effectiveness of healthcare. “Doing that, however, requires a solid research base to help understand how to make changes to the complex system that is healthcare,” Professor Coiera said.

“Through this Centre of Excellence, researchers and front-line service providers will tackle fundamental challenges that impede the creation of truly safe, efficient and effective digital health services for both clinicians and consumers.

“If Australia’s health system is to benefit from this digital revolution, we will need much more than just technology. We urgently need the evidence, skills and workforce to translate these advances into effective working health services.”

The CRE has a number of programs that it will support over its five years of operation, covering both research and support for policy development and training. This includes working with ACHI to create a new fellowship program in health informatics, to help build a national capacity in digital health research to meet rapidly expanding national health service needs.

The four-year research fellowship has two components: a three-year doctoral program in health informatics and a one-year program of work placements. At the completion of training, candidates will be awarded a doctorate and an ACHI fellowship.

ACHI president Chris Pearce said the college welcomed the funding for what is a rapidly growing area, with the need to train the next generation of health informatics professionals an urgent one.

“With the support of the new Centre of Excellence, ACHI will be able to develop our first national fellowship program in health informatics,” Dr Pearce said. “We hope that this will be the first of several different pathways through the fellowship program of the college, each catering to the very different needs and backgrounds of the digital health workforce.”

ADHA has also supported the fellowship proposal, and will be amongst the first organisations to offer fellowship trainees paid work placements as part of the training program. Professor Coiera said other organisations that have expressed interest in taking fellowship trainees on placement include leading digital health software companies, state government eHealth agencies, and public sector health service providers such as large hospitals.

ADHA chief medical adviser Meredith Makeham said the development of a digital health workforce was a major pillar in the agency’s national digital health strategy and work plan.

“The new Centre of Research Excellence in Digital Health will make a significant contribution to training our senior digital health workforce, and the agency is happy to support this endeavour,” Professor Makeham said.

“We look forward to hosting people undertaking higher degree training in the digital health sector in collaboration with academic partners. We also we encourage others in the clinical software and health services sectors to do the same.”

The centre will also operate a 'rapid response function', in which it will conduct rapid literature reviews in answer to critical questions from the community. The idea is to ensure that evidence-based decisions are made easier for policy makers, health services and industry who operate often on tight timeframes, and may not have access to the research literature or be set up to analyse it effectively.

The CRE will aim to maintain a neutral and independent position, while still meeting the needs of key bodies such as ADHA.

It will also have a number of research programs targeting the major evidence gaps that exist in the sector's understanding of how to successfully implement and monitor digital health.

Research will focus on three streams of work:

1. Safety and quality of digital health systems: To reduce the risk of patient harms from IT, the CRE will fund the development, evaluation and support of an automated IT critical incident database, which will extract and collate reports from national and international incident report databases.

CRE investigators will disseminate critical IT alerts in response to significant new risks identified in the reports. Additionally, the CRE will conduct research into automated surveillance methods to detect clinically significant problems associated with the safety and quality of IT, suitable for use in large health service organisations such as hospitals and general practice networks.

Working with clinicians and clinical informatics professionals, the CRE will also trial dashboards for IT surveillance systems to provide early warning of events such as downtimes.

2. Advanced clinical analytics: The CRE will undertake a research program to help translate the next generation in decision support technologies into practice, in support of better, and safer, clinical and population decision-making. It will undertake an internationally innovative research program to evaluate the impact of data and text analytics decision support tools such as dashboards for clinical and public health decision-making.

A major focus of the work will be to identify which clinical decisions are most in need of decision support, how this decision support fits into the clinical workflow, and the formulation of design and implementation processes for these new tools.

3. Consumer digital health: The CRE will work with consumers, system designers and service providers to carry out highly novel and much needed research into the factors that lead to successful implementation of consumer digital health tools. It will study the relationship between outcomes and the different features of consumer apps, users, and the context of use. It will seek to develop evidence-based guidelines for the design of consumer apps and the health services in which they are embedded.

Professor Coiera said that through the CRE, the research bodies can come together to deliver an integrated research program to understand the implementation challenges faced by digital health interventions when translated into real-world settings.

It aims to make crucial contributions to national digital health policy and practice by translating these insights into improved digital health design, implementation, performance and surveillance, he said.

(Photo courtesy of Microsoft.)

Posted in Australian eHealth

Tags: ACHI, Australian Digital Health Agency, CRE in Digital Health, Australian Institute of Health Innovation , Australasian College of Health Informatics

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