26 September 2016

In mid 2011, Australia’s state and territory governments signed up to the National Health Reform Agreement (NHRA). Its backers argued the NHRA would facilitate greater co-operation, information sharing and transparency between and within health services, plus generate better outcomes for patients and create a more economically sustainable health system for governments. Half a decade on, those ambitious goals are well on the way to being achieved.

“A couple of things came together back in 2011,” notes Alfa D’Amato, Deputy Director, Activity Based Funding Taskforce, NSW Ministry of Health. “Technology had emerged that allowed for the efficient capture and dissemination of large volumes of data. Equally important, there was the political will to change the way things had traditionally been done.”

The Australian hospital system’s embrace of big health data laid the groundwork for implementing what’s known as Activity Based Funding. Put simply, that means patient-level data is collected then analysed in order to calculate how much funding hospitals receive based on the number and mix of patients they treat.

“To take a real-life example, the data revealed that the costs of a procedure were higher than average at a particular NSW hospital,” D’Amato says. “Once the data was drilled down into, it was discovered that was because patients undergoing that procedure at that hospital were spending more time than usual in the ICU [Intensive Care Unit]. The clinicians at that hospital then realised they could significantly reduce the amount of ICU hours consumed by following the model of care in place at other hospitals.”

The above example illustrates one of Activity Based Funding’s most impressive qualities: an ability to satisfy all the relevant stakeholders.

“What my department does is bring clinical and financial data together,” D’Amato says. “The goal of Activity Based Funding is to provide the transparent environment to support better value care in NSW. Patients benefit from a better procedure or course of treatment. Clinicians benefit by being able to easily review the efficacy of different approaches. Clinicians can, for example, access the data for particular patients and follow their journey through the system, from the care provided in an acute ward to that provided in a community health centre.

“Those who have to work out how to fund health systems benefit by being able to identify opportunities to better integrate care provided to patients. Clinicians and managers can use the data to identify patients who are regularly seeking treatment and investigate why this is occurring and what they can do about it.”

D’Amato points out Australian health services have only been collecting and analysing big health data in earnest for around three years, so it’s still early days. But he argues it won’t be too long until hospitals are able to predict, almost down to the second and cent, what resources a particular patient will consume.

“To some extent, that’s already happening,” he says. “For example, we have developed a predictive model that allows my department to estimate, on a monthly basis, the cost of each individual patient treated in NSW and provide an estimate of the total cost of treating all patients who use the NSW hospital system each month.”

Other parts of the healthcare system, such as GP clinics and pharmacies, may then plug into the big health data network. “At that point, we should be able to pick up issues early on and reduce the number of people ending up in the emergency department,” D’Amato says.

Richard Schutte, NAB’s Head of Innovation Solutions, adds that private companies have plenty to learn from the likes of D’Amato and the NSW Ministry of Health.

“Often it’s the external climate that drives innovation,” he says. “Governments around the world are under financial pressure, not least from escalating health costs. That is driving change and the lessons learnt in the healthcare industry are transferable. Big data shines a light onto dark spaces. If there’s the will to innovate, big data-based policies and procedures can be introduced in many different types of organisations. That can create much better outcomes for stakeholders and powerful industry shifts.”

If what’s happened in the Australian hospital system since the turn of the decade is any guide, a lot of industries are soon to become far more quantified, data-driven and efficient. That will benefit smart and adaptable operators while disadvantaging those who’ve long relied on the fat in systems. Change may also be spurred along by the rise of the ‘Internet of Things’, in which everyday objects have network connectivity.

“The big data revolution is still in its early stages,” Schutte observes. “It will get a huge kick along as technologies such as the Internet of Things take off. Whatever industry they are part of, people would be well-advised to remain informed about the changes being driven by big data and willing to embrace emerging technologies.”

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