Staff Writer

A new app unveiled in Adelaide promises to significantly improve the assessment and subsequent treatment of scars by giving clinicians access to a huge range of reference resources. The app, ClinMAPS PRO, was developed by AusHealth and the Royal Adelaide Hospital (RAH) Burns Unit. The app houses data based on a traditional scar reference book called MAPS, widely used in hospitals around Australia, giving the user instant assessment of how active the scar is and clear photographic references that clinicians can use when assessing scar progress. The original MAPS reference book was developed in 2005 by Margot Masters and Margaret McMahon, who were therapists working with burn patients at the RAH. But while revolutionary at the time, AusHealth CEO Greg Johansen said that its useability is now limited by requirements for paper and manual assessment forms, which is why ClinMAPS PRO was created. “ClinMAPS is a great example of the outstanding talent we have in developing digital healthcare here in South Australia and we believe it will be a great asset to help all serious burns patients and their clinicians identify appropriate treatments for healing,” he said. The app is expected to initially be used by the RAH and its various clinics before being rolled out to other healthcare organisations nationally and internationally. “The app includes improved and updated photos superior to the original tool that was used, further assisting researchers who examine the effects of different scar treatments. It will be a great asset to help all serious burns patients and their clinicians to identify appropriate treatments for healing,” Johansen added. [Read more: New app for the blind uses 3D audio to help them create a mental map of their surroundings | St John WA offers virtual reality for emergency training] In addition to the MAPS scar assessment, the app also includes the Modified Vancouver Scar Scale, another common scar assessment, aimed at improving usability and variety. AusHealth has also negotiated the addition of the Japan Scar Workshop’s scale (called the Japan Scar Scale) to include another kind of scar assessment measure to a planned second version of the app.

St John Ambulance WA is now using mobile and virtual reality in its first aid training, allowing people to use virtual reality to learn how to respond to an emergency, hone lifesaving skills and make first aid more available. The non-profit is pioneering a technology called First Aid Skills which uses mobile app or a virtual reality headset to guide users through three training simulations – CPR, defibrillation and the DRSABCD action plan using a Medical Information Assistant (MIA) that offers step-by-step instructions throughout the training. Additionally, sensors are linked to a resuscitation manikin to provide feedback on things like the correct rate of compression during CPR and breathing frequency. St John CEO Tony Ahern said the mobile and virtual reality technology is “a breakthrough” in helping introduce more people to first aid. “This is truly groundbreaking technology that will allow more West Australians to develop or practice the skills needed to save a life,” he said. “Our education pods are durable and mobile, meaning people can undertake training at their own pace, and at their workplace, school or public event. The technology itself is immersive, fun and equips users with the confidence to effectively respond in an emergency.” A smartphone and tablet app has also been developed to deliver on the same training offered by the virtual reality version. [Read more: Virtual field hospital shows role for augmented reality in disaster relief | How VR is helping paramedics prep for natural disaster response] Ahern said the technology puts users in an environment that more closely reflects real-life scenarios, teaching them to maintain composure in high-stress situations. “Short, cost-effective training will allow us to conduct training all over WA. Think remote regional towns, while you are waiting for a plane at the airport, anywhere.” He added that the launch of St John Skills comes off the back of the success of the St John WA First Responder App, which has and continues to enable people to help someone in need and ultimately, save more lives.

The number of data breaches involving My Health Record has risen year-on-year, from 35 incidents in the last financial year to 42 incidents this year, a report by the Australian Digital Health Agency (ADHA) has shown. The agency’s Annual Report 2017–18 identified that “42 data breaches (in 28 notifications) were reported to the Office of the Australian Information Commissioner (OAIC)… concerning potential data security or integrity breaches”, but with “no purposeful or malicious attacks compromising the integrity or security of the My Health Record system”. Of the 42 instances, one breach resulted from unauthorised access to a My Health Record as a result of an incorrect parental authorised representative being assigned to a child.  Two breaches resulted from suspected fraud against the Medicare program, where the incorrect records appeared in the My Health Record of the affected individual and were viewed without authority by the individual undertaking the suspected fraudulent activity. The ADHA report also identified that 17 breaches were a result of data integrity activity initiated by the Department of Human Services to “identify intertwined Medicare records (that is, where a single Medicare record has been used interchangeably between two or more individuals)”. The remaining 22 breaches were from suspected fraud against the Medicare program involving unauthorised Medicare claims being submitted, and the incorrect records appearing in the My Health Record of the affected customers. An ADHA spokesperson confirmed to HITNA that in all instances, the Department of Human Services took action to correct the affected My Health Records. “Errors of this type occur due to either alleged fraudulent Medicare claims or manual human processing errors, as was the case for the breaches reported during the 2017-2018 financial year. There has been no reported unauthorised viewing of any individual’s health information from a notifiable data breach,” the spokesperson said.  “In each case, the affected individuals have been contacted and the OAIC has examined the circumstances of the breach and no unauthorised breach has been determined.” [Read more: Australia leads the world in personal control of electronic health records | Is the My Health Record technology out of date?] The ADHA spokesperson added that there are more than 6.3 million people with a My Health Record, but in the six years of its operations, there have been “no reported unauthorised views of a person’s health information”. “When a person’s health information is stored in different places – hospitals, doctors’ offices, filing cabinets, computers – they don’t know who is accessing it or when. In a My Health Record, every access is listed in a person’s record access history. A person can be notified by text message about who is accessing their record or restrict access to all or parts of their record,” the spokesperson said. On 26 November 2018, the Federal Parliament passed legislation to strengthen privacy protections in My Health Records Act 2012 without debate or division. The new legislation means that Australians can opt in or opt out of My Health Record at any time in their lives. Records will be created for every Australian who wants one after 31 January and after then, they have a choice to delete their record permanently at any time. “At the time of writing, almost one quarter of all Australians have registered for a My Health Record. That figure is expected to change dramatically with the transition to an opt out system early in the 2018–19 financial year,” ADHA CEO Tim Kelsey said in the report.] [Read more: Is it possible to build an Australia that is driven by patient-led healthcare? | Game changer: Creator of FHIR writes about approaching critical mass and a growing data sharing revolution] “Once this resource becomes almost ubiquitous across the Australian health system, clinical workflows and consumer behaviours will gradually and irrevocably change to take advantage of its many benefits.  “For many people the benefits of digital health will be realised gradually, as health and medical data gradually accumulates to form a comprehensive medical history,” Kelsey said.

Ambulance Victoria will soon deploy a predictive analytics platform that gives its paramedics access to real-time information, enhancing and accelerating its decision making as the need for emergency services grows. The platform, supported by Microsoft Azure, aims to support machine learning, data mining, AI and contextual models for richer data insights that the agency can use to better its services. The platform also has capabilities to store the data for use when needed and provides a single pane of glass for Ambulance Victoria staff to access data from multiple applications and across its different environments. Ambulance Victoria Chief Information Officer Mark Gardiner told HITNA that the proposed predictive analytics program will add to its current business intelligence capabilities by analysing its current data to better allocate resources. “Predictive analytics will enable Ambulance Victoria to use a single platform to combine data currently used… with other data sets such as weather and traffic patterns to better predict where resources are best allocated,” Gardiner said. This helps staff with their decision-making, by identifying which routes and areas they should avoid as a result of weather or traffic, for example, so as to get to patients in a quicker time and deliver on the services required. Ambulance Victoria currently uses some business intelligence capabilities using a Microsoft Dynamics-based system named Ambulance Victoria Reference Data Set (AVRDS) to manage its data. But according to the pre-hospital emergency care and ambulance services provider, the data is “manually handled and carries significant lag” particularly around quality and resource or supply data, doing “little or nothing to enable decision support”. “Ambulance Victoria currently lacks capabilities and tools to monitor and improve performance as well as support divisions in real-time, making the existing technology platforms one of the key challenges in delivering better patient outcomes,” the agency recently said. [Read more: Ambulance Victoria app fast-tracks urgent care to people suffering cardiac arrests | EMRs and the Royal Flying Doctor Service – how the iconic institution approaches innovation] “As a modern ambulance service, Ambulance Victoria focuses on continual improvement. This includes looking at any new or emerging technologies that are available to enhance what we already do with a focus on delivering the right patient care, at the right time, at the right place,” Gardiner said. “By harnessing all available data into a single platform, Ambulance Victoria will increase its ability to meet the growing demand for emergency services and deliver better patient outcomes. “Once the tender is complete Ambulance Victoria expects to begin rolling out the platform over five years.” Ambulance Australia has picked Microsoft Azure as the platform in delivering predictive analytics and is now on the lookout for a primary platform supplier to execute and support the platform securely, in addition to managing the data. It is also looking to appoint a panel of suppliers that Ambulance Australia said “will help deliver solutions and expedite the delivery of new capabilities” like data dashboards and data ingestion.

A national study into the risks of CT scans in children that was delayed by three years waiting for Commonwealth approval to access data has supported findings that Australian health and medical researchers face a myriad of problems around data accessibility for research. Another example, a University of Melbourne researcher who spent $60,000 of her research budget to access 6000 Victorian births, deaths and marriages certificates, also supported the claims of the Flying Blind 2: Volume 2 – Australian Researchers and Digital Health report. The study found that better access for researchers to health data could save the country $3 billion and improve the health of all Australians over the next 15 years. Flying Blind is a collaboration between the newly established Digital Health Cooperative Research Centre (CRC), the Capital Markets CRC and Research Australia. The report indicated that in spite of the abundance of digital data that Australia holds, health and medical researchers often spend several months and even years assembling data required for their research. This has impacted advances in both health and medical science, as well as the development of the health and medical technology and pharmaceutical sectors. According to the report, these obstacles very often result in long delays where research funding almost runs out, forcing many researchers to abandon linked data studies and make do with small data sets or seek overseas data banks to address their research questions. “We have digital health data that can save lives. We have technologies that can transform healthcare, saving lives and dollars. Yet researchers’ hands are tied,” the Digital Health Cooperative Research Centre research scientist and mentor and lead author of the report Uma Srinivasan said. Delays are caused by a range of factors, the report found. One of the factors is the fragmentation of health services delivery across primary, secondary, hospital and allied healthcare setting. Further barriers include: a health and medical research ecosystem comprised of complex funding and ethics approval processes, as well as ad hoc policies and data governance strategies that differ across state and federal data custodians. [Read more: Tech development, regulation, investment and implementation key to digital health | What are the barriers to widespread telehealth adoption?] The report stated that these “processes and policies lack consistency” and are “often not transparent to researchers, causing inordinate delays in getting necessary approvals and access to health and medical research data”. “The problem is that accessing anonymised data is difficult and expensive because of the fragmentation of health data, the multiple Commonwealth and State Acts applying to it and the need to often deal with large numbers of data custodians and ethics committee,” the report stated.     “[Australia can] do much more,” Digital Health CRC CEO David Jonas said. “Australia is an advanced nation when it comes to capturing data, but we are far behind our peers when it comes to providing access to that data.” The report also proposed a series of recommendations to enhance medical research in Australia: A harmonised process of data governance that provides a path from collection to researchers, and ensures privacy and confidentiality are maintained. Appointing organisations to act as data-holding organisations for both structured and unstructured data Creating Accredited Release Agencies to build data collections suitable for research  Privacy, security and confidentiality by design Publicly accessible protocols for all Australians to see how health data is used and how it is making a difference A single national data rich access point for researchers, as well as healthcare and health technology sectors. Flying Blind is a series of three reports dedicated to uncovering the acute levels of data fragmentation existing at all levels of Australia’s health landscape. The first in the series focused on the consumer health journey while the third will provide a view of data from the perspective of funders, policy and regulatory agencies.

Australia’s healthcare industry and government stakeholders need to focus on four key areas – technology development, regulation, investment and implementation – to stimulate a thriving digital health industry. A report released by digital business health accelerator ANDHealth, Digital Health: Creating a New Growth Industry for Australia, outlined these as next steps needed to create a cohesive and collaborative digital health industry. ANDHealth CEO Bronwyn Le Grice said that with the global digital health market expected to reach US$206 billion by 2020, driven by the mobile and wireless health market, Australia needs to pursue innovation in technology, such as AI, immersive simulation, big data and IoT. And in order to fully realise the industry’s full potential, there needs to be in place an integrated ecosystem that supports the growth and establishment of the industry. The report highlighted the significant investment to date by all levels of government in developing core components of the national health and health technology infrastructure, including supply chain interoperability, terminology standards, health identifiers and data repositories, such as the My Health Record system. But it identified that for fit-for-purpose regulation, reimbursement and procurement practices and supportive public policies, strong infrastructure is needed to contribute to a viable platform for digital health technology commercialisation and implementation. “Australia is ready to take the next step in creating a cohesive and collaborative digital health industry. Australia is considered a global leader in health and medical research. We’re also early adopters of new technology and have an abundance of innovative ideas,” Le Grice said. “These are the key ingredients needed to nurture commercially viable and resilient fast-growth companies in emerging sectors, like digital health. “However, in order to succeed, there needs to be widespread understanding that the digital health sector goes beyond health information technology and infrastructure, and that digital health is not a subset of the medical devices sector,” she said. [Read more: A futurist predicts what healthcare will look like in the late 2020s | What’s needed to drive innovation and improve affordability in healthcare?] The report also recommended six steps for the healthcare industry: Recognise that digital health is a sector, which sits alongside traditional bio-pharmaceutical/life sciences and medical devices, and is a key driver of both health and economic outcomes for Australia in the future. Support and incentivise industry-led innovation support programs to provide innovators with access to professionals and advisors with demonstrable track records of success throughout the commercialisation pathway. Address challenges relating to access to capital to retain equity and foster company growth within Australia until later in the company lifecycle. Leverage investment in national infrastructure and facilitate access to it for innovators, technology developers and growth companies, in a structured way. Act to implement necessary changes to the broader healthcare environment, specifically with respect to regulation, reimbursement and procurement. Recognise the need for specialised expertise to support digital health companies to develop their international commercialisation plans and identify and support programs that provide this. MTPConnect CEO Dr Dan Grant said these steps aim to influence the direction of the future of the Australian digital health environment. “There’s no doubt that a fully fledged Australian digital health industry can be a key driver of both health and economic outcomes for Australia,” Dr Grant said. “With the right incentives in place, improved access to capital and development of adaptive regulatory frameworks, we can realise our potential as a global digital health leader.” The ANDHealth report was prepared in collaboration with industry partners including CSIRO, the Australian Digital Health Agency and MTPConnect.

The Australian Government has launched a first-of-its-kind data tool that lets the healthcare industry compare Australian data on health and healthcare with comparable international data. The Australian Institute of Health and Welfare (AIHW) built the tool and said it provides a new way of comparing Australia’s performance across a range of health-related measures from the data of 36 Organisation for Economic Co-operation and Development (OECD) member countries. Some of these countries include Japan, Spain, Italy, Switzerland, Canada, New Zealand, the UK, the US, France, Korea, Israel, Norway, Germany and Denmark. The data tool, International health data comparisons 2018, gives users interactive data visualisations of snapshot comparisons of key health indicators such as life expectancy, health risk factors and causes of death. It also aims to give insights into how Australia’s healthcare system compares, including data on the pharmaceutical market, health insurance coverage and waiting times for elective surgery. All data is sourced from the OECD Health Statistics 2018 website and results are for 2017 or the nearest available year of data for countries with available data. According to the AIHW, the tool was built to aid local healthcare professionals compare health and healthcare data between countries and get a better understanding of how the market compares to other countries. [Read more: Google's tips for 2019? Data management and advanced insights | Australian healthcare researchers take too long to assemble data: report] "This new data tool is an important resource, facilitating international comparative reporting, supporting policy planning and decision-making and enabling new types of research and analysis," AIHW spokesperson Claire Sparke said. HOW DOES AUSTRALIA'S HEALTH COMPARE TO OTHER OECD COUNTRIES? The AIHW data presented some key findings for Australia, as compared to the rest of these 36 OECD member countries, including: Australia has the 6th lowest proportion of daily smokers (12 per cent) across OECD countries, below the OECD average of 18 per cent.   Australia has the 9th highest rates of overweight and obesity (63 per cent). This is even more notable for men, with Australian men having the 3rd highest rate of overweight and obesity, behind the US and Chile. Waiting times for most elective surgery procedures in Australia are below the OECD average. For example, Australians waited a median of 13 days for coronary bypass compared to the OECD average 22 days. “The data show that Australia performs relatively well across most of the indicators. For example, Australia has a life expectancy at birth of 82.5 years – above the OECD average of 80.6 years, and 6th highest among OECD countries,” Sparke said. “However, the data show that there are some areas where Australia could be doing better, such as rates of overweight and obesity”.

Almost 40 per cent of Australian healthcare professionals have nominated better information sharing as their number one wish for improving population health. Commissioned by Philips, the Telehealth: delivering value across institutional and geographical borders report revealed that the rate of adoption of telehealth solutions worldwide is still relatively slow, despite an increase in attitudes favouring connected care technologies.  Specifically, in Australia, 38 per cent of healthcare professionals said accessible, secure information sharing platforms between healthcare professionals would have the most positive impact on Australians taking care of their health. In Australia, a barrier to using telehealth was identified to be the “human touch” aspect of care, with only 14 per cent of the population saying remote appointments using hologram doctors in their home would have the most impact on improving healthcare today. Local healthcare professionals that do use telehealth are primarily interested in interacting with their patients online for scheduling appointments (74 per cent), receiving test results (67 per cent) and video consultations (52 per cent), indicating there is some interest in remotely communicating with patients. In addition, 74 per cent said IT-based cloud solutions around communication, record management and reporting will have a positive impact on primary care, hospital or healthcare staff.  But only 23 per cent of the Australian general population and 17 per cent of Australian healthcare professionals think the health system in Australia is very or completely integrated.  Almost three quarters agreed that connected care devices should be standardised so that all devices can interact with all parts of the health system no matter who makes them. And of those who have used connected care technology, 60 per cent said they have shared their data or health information with a healthcare professional, with 22 per cent saying that they do not understand the easiest way to share data with a healthcare professional. The study also showcased the adoption landscape across 16 countries. Despite the ever-growing number of case studies linking telehealth to more effective care and lower costs, the adoption landscape across these countries is mixed. [Read more: Call for Medicare to catch up, as the momentum of telehealth uptake grows | HealthEngine survey shows patients want on-demand convenience and calls for GPs to sign up to new teleheath platform]  The report identified five key factors that are potential, though not insurmountable, barriers to widespread telehealth adoption, which include outdated reimbursement and payment models, inadequate technological infrastructures, restrictive policies, cultural attitudes and a lack of financial incentives. According to Philips ASEAN Pacific CEO Caroline Clarke, these five factors indicate the success of value-based care systems. “A key function of telehealth is connecting people, data and systems. This ensures that patients, no matter when or where they are, can access quality care,” Clarke said.  “[The] report plays an important part in helping countries such as Australia identify the key barriers to the adoption of telehealth solutions, and find solutions to ensure our healthcare system is operating optimally and the health of the general population continues to progress. “As with other aspects of connected care, success in telehealth will ultimately be based on the involvement of multiple actors – healthcare professionals, the general population, payers, regulators and the private sector – together with the recognition that healthcare is, at heart, a human field that depends on people,” Clarke said.

Two major IT players have teamed up to deploy deep-learning AI to cut the time between medical imaging, diagnosis and beginning treatment. The project, a joint collaboration between Intel and GE Health, is promising to offer physicians automated diagnostic alerts for some conditions within seconds of medical imaging being completed. It leverages the Intel Distribution of OpenVINO toolkit, running on Intel processor-based X-ray systems to help prioritise and streamline patient care. Using this system, X-ray technologists, critical care teams and radiologists will be immediately notified to review critical findings that may accelerate patient diagnosis. Intel Internet of Things Group Health and Life Sciences Sector General Manager David Ryan told HITNA that the AI imaging models are optimised for inference and deployment using the model optimiser component of OpenVINO. The optimised models are then integrated into the GE application with the OpenVINO inference engine APIs. As X-ray images are acquired by the machine, the inference engine runs them for clinical diagnosis. GE Healthcare Senior Vice-President of Edison Portfolio Strategy Keith Bigelow said medical imaging is the largest and fastest-growing data source in the healthcare industry. But, even though it accounts for 90 per cent of all healthcare data, more than 97 per cent of it goes unanalysed or unused. “Before now, processing this massive volume of medical imaging data could lead to longer turnaround times from image acquisition to diagnosis to care. Meanwhile, patients’ health could decline while they wait for diagnosis,” he said. “Especially when it comes to critical conditions, rapid analysis and escalation is essential to accelerate treatment.” According to Bigelow, a key implementation of this technology is providing earlier detection of a potentially life-threatening event – a collapsed lung, also known as pneumothorax. He said radiologists can now deploy optimised predictive algorithms that scan for and detect pneumothorax “within seconds at the point of care”, allowing rapid response and reprioritisation of an X-ray for clinical diagnosis. “Deploying deep learning solutions on existing infrastructure delivers the potential to power more efficient and effective care, enhance decision-making, and drive greater value for patients and providers,” he said. [Read more: AI and machine learning – how soon will it be key to a learning health system? | AI algorithms show promise for colonoscopy screenings] Ryan said deep learning was a promising approach for radiology because its models can be trained to recognise desired features in an image, such as tumors or anatomies. “Furthermore, training is done by giving numerous labeled example images to the models, without having to specify the exact features to look for. Deep learning can identify details that can be missed by the human eye,” he said. According to Ryan, in future applications, deep learning models can be used to identify incidental findings, as well as help radiologists manage their workload, enhance quality of scans, and reduce ‘retakes’, which can cause unnecessary exposure to radiation. “Deep learning is also showing promising results in image reconstruction from the imaging modalities. Future applications of deep learning can extend beyond imaging data to include electronic health records, pathology, cellular microscopy data, etc. to help develop targeted drugs and achieve precision in medicine,” Ryan said. Ryan said deep learning was a promising approach for radiology because its models can be trained to recognise desired features in an image, such as tumors or anatomies. “Furthermore, training is done by giving numerous labeled example images to the models, without having to specify the exact features to look for. Deep learning can identify details that can be missed by the human eye,” he said. "For the more than 12,000 Australians diagnosed with lung cancer each year, this means a higher chance of survival.” According to Ryan, in future applications, deep learning models can be used to identify incidental findings, as well as help radiologists manage their workload, enhance quality of scans, and reduce ‘retakes’, which can cause unnecessary exposure to radiation. “Deep learning is also showing promising results in image reconstruction from the imaging modalities. Future applications of deep learning can extend beyond imaging data to include electronic health records, pathology, cellular microscopy data, etc. to help develop targeted drugs and achieve precision in medicine,” Ryan said.