Health Networks Build Medical Muscle
New data-mining technology helps researchers plan for better patient care.
2 February 2005
David Adams
www.solve.csiro.au
Medical practitioners have been given the opportunity to bring an unprecedented body of diagnostic experience to bear when assessing or treating patients—by being able to draw on medical records from around the country and even from overseas.
The key to this powerful diagnostic resource is new developments in information and communications technology (ICT), including new CSIRO data-mining systems that specifically allow records to be accessed without revealing patients' identities.
It means doctors, no matter where they are geographically, can effectively 'compare notes' with colleagues or medical researchers from around the world.
"The technology will be used by clinicians and public health researchers, who for the first time will be able to discover the knowledge that's locked up in their data," says Gary Morgan, chief executive of the Brisbane-based e-Health Research Centre (EHRC).
"The benefit is two-fold; patients are afforded better care, while clinicians and researchers have access to a wealth of information."
The EHRC is a a $15 million joint venture between CSIRO and the Queensland Government. It was set up in 2003 to develop and pilot ICT-related innovations in the health sector.
A network of public and private hospitals in Queensland has now begun sharing data in an initiative known as the Health Data Integration (HDI) project, conceived in CSIRO's Preventative Health Flagship Program*, which is targetting prevention and early detection of disease. Researchers at the CSIRO ICT Centre are now translating this into clinical applications at the EHRC.
Mr Morgan says the project is aimed at allowing health professionals to share data which could be used to uncover valuable trends and clinical insights while at the same time maintaining patient privacy.
"For example, if a doctor is treating a patient in Australia with a particular cancer, then it would be extremely useful to link to data about patients with similar prognoses, in Australia or North America, to provide information on treatment regimes and patient outcomes," he explains.
As well as clinicians treating patients, users also include researchers interested in improving evidence-based practice, and researchers with an interest in population-based public health research.
Mr Morgan says patient privacy is protected by CSIRO Privacy-Preserving Linking (PPL) technology that encrypts any data which identifies patients, while allowing all non-identifiable data to be analysed.
"Privacy and trust and security are paramount in this project," he says.
In the first 'real-life' application of the technology, some of the 20 research scientists and software engineers at the EHRC are working with the Queensland Health Cancer Control and Analysis Team to provide researchers with a better understanding of who is affected by lung cancer.
Under the three-and-a-half year project, which has only recently gone live, software tools are being used to link, integrate and analyse cancer patient data which can be accessed by researchers in a range of ways. These include grouping lung cancer sufferers by postcodes—information which Morgan says is useful for a number of reasons.
"With public health research, this information will help to identify where to concentrate public health education programs," he says. "It also helps identify which hospitals are working more effectively in terms of survival rates."
Dr Euan Walpole, medical oncologist at the Princess Alexandra Hospital in Brisbane, which is taking part in the lung cancer project, says the initiative has the potential to "revolutionise the amount of data we have to manage cancer patients."
Dr Walpole says the lack of a system to efficiently and securely extract data within the health care sector means that, up until now, researchers were only able to access information on the frequency and crude mortality rates of diseases such as lung cancer—information which did not allow them to assess the effectiveness of treatment systems.
Employing the HDI system, he says, will not only enable researchers to access this valuable information, which can then be compared with published standards, but will also enable them to examine the 'patient journey' and identify issues that block adequate and timely treatment.
"Timely treatment is perhaps the greatest issue, as the distances in Australia and the geographical location of the treatment services provide potential for problems," he says.
With the privacy of patients a key consideration, Dr Walpole says that under the lung cancer initiative, only cancer characteristics and demographics will be captured for study. Any data which can identify patients remains unseen.
"We will work hard to make certain this is the case to make this a viable project," he says. "It is being examined as a gazetted quality assurance project, so we are doing this for the benefit of the patient population as a whole and (are) mindful of the risks."
Security of the data is ensured via a multi-tiered approach, which includes not only encryption, but also secure web services and the use of tokens.
Other projects to be carried out as part of the research program at the EHRC include a clinical trial using personal ambulatory monitoring devices, under which a cohort of fallers and stroke patients will use monitoring technologies to help overcome the high demands on intensive care and homecare distance barriers.
The first phase of this initiative, at The Prince Charles Hospital in Brisbane, involves a trial of low-bandwidth devices which are worn by elderly patients at risk of falling. The devices alert staff if the patient falls. These data sets are then collected and collated centrally for research purposes.
Another initiative—being launched in partnership with the Brisbane North Division of General Practice—involves the development of an adaptive software environment known as EDox, which can display patient summary details according to varied healthcare circumstances.
The system allows key data collected by GPs, such as information on allergies or what medication a patient is taking, to be shared with other local healthcare facilities in a bid to provide a better quality and safer service to patients.
While under the terms of the EHRC's charter new technologies are all being trialled with Queensland Health, the centre has also been charged with preparing the technologies for release to other markets, including not only other states in Australia but also Europe and North America.
Gary Doherty, general manager of business development at the CSIRO ICT Centre, says that to achieve this, the EHRC is looking at whether it will partner with a multinational company or an SME, or establish its own company, to ensure the HDI tools developed at the centre are commercially released. "We pretty clearly have a view that there will be a social benefit and commercial value," he says.
He believes the fundamental interrogation technologies being developed within CSIRO could have widespread applications across a range of industries, including counter-terrorism investigation.
Mr Doherty, who led the negotiations with the Queensland Government to form the EHRC, says the Centre's establishment has enabled CSIRO researchers to work closely with clinicians and industry to identify their needs.