Alternative Models of Care Delphi Study 16 October 2018
On 16 October stakeholders were invited to attend a one day workshop at Macquarie University hosted by Research Stream 2.2 to prioritise the alternative models of care that had shown promise following a systematic review of the literature.
The webinar and slides can be downloaded here: Alternative Service Models to Achieve Lower Cost Delivery of Healthcare.
Investigator Workshop 15 October 2018
On 15 and 16 October, the NHMRC Partnership Centre for Health System Sustainability hosted researchers from the Centre’s ‘Reducing waste and low-value care’ research stream (2.2).
Associate Professor Yvonne Zurynski opened the meeting with an overview of the Centre’s recent activities. These include the recently completed Crowd-Wisdom survey at the International Hospital Federation’s World Hospital Conference (10-12 Oct 2018), the upcoming Consumer Sentiment Survey in conjunction with Consumer Health Forum, three comprehensive literature reviews that are underway, and projects to address the future of healthcare, such as the 60:30:10 Challenge and work with Research Australia on improving research translation in healthcare.
Professor Paul Glasziou from Bond University then talked about the importance of reducing over treatment, over diagnosis and pricing failures. He outlined several pieces of work on interventions to reduce these areas of waste, including reviews of cancer and non-cancer over diagnosis. He discussed the effects that these three areas have on individuals, the economy and the sustainability of the healthcare system and potential ways to improve these areas.
Professor Rachelle Buchbinder of Monash University and Cabrini Health discussed the progress in ‘Lower cost delivery of effective services’ research stream. Inefficiently delivered services (e.g. costly care settings, care fragmentation and the use of unnecessarily expensive providers) are a huge cost to the health care system. To identify and reduce these types of issues, the investigators conducted a scoping review of systematic reviews of alternative delivery arrangements across all healthcare settings and conditions. They are working with partners to identify other potential alternative means of service delivery of interest. Based on their research, they determined which alternative delivery models could be investigated further and conducted a Delphi study to achieve consensus on which interventions to pursue. Later in the meeting, Dr Polina Putrik provided an overview of the Delphi survey results and the webinar and meeting with stakeholders planned for 16 October.
In his presentation entitled, ‘Early Economic Evaluations to Inform the Design of Services’, Professor Jon Karnon from the University of Adelaide explained the two sub-streams that he and his collaborators are evaluating: Primary Health Networks and State health service providers, including local health networks/districts. Jon emphasised the importance of working with stakeholders and outlined the new iN-DEPtH (Evidence-informed, co-creation framework for the Design, Evaluation and Procurement of Health Services) Framework. This framework, which is currently under review in a prestigious journal, is designed to engage stakeholders in each stage of the implementation of health programs. Jon also outlined their work on 1) complex contexts (which is a model for examining decision making processes under different level of agreement and certainty), 2) using Donabedian models to look at different types of intervention (policy, clinical service) and how economic evaluation might help, as well as 3) examining the benefits of conducting local economic evaluations. Investigators and partners from this research stream also held a webinar on 17 October. Jon, Jade Hart (Victorian PHN Alliance and the Melbourne School of Population and Global Health at the University of Melbourne) and Kenneth Lo (The University of Adelaide and Macquarie University) presented a webinar entitled, ‘Designing Evidence-Informed and Cost-Effective Primary Health Services’, which was attended by over 90 people. The webinar can be downloaded from the PCHSS website, Designing Evidence-Informed and Cost-Effective Primary Health Services.
Next, Professor Catalin Tufanaru provided a fascinating overview of methods for reviewing non-peer-reviewed literature, also known as non-research or ‘grey’ literature. He provided definitions and good examples of what non-research evidence is (e.g. expert opinions, policy or position statements, perspectives, commentaries or working papers) and how to conduct systematic reviews of the non-research literature. The presentation included a list of suggested tools (e.g. Grey Matters) and resources for investigators undertaking these types of systematic reviews (e.g. Joanna Briggs Institute Reviewers Manual). This was the final presentation of the one-day meeting.
Investigator Workshop 22 May 2018
The full Investigation Team came together at the Australian Institute of Innovation to discuss research progress and plan future research strategy.
Most streams are completing scoping reviews and prioritising the highest-value interventions in collaboration with system partners. During Years 2 and 3 implementation partners will be sought to pilot and evaluate scalability of interventions. The level of interaction between Research Streams was notable.
A report of the Workshop is available here.
Preliminary Investigator Workshop 23 June 2017
Members of the full Investigation Team – Research and System Leads as well as Investigators nominated by Funding Partners – came together at AIHI to plan the first year’s research strategy and to map out ways to optimise collective endeavour, prior to commencement of the Grant. The outcomes of the Workshop are available here.
Inaugural Symposium: NHMRC Partnership Centre for Health System Sustainability 16 March 2017
This symposium, held on 16 March 2017 in Sydney, was attended by over 120 people from all around Australia. The proposed research plans of the Investigation Team were presented and then participants assisted in shaping and refining the future research agenda of the new Partnership Centre. This highly productive day of deliberation was followed by a Consumer Symposium to purposefully involve consumers in co-designing and co-producing research.
Research Area 1: Using Analytics, Technology & Shared Data
- Professor Johanna Westbrook & Dr Teresa Anderson: Using shared health information to improve the appropriateness, quality and effectiveness of care
- Professors Enrico Coiera & Robyn Ward: Big Data and the quality, effectiveness and cost of care
- Professor Len Gray & Mr Tim Kelsey: Telehealth
Research Area 2: Reducing Waste and Low-Value Care
- Professors Paul Glasziou & Helena Teede: Impact of different sources of health care waste
- Prof Rachelle Buchbinder & Ms Kim McClymont: : Lower cost delivery of effective and appropriate services
Research Area 3: Promoting Better Value for the Health Dollar
- Professor Tony Scott & Dr Trent Yeend: Using financial incentives to encourage value-based health care
- Professor Jon Karnon & Ms Leanne Wells: Priority setting and decision making in health care organisations
- Prof Tony Scott & Prof Christine Bennett AO: Markets, competition and choice in health care