Increasing the SPEED of Data Use to Improve Patient Care

In a process likened to trying to find needles in a haystack, a research team led by Professors David Brieger from Concord Hospital and Jonathan Morris from Royal North Shore Hospital were able to extract and collate the eMR data of heart attack patients and use it to describe cardiovascular care and outcomes in patients with acute coronary syndrome, particularly ST-elevation Myocardial Infarction (STEMI).

“Despite having one of the best health care systems in the world, with expanding electronic medical record capacity, to date there have been limited efforts to extract the data in a meaningful way to improve our clinical practice,” said Professor Brieger. “SPEED extract is providing us with an opportunity to address this.”

The project brought together a multi-disciplinary team with expertise spanning cardiology, population health, software engineering and data science from the University of Sydney, Local Health Districts, Ministry of Health and eHealth NSW.

SHP funding from the first round of the Rapid Applied Research Translation scheme was leveraged to attract additional funding from NSW Health and other sources. In late 2019, Sydney Health Partners provided additional financial support to the project as part of its leadership of the Australian Health Research Alliance national systems-level initiative in data-driven healthcare.

Using existing and bespoke software infrastructure, the SPEED-EXTRACT team mined five years of eMR data about chest pain patients at hospitals within Northern Sydney and Central Coast Local Health Districts to compare their treatment to national clinical care benchmarks.

Senior Research Fellow and Project Manager Charmaine Tam says results presented to the NSW Health Senior Executive Forum demonstrated the validity of the concept and its potential for wider application.

“We have shown that eMR data is helpful to doctors and that they trust it to measure clinical performance and identify variations in care,” said Dr Tam.  “The research taught us what ingredients and skills are required for success - what the ICT teams need, how to work with the performance analytics units, and what level of engagement we need from hospital clinicians.”

Dr Tam says that thanks to the success of SPEED-EXTRACT there is greater appetite for using eMR data for near real-time quality improvement.

“There’s real enthusiasm now for the process and the value that insights generated from routinely collected information systems can bring”.

SPEED-EXTRACT is now working on a process to provide the performance data to clinicians on a more frequent basis. It plans to access the data through a continuously updated duplicate of hospital eMR systems known as a data lake, which is being established by eHealth NSW.

Professor Morris, who co-chairs the Digital Heath and Informatics Network and leads Sydney Health Partners’ Informatics and eHealth theme, says while it’s clear that data-driven healthcare will become core business for health services in the coming years, some major barriers and impediments must be overcome.“We have a wealth of patient health information in our systems, we can use that information to generate knowledge and that knowledge can then be used to measure the quality of the healthcare we provide,” he said.

“The challenge is to make the data accessible and have the health system articulate its priorities when measuring the quality of care. It would be preferable if we didn’t collect data in the hospital system for one thing, the university system for another and use a third system to collect data on the outcomes of clinical trials. The mantra here should be, collect data once and use it often.”