David Hansen and the AEHRC recently held their annual e-Health Colloquium in Brisbane – a gathering of some of the greatest minds focussed on using technology to solve Australia’s biggest health challenges. It was a resounding success, attracting more than 300 e-health aficionados. Check out this video for some of the day’s highlights.
Can you name the two words that tie together mobile phones, gestational diabetes, information systems, image processing, mobile phones, Alzheimer’s disease, and cerebral palsy?
Heard the term, but not sure what it means, or why you should care?
Here’s Australian e-health Research Centre (AEHRC) CEO David Hansen on what digital health involves, how it’s transforming your healthcare, and some of the challenges facing the industry.
Welcome David! Let’s jump straight in: what does digital health mean?
Digital health is about using data, analytics and digital communication in any and every way we can think of, to find new ways to improve the safety, quality and efficiency of our health services – providing the information clinicians need at the right time, extracting personalised health information from technologies ranging from imaging and genomics to wearable sensors and devices, and improving health outcomes and the health system experience for patients.
This covers everything from increasing the use of electronic health records – including by giving patients access to their own records – to new methods of medical image processing to help fight diseases such as Alzheimer’s disease, cerebral palsy and cancer; finding ways to detect disease earlier so it can be treated more efficiently; and developing tech that can be used remotely so every Australian can access healthcare. Of course using big data analytics techniques on all this data is a big topic, and one we’re particularly interested in at CSIRO of course! It’s a huge field, and it’s transforming the way healthcare is delivered around the world.
So what does it have to do with me?
Globally, we’ve got some significant health challenges to overcome. The growing aging population together with new expensive technologies and pharmaceuticals are increasing the cost of providing healthcare.
And while healthcare has been good at embracing new technologies in areas such as pathology and medical imaging, it hasn’t been very good at capturing and sharing data about patients. This is changing; the health system is also increasing the data shared with patients, and patients are now seen as part of their own care team.
We also want to make sure that people in rural and remote areas, where hospitals aren’t close by, are able to access health services.
This is where digital health, or e-health, can really have an impact.
What are we talking about in terms of numbers?
Australian governments spent $115 billion on health expenditure in 2015-16, and this is expected to increase in coming years, particularly as the percentage of people 65 and older is expected to more than double by 2057.
We’ve been involved with a number of national initiatives and programs that are being used nationally or have informed national policy.
A great example is our work with the Australian Digital Heath Agency where we have co-developed the National Clinical Terminology Service, one of the four core services for digital health in Australia.
Another example is Australia’s first large-scale telehealth clinical trial, conducted in 2014 and 2015 with funding from the Federal Government. Our research showed the return on investment of a telemonitoring initiative on a national scale would be in the order of five to one by reducing demand on hospital inpatient and outpatient services, reduced visits to GPs, reduced visits from community nurses and an overall reduced demand on increasingly scarce clinical resources.
In more detail, we were able to show:
- A 36 per cent decrease in hospital admission and 42 per cent reduction in length of stay if admitted to hospital
- Reduced patient mortality rate of more than 40 per cent
- Patients reported improvements in anxiety, depression and quality of life, with many finding that home monitoring gave them a better understanding of their chronic conditions.
Exciting stuff. Can you tell us more about the AEHRC?
The Australian e-Health Research Centre is CSIRO’s Digital Health Research Program and a joint venture between CSIRO and Queensland Health. Even though we are based in Queensland, we have grown around Australia and now have a strategic relationship with WA Health and numerous projects with the health departments, universities and medical research institutes in Victoria and New South Wales, as well as increasing work with the Federal Department of Health and agencies.
What sort of skills do you have in the team?
Our research is across three main areas: health informatics, biomedical informatics and health services research – or “data, diagnosis and services” as I like to say. All three are full of some seriously smart people, with qualifications and experience in everything from healthcare delivery to biostatistics. We need a huge range of skills to design new technology and programs, to work with and process big data, and to be able to understand the impact and practical use of these developments in the real world. Importantly these scientists and engineers have expertise in both digital research as well as deep understanding in the health domain, which is necessary to be respected in both areas of research.
So what have you guys been up to lately? You mentioned Alzheimer’s – what’s the digital health connection there?
We’re heavily involved in efforts to understand and work against diseases like Alzheimer’s disease. Recently two of our team members, working on biostatistics and image analysis, were co-authors on a paper in Nature that demonstrated the first blood test for Alzheimer’s – a result that may have huge implications for the speed of clinical trials for potential treatments.
This was part of our larger collaboration with organisations like the Florey Institute of Neuroscience, the AIBL study, and the CRC for Mental Health, to which a number of our image analysis, health informatics and telehealth teams contribute. Other ground-breaking work announced from this collaboration recently includes the link between amyloid and iron levels in the brain as a predictor of Alzheimer’s disease and potential ocular imaging-based screening for the disease.
Interesting! What else has been happening?
What haven’t we been up to? We’re working on:
- Apps to make chronic disease management more accessible, and easier to use for both patients and healthcare providers. This includes apps like Cardihab and Total Knee Replacement: apps designed to help guide people through rehab with greater success rates
- Smarter Safer Homes: a low-cost, smart sensor system to help older people live independently in their own homes for longer. It can alert their family or carer if they have a fall or fall ill, so someone can lend a hand
- Dr Grader: AI-based technology that GPs can use to scan patients for debilitating eye disease, a scan usually only done by specialists – helping people wait less and get treatment faster
- A mobile app developed with Western Health called CALD Assist: it helps patients from non-English speaking backgrounds communicate with clinicians and nursing staff when an interpreter isn’t available, in 10 different languages
- A risk algorithm developed in partnership with Sonic Healthcare for the Commonwealth Health Care Homes program: to identify patients who qualify for additional funding for increased care from their GP.
So you can see digital health has a huge reach and potential to affect many parts of your life, and that of our healthcare system.
We saw some of your team are even working on CRISPR – gene editing. How does that tie in?
Our bioinformatics team is doing a great job of using new cloud computing architectures from Amazon Web Services, Google, Microsoft and Alibaba to greatly reduce the time required to do big data machine learning on genome sequences. Related to that research is searching the genome for the optimal place for CRISPR targets. There are now cancer trials underway to look at how CRISPR can be used to treat cancer – so this is very exciting stuff!
Sounds amazing. Is it really all sunshine and rainbows?
The healthcare system is a complex system, so understanding the way health works is important to our success. We’ve built strong relationships with clinicians, health service leaders and the medical research community that puts our research into a good position to succeed.
But of course there are significant challenges when your research is about capturing, processing and sharing clinical and health-related information. Certainly privacy and data security are some of those issues.