Combining Primary and Secondary Care Data
New Zealand has a huge advantage in being one of the few countries in the world with a highly digitised health system. There is over 15 years of primary care data (from general practices) that has been collected, providing researchers with a rich source of information to use when investigating new ways to enable precision health or personalised care.
Unfortunately, while the patients flow freely from primary care (such as General Practice) to secondary care (such as hospitals), primary care data is woefully underutilised for population health and demand planning. This is partly because the systems that collect and store this data are different to the systems that collect and store secondary care data (from District Health Boards (DHBs)). People providing secondary care receive very little data from primary care, which could be used for planning and providing services.
What if you could find some way of bringing together these two critically important data sources for the benefit of research, and ultimately practice? Dr Farhaan Mirza1 and his team are creating a proof of concept that will leverage primary care data analytics to improve predictive models and precision health.
The team is looking at how Orion Health’s secondary care solutions such as Consult and Coordinate, which are used in District Health Boards, can leverage HealthStat’s primary care intelligence tools, which are accessible by 95% of general practices in New Zealand.
As you might expect this is a project that will involve not only two commercial entities, Orion Health and HealthStat, it must also be carried out with the strictest observance of privacy laws and ethical considerations. It is therefore divided into several phases, with the team working through technical and business challenges including access to software, licenses and APIs. In addition, they will need to obtain ethics approvals from a number of stakeholders such as general practitioners, DHB staff and clinicians.
It is an ambitious project – not least because it seeks to combine academic research with vendors’ commercial roadmaps – but the results are likely to be hugely beneficial to the New Zealand healthcare sector. Integrating, merging, and querying primary and secondary care data profiles will enable clinicians and healthcare planners to view an end-to-end patient record which will assist with better decision making, conduct population health analysis, and develop precision health models to aid predictive and preventative health goals. For example, the researchers plan to investigate how primary health records can help forecast secondary health demands, by identifying patients most likely to need further care.
The proof of concept is expected to be complete by December 2018 and, if successful, will provide a raft of opportunities for all stakeholders involved. While finding a way to combine primary and secondary data will itself be an immense achievement, it is actually just the first step. A whole range of new data, such as genetic, social and environmental, is fast becoming available and this proof of concept could provide the foundation for integrating it with traditional information sources.
1Dr Mirza is being assisted by Dr Barry Gribben, General Practitioner and Director of the New Zealand Health Survey, Dr Mirza Baig, Clinical Decision Support Manager, Orion Health.