Health Services Research – where to from here? A review of the state and potential of HSR in Australia and New Zealand - 1 December 2016
The day commenced with a presentation from Suzanne Robinson of Curtin University and member of the HSRAANZ Executive Committee on the preliminary results of the HSRAANZ commissioned study of the state and potential of Health Services Research in Australia and New Zealand. (Slides) (Please note that the slides contain preliminary data only which could change as the study progresses.)
Suzanne explained that as the peak body for HSR in Australian and New Zealand the HSRAANZ has a major role in assisting health services researchers and policy makers to meet the challenges facing the health system in the 21st Century. To inform the Association's strategy over the next decade we have commissioned a study to provide a clearer picture of the current state of health services research in Australia and New Zealand.
Newcastle University Team
The evaluation team from University of Newcastle team is Dr Elizabeth Fradgley, A/Prof Christine Paul, Prof John Wiggers, Prof Deborah Loxton, Dr Catherine Chojenta, and Dr Melissa Harris. With support from Della Roach, Emma Byrnes, and Annika Ryan.
Prof Jon Karnon President of the HSRAANZ then spoke on the opportunities offered by the MRFF and Mark Booth and Erica Kneipp from the Department of Health responsed on the challenges facing health services and primary health care research and the opportunities offered by the MRFF; research translation centres and emphasis on evidence based policy and greater data availability. (Slides).
The morning concluded with examples of the best and most impactful health services research nominated for the HSRAANZ Impact Award (details attached)
The event concluded with breakout sessions addressing the potential role and approaches to HSR in different healthcare sectors:
A. Data infrastructure
What makes a useful clinical registry?
Need for transparency (quality, standards, integrity)
Clinical Registry – for data linkage; opt out system; other governance issues.
Long term as appropriate.
Regular reviews of minimum data sets.
What are the data linkage priorities?
Going national, linking of hospital collections, MBS and PBS data and national death index are most important
Also cancer, ED, administration, perinatal.
Rationalise governance and ethics.
Is patient reported outcomes data a priority? If so, how could it be supported?
Yes – quality of life
Fit for purpose – generic and disease specific
Clinical care vs research
Utility based measures
Link to clinical registries
What are other data infrastructure priorities?
Linkage of Federal data sets. Health plus
Trusted user model to other data sets and linked data sets.
B. Consumer Engagement
Why engage with them?
Expertise/lived experience/understand patient/community preferences
Should they be renumerated?
Paying can take away altruism.
Alternative is non- monetary gifts.
When should they be involved?
Early in priority setting
KT at start.
How should they be involved?
Consumer Health Forum
Panels/ citizens juries.
Facilitate by funding agencies etc.
C. Implementation and improvement in public hospitals
Need junior doctors in research positions. Research needs to be part of their rotation and well resourced.
Need to infiltrate clinical microsystems. Research related to clinical work. Snr Drs need to train juniors.
Need a critical mass of clinical researchers, with collaboration across smaller hospitals.
Need to include nursing and allied health
Need clinician led research and practice based research.
Undertake a survey of what clinicians need – time, funds, mentoring etc.
Simpson Centre clinician led NHMRC program grant.
Clinicians now more involved in health policy and provide a good opportunity to grow HSR.
NIR - put HSR on the agenda; leadership program; Fellowships
Horizons gap – need to predict gaps and have solutions ready.
Joint clinical and academic appointments. Harder in some areas. Senior doctors need training in mentoring. Junior doctors need training in research methods.
D. How to fund research in primary health care?
Should PHNs be allocated research budgets? For what scope and with what support?
They are already overworked so research budgets should be managed by others
But they are well placed to undertake research.
They have great billing data, but limited diagnostic data.
Opportunities – well positioned in rural and urban centres
If not, how else to fund and organise research in PHC?
Universities may have a role working with them.
Consider more joint appointment (academic and PHN-based) health services researchers