Latest AHHA-published research points to patient-centred healthcare future

Monday, February 5, 2018

Research published in the latest issue of Australian Health Review (AHR) points to a patient-centred healthcare future, according to the AHR’s chief editor, Professor Gary Day.

AHR is the Australian Healthcare and Hospitals Association’s peer-reviewed academic journal. The February 2018 issue is now available online.

‘For example, for a patient-centred (rather than provider-centred) healthcare system to work, the patients or their families need to have a requisite level of “health literacy”—that is, the knowledge, skills and understanding that enable them to make sound health decisions’, Professor Day said.

‘Often it is up to health professionals themselves that impart these elements of health literacy to patients. A Melbourne based research team has found, however, that this doesn’t necessarily happen. Consequently, health literacy courses for health professionals have emerged—a kind of “train the trainer” situation. The courses are popular, but the research team found that, even so, these courses could benefit from using professional educational learning design.

‘Another critical part of patient-centred care is to have good individual patient health and medical records that are easily shared across hospitals and between hospitals and other types of care such GP clinics.

‘A Monash University based team set out to examine the quality of medical records for 40 randomly-selected patients from each of five major metropolitan Melbourne hospitals. Some hospitals still rely on paper-based and scanned records.

‘The records were found to be variable in completeness. A lack of good discharge summaries was particularly apparent, with the evidence pointing to only one in two summaries being sent outside the hospital, for example to the patient’s GP.

‘The researchers advocate the benefits of developing medical history documentation guidelines to apply across Australia, as well as standardised discharge summaries. They also support integrating these into a solely electronic system such as My Health Record—with the proviso that information uploaded to My Health Record can only be as good as information contained in the clinical systems contributing to it’, Professor Day said.

‘Another relevant article looks at the Hunter and New England HealthPathways project. This is a web-based portal for GPs that provides a single source of locally relevant evidence-based clinical pathways and referral information. This encourages the provision of integrated and coordinated services within a region. The actual development of the portal itself established and built strong relationships and shared governance arrangements. Although difficult to evaluate formally, the portal is proving a success in terms of the increasing number of GPs using the site.

‘The cost of assistive technology such as disability aids and equipment is an important part of integrated care for people with a disability. For some time there has been a suspicion that such aids are more expensive in Australia than overseas, which has led some governments to bulk buy certain categories of items. A two-person research team based at LaTrobe University and KPMG/Griffith University found that this was not the case when freight charges are taken into account. The authors also warn that bulk buying schemes lead to less choice for consumers and potentially poorer outcomes, and will eventually result in higher prices due to fewer major suppliers.

‘Finally, a team from the George Institute in Sydney has taken a look at the funding of therapies for rare diseases in Australia, and the Commonwealth’s Life Savings Drugs Program in particular.

‘It is an ethical dilemma in that most Australians value equality and equal opportunity health care—but there are legislative requirements to consider cost-effectiveness. There is also the opportunity cost—in short could that money have been better used in doing the greatest good for a greater number of people. The authors have some very useful suggestions on how to evaluate and fund rare disease technologies, drawing on overseas best practice.’

Articles from the February 2018 AHR can be found here. Some are freely available through open access, while others need a subscription or can be purchased individually.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, Primary Health Networks, and community and primary healthcare services.

Media enquiries: Prof. Gary Day, Editor-in-Chief, Australian Health Review, 0422 236 571