Symposia

Symposium 1: HCF Research Foundation Symposium: driving translation in health services research 

The HCF Research Foundation proudly commits all research funds to the field of health services research. As a corporate sponsor of the HSRAANZ, and a platinum sponsor of the HSRAANZ biennial conference, the HCF Research Foundation Symposium will provide conference attendees with an overview of key research activities at the HCF Research Foundation that are encouraging positive change in health care policy and practice:

Professor Adam Elshaug, Low-value care – the next quality frontier
Presentation 1: Low-value care – the next quality frontier

Dr Mary McCaskill, Executive Medical Director, Paediatric Emergency Physician, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network
Presentation 2:  iPASS – My tummy hurts: could it be appendicitis?

Associate Professor Ilana Ackerman, Experienced physiotherapist and musculoskeletal researcher in the Department of Epidemiology and Preventive Medicine at Monash University
Presentation 3: Feasibility of implementing the ICHOM Standard Set for Osteoarthritis in clinical practice

Conjoint Associate Professor Justine Naylor, Whitlam Orthopaedic Research Centre, SWSLHD, UNSW, and the Ingham Institute of Applied Medical Research
Presentation 4: Inpatient rehabilitation after TKA: what we know, what we don’t know and the path forward

Symposium 2: Queensland Health: The Integrated Care Innovation Fund

This symposium presents case studies from the Integrated Care Innovation Fund (ICIF), a multi-million dollar grant by Queensland Health to improve chronic disease management through integration. Hundreds of thousands of people across the state suffer from chronic diseases, including diabetes and liver disease. Innovative projects, ranging from tele-dentistry for isolated Queenslanders in the Torres Strait all the way to mental health delivery in the Darling Downs, have received grants to bring together patients, providers, and government. Integration of key services aims to reduce costs, improve outcomes, and provide a platform for how care will be delivered in the future.

Mitchell Potts, Manager Service Improvement Projects, Royal Brisbane and Women’s Hospital
Mary Humprey, QCAT Social Work Coordinator, MNHHS
Presentation 1: Buying time: the MNHHS-QCAT Guardianship Process Initiative

Dana Newcomb, Children's Health Queensland Hospital and Health Service
Presentation 2:  Using the ECHO (TM) model to empower GPs to manage children and young people with Attention Deficit Hyperactivity Disorder (ADHD)

James O'Beirne Sunshine Coast University Hospital
Presentation 3: Maximising access to Hepatitis C (HCV) treatment – the Hepatology Partnership project

Yvonne Mangan, Project Clinical Lead, Torres and Cape Hospital and Health Service
Stephen Power, Project Manager, Torres and Cape Hospital and Health Service

Presentation 4: Integrated oral health in remote primary health care locations

Jacklyn Whybrow, Acting Regional Manager West- Aftercare QLD
Leah Christie, Credentialed Mental Health Nurse, Service Manager – Floresco Toowoomba – Aftercare QLD

Presentation 5: Integrated care and innovation – Floresco Toowoomba, Darling Downs QLD

Symposium 3: What's happening in mental health care for Australian children? Primary, specialist, and emergency department care, and transition to adult services

Child and adolescent mental health disorders represent a high burden to the health system, regardless of whether they are assessed based on prevalence, short and long-term morbidity, or costs, both in fiscal and human terms. At any given time, 14% of 4-17 year-olds in Australia (580,000 children and adolescents) are experiencing mental disorders, and 50% of these disorders begin before the age of 14 years. Despite this, the 2013 National Child and Adolescent Mental Health Survey found that only 50% of children with a mental health disorder received professional care. Understanding who is receiving care, who is not, where care is accessed, and clinician concerns about current service models can help policy makers, clinicians and service providers to better meet the needs of Australian children and youth with mental health difficulties. This symposium will present contemporary data on child and youth mental health service use, highlighting current inequities and variation in care, as well as emerging concerns about the primary/specialist care interface, use of emergency departments for care, and transition to adult mental health services.

Professor Harriet Hiscock, Health Services Research Unit, Royal Children’s Hospital, Melbourne, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne, Department of Paediatrics, University of Melbourne
Presentation 1: Trends in use of Medicare Benefits Schedule (MBS) services for Australian children with mental health difficulties: who is missing out?

Dr Shaoke Lei Health Services Research Unit, Royal Children’s Hospital, Melbourne, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne
Presentation 2:  Attention-Deficit/Hyperactivity Disorder (ADHD) medications for children and adolescents: a utilization and cost comparison

Ms Kate Paton, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne
Presentation 3: Clinician perspectives on the interface between primary and specialist care for children with complex mental health conditions; a national, qualitative study

Ms Rachel Neely, Health Services Research Unit, Royal Children’s Hospital, Melbourne, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne
Presentation 4: Trends in in paediatric mental and physical health presentations to Victorian Emergency Departments

Dr Daryl Efron, General Medicine, Royal Children’s Hospital, Melbourne, Centre for Community Child Health, Murdoch Children’s Research Institute, Melbourne, Department of Paediatrics, University of Melbourne
Presentation 5: Transition to adult services for young people with dual diagnoses; clinician voices across care sectors

Symposium 4: Economics of Australian General Practice

The Australian primary care context is characterised by unrestricted access to general practice services, and the absence of routinely shared clinical information.  Current health system reforms (including the Health Care Home roll-out, changes to general practice ownership structure, Medicare Schedule review, and the growing impact of Primary Health Networks) make evaluation of primary care services increasingly important.  Attendees at this symposium (co-hosted by the Centre for Health Economics Research and Evaluation at the University of Technology Sydney and the Melbourne Institute of Applied Economic and Social Research, University of Melbourne) will hear from presenters using a variety of available data sources (Medicare, longitudinal data sets) and approaches to analyse the important role primary care plays in the Australian health care system.  These presentations provide new evidence that focus on the behaviours of patients and GPs, including the role of continuity of care, impact on hospital utilisation, drivers of prescribing behaviour, and the role of corporate medical practices. These presentations highlight the practical challenges of evaluating the economic impact of primary care services, but suggest that the effects of future health reform and health policy are not (entirely) unpredictable.

Michael Wright, Centre for Health Economics Research and Evaluation, University of Technology Sydney, NSW
Presentation 1: The association between continuity of primary care and mammography rates

Yuting Zhang, Australian-American Health Policy Fellow, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, VIC, Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
Presentation 2: Factors Affecting General Practitioners’ Decisions to Adopt New Prescription Drugs

Thomas Longden, Centre for Health Economics Research and Evaluation, University of Technology Sydney, NSW
Presentation 3: Quelling the impact of hot weather on hospital demand – an analysis of the role that GPs

Tamara Taylor, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, VIC
Presentation 4: Associations between corporate general practice and GPs’ practice patterns

Symposium 5: Improving acute and emergency care of older people: the results of the Cedric Project

Ageing populations increase pressure on provision of aged care services and emergency departments (EDs). This symposium will present the findings from the evaluation of the Care coordination through Emergency Department, Residential Aged Care and Primary Health Collaboration (CEDRiC) project. CEDRiC focused on providing quality healthcare, related to acute illness episodes, for older people dwelling in the community and residential aged care facilities (RACFs).   The aim was to avoid transfer or admission to hospital where appropriate. CEDRiC delivered care for older people via two geographically separate, but linked, services. These were the Geriatric Emergency Department Intervention (GEDI) based in the local, regional ED and the Health Intervention Program for Seniors (HIPS) within a RACF. In HIPS, a Nurse Practitioner Candidate worked collaboratively with General Practitioners (GPs) to provide early health assessment and intervention to RACF residents. GEDI consisted of an advanced-practice nurse-led, physician championed ED team with experience and education in care of the frail aged. These services communicated with GPs (as the centre of each person’s ongoing care) and other existing services (offered under the umbrella of community health) and coordinated care between the RACF and ED. The evaluation demonstrated that CEDRiC improves client outcomes and reduces costs.

Marianne Wallis, University of the Sunshine Coast
Presentation 1: Care coordination through emergency department, aged care and primary health collaboration: the CEDRiC project

Andrea Taylor, Sunshine Coast Hospital and Health Service, University of the Sunshine Coast
Presentation 2:  The Geriatric Emergency Department Intervention

Kaye Coates, Sundale Ltd
Presentation 3: A Nurse Practitioner Candidate in residential aged care providing the Health Intervention Project for Seniors (HIPS)

Elizabeth Marsden, Sunshine Coast Hospital and Health Service, University of the Sunshine Coast
Presentation 4: Development of an implementation toolkit for knowledge translation

Symposium 6: Gold Coast Integrated Care - priorities at the acute and primary care interface

This symposium presents preliminary results from an innovative integrated care program being trialled as a partnership between the local Hospital and Health Service and fifteen general practices. The Gold Coast Integrated Care (GCIC) program has two main themes; hospitalisation risk avoidance and chronic disease management.  Our innovative data matching process has identified a baseline population of 92 000 patients, 1 600 of whom have been identified at being of high risk of hospitalisation. Using a novel dataset the system links information from hospital and primary care, allowing us to identify patients with diagnosed chronic conditions and gaps in care from which we can assess and plan cross-sector strategies to mitigate risk and optimise care. The program has also introduced a new care provider role, the Nurse Navigator, employed jointly by the Health Service and General Practices to work at the interface of the acute and primary care sectors to manage risk and facilitate continuity of patient care through information sharing. In addition, we have developed a number of alternative care models that position hospital clinicians in a community setting to integrate service provision, thereby addressing impending but preventable hospital presentations.

Michelle Cleary, Gold Coast Health, Gold Coast Integrated Care
James Fink, Gold Coast Health, Gold Coast Integrated Care, Bond University
Presentation 1: Identifying, assessing and planning care for patients at increased risk of hospitalisation 

Mirja Vantanen, Gold Coast Health, Gold Coast Integrated Care, Health HQ
Presentation 2:  Nurse Navigators: expanding the primary care role for nurses?

Evelyn Rank, Gold Coast Health, Gold Coast Integrated Care
Presentation 3: Integrated care alternatives to acute care: Impact and lessons learned

Kate Johnston, Gold Coast Health, Gold Coast Integrated Care; Menzies Health Institute Queensland, Griffith University
Presentation 4: Determining chronic disease prevalence and optimising management across the care continuum

Symposium 7: Disinvesting from low-value care: if you can't measure it, you can't manage it

Due to the international movement, Choosing Wisely (and in Australia the RACP’s ‘EVOLVE’ initiative), thousands of doctors have banded together to specify low-value medical interventions. Yet when asked how often these practices occur, they cannot say as measurement of the scale and scope of the problem has been lacking. That is until now. A comprehensive measurement program has been underway for the past two years led out of the Menzies Centre for Health Policy (USyd) and Centre for Big Data Research in Health (UNSW). We have estimated the proportion of patients receiving, as well as number of low-value services rendered, including costs, from (i) a sample of private health insurance (PHI) beneficiaries; (ii) NSW public hospital attendees, and (iii) those prescribed pharmaceuticals within the hospital environment, and from the pharmaceutical benefits scheme (PBS). We are also leading an international collaborative comparing estimates between countries. This will be the first forum where all the measurement results will be presented together. Professors Adam Elshaug and Sallie Pearson will moderate the session. Adam is the Co-Director, Menzies Centre for Health Policy, School of Public Health and Sallie heads the Medicines Policy Research Unit at the Centre for Big Data Research in Health, UNSW.

Kelsey Chalmers, School of Public Health, Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia, Health Market Quality, Capital Markets CRC Ltd, Sydney, NSW, Australia 
Presentation 1: Measuring low value care from the private payer perspective

Tim Badgery-Parker, School of Public Health, Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia. Health Market Quality, Capital Markets CRC Ltd, Sydney, NSW, Australia
Presentation 2:  Exploring variation in low value care in the NSW public hospital system

Jonathan Brett, Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW, Australia
Presentation 3: Quantifying low-value prescribing using dispensing claims data

Vanessa Simpson, NPS MedicineWise, Sydney, NSW
Presentation 4: Measuring the impact of a social movement: insights from Choosing Wisely Australia

Ian Scott, Princess Alexandra Hospital, Brisbane, QLD, Australia, University of Queensland, Brisbane, QLD, Australia
Presentation 5: The ‘ABDCE’ approach to minimising low value care

Symposium 8: Pharmacy roles in Australia and New Zealand: fulfilling the potential

Ageing populations and growing numbers of people with long-term conditions continue to increase demand for health services. The associated pressure on the health workforce means it is vital the best use is made of all health practitioners’ skills. Community pharmacies are the most accessible primary health care service and pharmacists are a highly trained and skilled workforce not currently being used to their full potential. Pharmacists are therefore well positioned to contribute to improvements in population and personal health and a reduction in health disparities by expanding roles in both individual care and population health arenas.  Internationally, changes are occurring in community pharmacy models of care and funding to enable optimal use of pharmacists’ skills. 

This symposium will explore changes underway in pharmacy services on both sides of the Tasman. Changes include a range of cognitive service initiatives (e.g. de-regulated medicine supply, screening and prescribing), moving beyond more traditional dispensing and medicines advice roles towards more pro-active service delivery especially for people with long-term conditions. We will explore the key factors that support or provide barriers to expanding pharmacy services, consider how they can best be integrated with other health care, and the evidence to support their wider health benefit.

Dr Caroline Morris, Department of Primary Health Care & General Practice, University of Otago, Wellington
Dr Janet McDonald, Health Services Research Centre, Faculty of Health, Victoria University of Wellington

Presentation 1: Exploring the development and impact of changes in community pharmacy services in New Zealand

Associate Professor Rhiannon Braund, School of Pharmacy, University of Otago
Presentation 2:  Increased access and enhanced clinical services via medication reclassification in New Zealand

Professor Ines Krass, University of Sydney
Presentation 3: Building evidence for the role of pharmacy in prevention and screening – the Pharmacy Diabetes Screening Trial

Ms Tara Officer, Health Services Research Centre, Faculty of Health, Victoria University of Wellington
Presentation 4: What works, for whom, and in what circumstances:  the development of pharmacist prescriber roles in New Zealand primary health care