Queensland Trauma Data Warehouse Project

Alison Kelly and Kirsten Vallmuur

15th November 2017

ACKNOWLEDGEMENTS

Clinical Excellence Division

• CED’s role is to drive the patient safety, quality improvement and

clinical improvement agendas for the Queensland health system.

• Our key customers are Hospital and Health Services.

• Facilitate Queensland Clinical Senate and Statewide Clinical

Networks.

• Professional leadership for clinicians through:

– Office of the Chief Dental Officer,

– Office of the Chief Nurse and Midwifery Officer and

– Allied Health Professions Office of Queensland.

• Chief Psychiatrist and administration of the Mental Health Act.

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Healthcare Improvement Unit

• Specialist Outpatient Strategy

• Winter Beds Strategy

• SEQ Emergency Care Action Plan

• Statewide Surgery Strategy

• Clinical Pathways

• Clinical Prioritisation Criteria Program

• Gastroenterology Referral Guidelines

• Statewide Telehealth Services

• End of Life Care

• Integrated Care Innovation Fund

4

National digital health agenda

• National Digital Health Agenda (Agency est. Jul 2016). See:

https://www.digitalhealth.gov.au/

• Strategy released August 2017 – to be delivery by 2022. See:

https://www.digitalhealth.gov.au/australias-national-digital-

health-strategy

• My Health Record – opt out system by end of 2018 -> expected

98% coverage of Aust population

• Public consultation to establish framework for secondary data use

(incl. research) - open till 17th Nov:

https://consultations.health.gov.au/health-systems-policy-

division/developing-a-framework-for-the-secondary-use-of-my/

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State eHealth agenda

• Queensland Health eHealth initiatives, See:

https://www.health.qld.gov.au/clinical-

practice/innovation/ehealth/queensland

• Digital Health Strategic Vision – to be delivered by 2026. See:

https://www.health.qld.gov.au/__data/assets/pdf_file/0016/6450

10/digital-health-strat-vision.pdf

– HORIZON 1 (within 3 years): Building consistent and sustainable capability

– HORIZON 2 (within 5 years): Optimising integrating, growing and expanding

digital health and digital workforce capabilities

– HORIZON 3 (within 10 years): Transforming scaled digital health

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State eHealth progress

• $1.26B investment in eHealth/ICT

• First fully digital hospital in Australia (PAH)

• Mackay went live a few weeks ago

• Currently 5 hospitals live with ieMR (at different levels of maturity)

• Logan live in a few weeks

• Currently about 20% of Queensland hospital patients are looked

after on a digital platform

• There is investment for an additional 19 hospitals to be live before

2020

• Within 2 years almost all Queensland hospital patients will be in

digital hospitals - this is expected to cover all Queensland trauma

services

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Healthcare Improvement Unit

• Work with HHSs to develop and spread improvement

• We have always used ICT as an enabler for improvement

• But the scale is now massive and transformative

• CED is transforming in step with the changes around us

• Digital transformation provides a unique opportunity to use data-

driven decision making to improve the quality of clinical care

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Clinical Intelligence Solution

The Clinical Intelligence Solution (CIS) Project aims to

deliver technical and information management

infrastructure to allow the reporting of clinical data from

the ieMR and other sources for use in improving clinical

quality for Queenslanders.

3 aspects:

• Foundational infrastructure - warehouse

• Governance – access, security, privacy

• Use Cases – demonstrate practical applications

9Clinical Intelligence Solution

CIS and trauma

• high volume / health impact / cost

• Statewide Trauma Clinical Network is a leader in using

data for improvement

• Roadmap – trauma is modular

10Clinical Intelligence Solution

The TDW Project Context

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Clinical Intelligence

Solution Project

• Data warehouses

• Data views for dif users

• Governance/security/documentation

• Engaging clinicians in improvement

Digital healthcare

transformation

• Building foundations/workforce

• iEMR introduction/integration

• Move to fully digital hospitals

• Support collection, reporting, analytics

Trauma Data

Warehouse

(TDW)

Acknowledgement: Benson Choy, eHealth Digital Architecture, Qld Health

Overview of TDW stages

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• Stage 1: Business requirements articulated (completed)

• Stage 2: Building trauma components in data warehouse

(in process)

– Acquiring data and building and data views

– Integrating, testing, verifying data

– Clinical and data governance agreements

– Developing basic frontline reporting

• Stage 3: Business intelligence tools and resources (future)

– Development and testing of BI tools

– Deployment and training of users

– Establishment of TDW analytics team

Stage 1 Stakeholders

• Trauma and burns teams at major trauma services and regional

services

• QAS/RSQ/Disaster coordination

• eHealth Queensland/ieMR

• Healthcare Improvement Unit

• EDIS/ORMIS/ICU/QHAPDC/QNAPDC Data Custodians

• Statistical Services Branch (Data collections and linkage)

• Statewide Trauma Clinical Network

• Forensic and Scientific Services

• BDHP Trauma and Critical Care Theme

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Trauma Data Warehouse Business Needs

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1. Establish an integrated TDW to support reporting & analysis to:

– Facilitate trauma quality improvement

– Determine efficient and effective practices

– Inform injury prevention policy and practice

– Enable clinical review and quality audits

– Facilitate trauma research

2. Link patient info across journey of care to:

– Improve data collection coordination

– Avoid manual data entry and duplication

– Improve data quality through verification of data across systems

– Provide comprehensive view of patient journey

Trauma Data Warehouse Business Needs (continued)

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3. Provide flexibility to expand TDW as new technologies/

information systems/data collections develop

4. Establish clinical and data governance for trauma data sets and

views stored in the TDW and implement a mechanism for

review, approval and update

5. Establish authorisation protocols for defined user groups to

access different levels of data

6. Develop different data views for different users

TRAUMA DATA NEEDS AND SOURCES

TDW Concept

TRAUMA DATA

WAREHOUSE

Local Trauma

Registries

Patient Linkage

Keys

Trauma Quality

Improvement

Injury Monitoring and

Reporting

Clinical Audits and

Benchmarking

Clinical Decision Support

EDIS

Firstnet

HBCIS

AusLab

iEMR

ORMIS

Near Real-Time (10-15min)

QRIS

ICU

Finance

QHAPDC

Outpatient

Batch Inputs (2-3mth+)

RSQ

Rehab

QAS

Where we are at

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• Stage 2: Building trauma components in data warehouse

(in process)

– Emergency department

– Joining ED data from diff apps

– Identifying trauma patients

– Standardising ED data elements

– Testing ED view

– Inpatient stay / transfer

– Clinical and data governance agreements

– Metadata

Queensland Trauma Data Warehouse Project

Alison.Kelly@health.qld.gov.au

KirstenVallmuur@health.qld.gov.au