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DIGITAL HEALTH:
CHANGING THE WAY HEALTHCARE IS
CONCEPTUALISED AND DELIVERED
Studies in Health Technology and
Informatics
International health informatics is driven by developments in biomedical technologies and
medical informatics research that are advancing in parallel and form one integrated world of
information and communication media and result in massive amounts of health data. These
components include genomics and precision medicine, machine learning, translational
informatics, intelligent systems for clinicians and patients, mobile health applications, data-
driven telecommunication and rehabilitative technology, sensors, intelligent home technology,
EHR and patient-controlled data, and Internet of Things.
Studies in Health Technology and Informatics (HTI) series was started in 1990 in
collaboration with EU programmes that preceded the Horizon 2020 to promote biomedical and
health informatics research. It has developed into a highly visible global platform for the
dissemination of original research in this field, containing more than 250 volumes of high-quality
works from all over the world.
The international Editorial Board selects publications with relevance and quality for the
field. All contributions to the volumes in the series are peer reviewed.
The HTI series is indexed by MEDLINE/PubMed; Web of Science: Conference
Proceedings Citation Index – Science (CPCI-S) and Book Citation Index – Science (BKCI-S);
Google Scholar; Scopus; EMCare.
Series Editors:
B. Blobel, O. Bodenreider, E. Borycki, M. Braunstein, C. Bühler, J.P. Christensen, R. Cooper,
R. Cornet, J. Dewen, O. Le Dour, P.C. Dykes, A. Famili, M. González-Sancho, E.J.S. Hovenga,
J.W. Jutai, Z. Kolitsi, C.U. Lehmann, J. Mantas, V. Maojo, A. Moen, J.F.M. Molenbroek,
G. de Moor, M.A. Musen, P.F. Niederer, C. Nøhr, A. Pedotti, N. Peek, O. Rienhoff, G. Riva,
W. Rouse, K. Saranto, M.J. Scherer, S. Schürer, E.R. Siegel, C. Safran, N. Sarkar,
T. Solomonides, E. Tam, J. Tenenbaum, B. Wiederhold, P. Wilson and L.H.W. van der Woude
Volume 266
Recently published in this series
Vol. 265 R. Marcilly, C.E. Kuziemsky, C. Nøhr and S. Pelayo (Eds.), Context Sensitive Health
Informatics: Sustainability in Dynamic Ecosystems
Vol. 264 L. Ohno-Machado and B. Séroussi (Eds.), MEDINFO 2019: Health and Wellbeing
e-Networks for All – Proceedings of the 17th World Congress on Medical and Health
Informatics
Vol. 263 P. Scott, N. de Keizer and A. Georgiou (Eds.), Applied Interdisciplinary Theory in
Health Informatics – A Knowledge Base for Practitioners
Vol. 262 J. Mantas, A. Hasman, P. Gallos, A. Kolokathi, M.S. Househ and J. Liaskos (Eds.),
Health Informatics Vision: From Data via Information to Knowledge
ISSN 0926-9630 (print)
ISSN 1879-8365 (online)
Digital Health:
Changing the Way Healthcare is
Conceptualised and Delivered
Selected Papers from the 27th Australian National Health
Informatics Conference (HIC 2019)
Edited by
Elizabeth Cummings
University of Tasmania, Hobart, Australia
Mark Merolli
University of Melbourne, Melbourne, Australia
and
Louise K. Schaper
Health Informatics Society of Australia, Melbourne, Australia
Amsterdam • Berlin • Washington, DC
© 2019 The authors and IOS Press.
This book is published online with Open Access and distributed under the terms of the Creative
Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).
ISBN 978-1-64368-006-4 (print)
ISBN 978-1-64368-007-1 (online)
Library of Congress Control Number: 2019947453
doi: 10.3233/SHTI266
Publisher
IOS Press BV
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LEGAL NOTICE
The publisher is not responsible for the use which might be made of the following information.
PRINTED IN THE NETHERLANDS
Preface
The digital journey of healthcare, has resulted in many changes in the way healthcare is
conceived and delivered in Australia and internationally. With this comes challenges, but
equally significant opportunities to continue to shape healthcare. Strategic planning in
health informatics for the introduction and management of systems and innovations, their
evaluation, along with the essential furthering education of healthcare practitioners, is
essential at micro, meso and macro levels. Within Australian digital health and informat-
ics practice, the current directional driver is Australia’s National Digital Health Strategy
to be achieved by 2022. The annual Australian national Health Informatics Conference
(HIC), Australia’s premier health informatics event, is a key avenue for developing, pro-
moting and maintaining key partnerships. The conference, organised by the Health In-
formatics Society of Australia (HISA), with the support of the Australasian College of
Health Informatics (ACHI), provides the ideal professional and social environment for
clinicians, researchers, health IT professionals, industry and consumers to integrate, col-
laborate, educate and share their knowledge to drive innovative thinking, to enhance ser-
vices, improve data-driven decision making, and allow greater consumer involvement.
This year we have focussed on the following ten key themes that underpin a fully
digital healthcare sector: Analytics and the Learning Health System; Clinical Informat-
ics; Digital Health Workforce Development; Health Policy, Ethics and Business Models;
Informatics in Health Professional Education; Innovations, Informaticians and Digital
Health Entrepreneurship; Integrated and Connected Care; Interoperability and Informat-
ics Infrastructure; Participatory Medicine and Consumer Informatics; and System Imple-
mentations and Digital Hospitals.
The papers in this volume reflect these themes, highlighting the cutting-edge re-
search evidence, technology updates, and innovations that are supporting the digital
transformation of the healthcare sector. The papers are indicative of the wide spectrum
of work encompassing major theoretical concepts, examples of key applications of new
technologies and important new developments in the field of health informatics. They
emphasise the central role that digital health plays in our current and future healthcare
organisations..wherever they be.
This year’s program maintains the high-standard of papers for which the conference
is well-known. All papers were double blind-peer reviewed by three experts in the field
of health informatics. These volunteer reviewers are prominent academics, digital health,
and industry specialists. The contribution of ACHI in supporting this review process is
gratefully acknowledged. Similar contributions made by many senior and experienced
members of HISA are also acknowledged. Forty papers underwent the initial review and
feedback process. Resubmitted papers were then validated by the Scientific Program
Committee to ensure that reviewers’ recommendations were appropriately addressed, or
rebutted. In total 29 papers were selected for inclusion in this volume. We congratulate
all the authors on their contribution and commend them to you, the reader.
Elizabeth Cummings
Mark Merolli
Louise K. Schaper
v
Acknowledgements
The Editors wish to thank the following people for their efforts in reviewing the papers
submitted for HIC 2019.
Dr Sarah Ahmed, Primary Health Tasmania
Elina Amatya, eHealth NSW
Lorraine Anderson, ACT Health
Amy Barnett, Metro South HHS
A/Prof Melissa Baysari, University of Sydney
Dr Marc Belej, Allscripts
Vicki Bennett, Australian Institute of Health & Welfare
Dr Peter Bentley, Australian Red Cross Blood Service
Brooke Berry, Pathology Queensland
Dr Jen Bichel-Findlay, University of Technology Sydney
Heidi Bjering, Western Sydney University
Karen Blake, Healthalliance
Dr Derek Buchanan, HINZ
Ian Bull, ACT Health
David Bunker, Queensland Genomics
A/Prof Kerryn Butler-Henderson, University of Tasmania
April Chan, Queensland Health
Dr Hwee Sin Chong, Darling Downs Hospital And Health Service
Paul Clarke, JamPac
Matt Cordell, Australian Digital Health Agency
Dr Alison Craswell, University of The Sunshine Coast
A/Prof Elizabeth Cummings, University of Tasmania
Dr Maria Dahm, Australian Institute of Health Innovation
Herbert Down, Australian Commission on Safety & Quality In Health Care
Dr Andreas Duenser, CSIRO
Brian Dunstan, Telstra Health – Communicare
Dr Sisira Edirippulige, The University of Queensland
Lynne Everett, Nganampa Health Council
Christine Fan, Sydney Children's Hospitals Network
Dr Timothy Fazio, Melbourne Health
Dr Craig Ferguson, The Prince Charles Hospital
Dr Juanita Fernando, Monash University
Dr Isobel Frean, Bupa ANZ
Dr Valerie Gay, University of Technology Sydney
Prof Andrew Georgiou, Macquarie University
Mina Georgy, eHealth NSW
Dr Birinder Giddey, Western Health
Shou Goh, Bendigo Health
Dr Kathleen Gray, University of Melbourne
Dr Sharon Hakkennes, Barwon Health
vii
Dr Terry Hannan, Aihi
Dr David Hansen, AEHRC, CSIRO
Andrew Hargreaves, eHealth NSW
Narelle Haucke, Mackay Hospital And Health Service
Lis Herbert, Elsevier
Rebecca Hermon, Flinders University
Aidan Hobbs, CheckUP
Dr Inga Hunter, Massey University
Dr Inga Hunter, Massey University
Carolyn James, DXC Technology
Stephen Kalyniuk, The Information Group Pty Ltd
Dr Sankalp Khanna, CSIRO
Edmund Kienast, Australian Digital Health Agency
Dr Martin Knapp, University of Tasmania
A/Prof Carl Kuschel, Royal Women’s Hospital
Prof Michael Legg, Michael Legg & Associates
Dr Lawrence Lim, Telethon Kids Institute
Dr Lawrence Lim, Telethon Kids Institute
Asst Prof Nan Liu, Duke-NUS Medical School
Prof Anthony Maeder, Flinders University
Dr Carey Mather, University of Tasmania
Dr Jillian Milne, Wesley Medical Research
Natalie Page, Metro North IT
Dr Patrick Pang, University of Melbourne
Travis Pearson, Metro North HHS, Royal Brisbane And Women’s Hospital
Vadim Peretokin, Firely
Lisa Pomery, Queensland Heatlh
Mark Rainford, Navilluso Medical Ltd
Keeley Reade, Telstra Health
Angela Ryan, Australian Digital Health Agency
Dr Geoffrey Sayer, Clanwilliam Group ANZ
Rhian Sketcher, MKM Health (An Alcidion Group Company)
Valerie Thiessen, MKM Health – Best Patient Outcomes
Dr Deborah van Gaans, The University of Adelaide
A/Prof Klaus Veil, Australian Council of Professions
Dr Deborah Verran, SLHD
Helene Walton, Alphazeta Group
Prof Jim Warren, University of Auckland
Dr Andrew Westcombe, Australian Digital Health Agency
Peter Williams, Oracle
Prof Trish Williams, Oracle
Leanna Woods, University of Tasmania
Mengyang Yin, Catholic Healthcare Ltd.
Dr Xiaojun Zhang, Chinese Academy of Science
viii
Contents
Preface v
Elizabeth Cummings, Mark Merolli and Louise K. Schaper
Acknowledgements vi
Early Identification of Undesirable Outcomes for Transport Accident Injured
Patients Using Semi-Supervised Clustering 1
Hadi A. Khorshidi, Gholamreza Haffari, Uwe Aickelin
and Behrooz Hassani-Mahmooei
Privacy in Aged Care Monitoring Devices (ACMD): The Developers’ Perspective 7
Sami Alkhatib, Jenny Waycott and George Buchanan
Empowerment, Digital Literacy and Shared Digital Health Records: The Value
of ‘nothing about me without me’ 13
H. Almond, E. Cummings and P. Turner
Predicting Patients at Risk of 30-Day Unplanned Hospital Readmission 20
Mirza Baig, Ning Hua, Edmond Zhang, Reece Robinson, Delwyn Armstrong,
Robyn Whittaker, Tom Robinson, Farhaan Mirza and Ehsan Ullah
The Care Informatics and Technologies Project – Enhancing Capability, Motivation
and Opportunities in Digital Health Among Health Professionals and Students 25
Alline M Beleigoli, Anthony Maeder, Didy Button, Belinda Lange
and Jennifer Tiemann
Validation of Anthropometric Measures Self-Reported in a Randomized Controlled
Trial of a Web-Based Platform for Weight Loss 30
A. Beleigoli, A. Andrade, M. Diniz, R. Alvares, M. Ferreira, L. Silva,
M. Rodrigues, L. Jacomassi, A. Cerqueira and A. Ribeiro
Understanding the Barriers to Genomic Healthcare in Queensland Through
an Information Management Lens 37
Dana Kai Bradford, John Pearson, Dom Gorse, Alejandro Metke,
Hugo Leroux, Kathy Dallest, David Bunker and David Hansen
Exploring the Health Informatics Occupational Group in the 2018 Australian
Health Information Workforce Census 44
Kerryn Butler-Henderson, Kathleen Gray, Christopher Pearce, Ann Ritchie,
Julie Brophy, Louise K. Schaper, Vicki Bennett and Angela Ryan
Wearable Technology to Support Early Child Language Experiences:
What’s Important to Parents and Clinicians? 51
Dawn Choo, Shani Dettman, Richard Dowell and Robert Cowan
Assessment of Manual Dexterity in VR: Towards a Fully Automated Version
of the Box and Blocks Test 57
Edwin Daniel Oña, Jaime A. García, William Raffe, Alberto Jardón
and Carlos Balaguer
ix
A Virtual Reality Game-Like Tool for Assessing the Risk of Falling in the Elderly 63
Jaime A. Garcia
Using Asynchronous Exergames to Encourage an Active Ageing Lifestyle:
Solitaire Fitness Study Protocol 70
Valerie C. Gay, Jaime A. Garcia and Tuck W. Leong
SRA Down Under: Cache and Analysis Platform for Infectious Disease 76
Thom Cuddihy, Brian Forde, Nicholas Rhodes, David Paterson,
Dominique Gorse, Scott Beatson and Patrick Harris
Clinical Safety Incident Taxonomy Performance on C4.5 Decision Tree
and Random Forest 83
Jaiprakash Gupta, Jon Patrick and Simon Poon
Pain ROADMAP: A Mobile Platform to Support Activity Pacing for Chronic Pain 89
David Ireland and Nicole Andrews
Factors Influencing Implementation of an Electronic Medical Record in a Tertiary
Cancer Centre 95
Anna Janssen, Candice Donnelly, Elisabeth Elder, Nirmala Pathmanathan
and Tim Shaw
Mind the Gap: Information Sharing Between Health, Mental Health and
Social Care Services 101
Timothy Kariotis, Megan Prictor, Kathleen Gray and Shanton Chang
The Impact of Information Systems Use on Work Tasks and Work Practices
in an Emergency Department 108
Atlarelang Basetsana Kesiilwe, Reeva Lederman, Suelette Dreyfus,
Sherah Kurnia and Jonathan Knott
Promoting Participatory Health: Connecting Nurses and Consumers at Point
of Care to Enhance Safety and Quality in Australia 115
Carey Mather and Elizabeth Cummings
A SMART on FHIR Prototype for Genomic Test Ordering 121
Alejandro Metke-Jimenez, Karen Harrap, David Conlan, Simon Gibson,
John Pearson and David Hansen
Health Smart Homes: User Perspectives 127
Swetha Nagapuri, Anthony J. Maeder and Patricia A. H. Williams
Can Wikipedia Be Used to Derive an Open Clinical Terminology? 136
Duy Hoa Ngo, Donna Truran, Madonna Kemp, Michael Lawley
and Alejandro Metke-Jimenez
The Twitter Adventure of #MyHealthRecord: An Analysis of Different User Groups
During the Opt-Out Period 142
Patrick Cheong-Iao Pang and Shanton Chang
Running Genomic Analyses in the Cloud 149
Conrad Leonard, Scott Wood, Oliver Holmes, Nic Waddell,
Dominique Gorse, David P. Hansen and John V. Pearson
x
Do Digital Health Interventions Improve Mental Health Literacy or Help-seeking
Among Parents of Children Aged 2–12 Years? A Scoping Review 156
Daniel Peyton, Harriet Hiscock and Emma Sciberras
The MyHealthRecord System Impacts on Patient Workflow in General Practices 162
Urooj Raza Khan, Tanveer A. Zia, Chris Pearce and Kaushalya Perera
Towards Intelligent, Multidimensional Context-Aware Personalised Healthcare
and Wellness Support Services 168
Hamza Sellak and Marthie Grobler
Barriers to Telehealth Uptake in Rural, Regional, Remote Australia: What Can Be
Done to Expand Telehealth Access in Remote Areas? 174
Marianne St Clair and David Murtagh
Co-Design of a Mobile Health App for Heart Failure: Perspectives from the Team 183
Leanna Woods, Erin Roehrer, Jed Duff, Kim Walker
and Elizabeth Cummings
Subject Index 189
Author Index 191
xi
Mind the Gap: Information Sharing
Between Health, Mental Health and Social
Care Services
Timothy KARIOTIS a,1
, Megan PRICTORb
, Kathleen GRAYc
and Shanton CHANGa
a
School of Computing and Information Systems, The University of Melbourne,
Victoria, Australia
b
Melbourne Law School, The University of Melbourne
c
Health and Biomedical Informatics Centre, The University of Melbourne
Abstract. Information sharing is key to integrated, collaborative, and continuous
care. People with a lived experience of mental illness may access several services
across the health, mental health and social care sectors, which creates challenges for
information sharing. The health informatics community has traditionally not
prioritised social care informatics. However, with the growing role of social care in
the lives of people with complex health conditions, now is the time when we must
consider the articulation between health informatics and social care informatics in
Australia. This paper reports the results of a qualitative study to understand the
current context of information sharing between health, mental health and social care
services. Interviews and focus groups with nine clinicians, caseworkers and support
workers were undertaken. Thematic analysis supported the development of several
themes. These include the growing role of social care services, the importance of
trust and the challenge created by the complexity of conditions people can present
with when accessing social care services. To ensure the growing range of social care
services do not get left behind with the increasing digitisation of the Australian
health system, the health informatics community should prioritise the inclusion of
social care informatics in its scope of practice.
Keywords. Mental Health, Social Care, Health Informatics, Social Care
Informatics
Introduction
Since the deinstitutionalisation of mental health care, there has been a growing range of
services in the community targeted at providing recovery orientated support to people
living with mental illness [1,2]. In addition, there are a number of services, such as
housing and homelessness services, employment services, and welfare services that may
play a key role in a person’s health [3]. In this paper, we differentiate between health
services (e.g. physical and mental health services) and social care services (e.g. disability
support and homelessness services). People with a lived experience of complex mental
illness may access a wide range of health and social care services [1]. It is well recognised
1
Corresponding Author: School of Computing and Information Systems, The University of Melbourne,
Parkville, VIC, 3010, Australia; E-mail: [email protected]
Digital Health: Changing the Way Healthcare is Conceptualised and DeliveredE. Cummings et al. (Eds.)© 2019 The authors and IOS Press.This article is published online with Open Access by IOS Press and distributed under the termsof the Creative Commons Attribution Non-Commercial License 4.0 (CC BY-NC 4.0).doi:10.3233/SHTI190780
101
in Australia that the mental health system is highly fragmented, with one key issue being
a poor level of information sharing between physical health and mental health services
[4]. What is less well understood is how information sharing occurs between health
services that provide treatment, and the large range of social care services that provide
support in the community.
1. Mental Health Services in Australia
Australia’s mental health system is complex and fragmented [5,6]. The Australian
Institute of Health and Welfare [3] describes the mental health system as containing three
spheres, as outlined in Table 1. There is limited evidence on the relationship between
health services and social care services in Australia. However, 2002 [6] and 2014 [3]
reports into mental health services provided anecdotal evidence of a lack of linkages
between health and social care services, resulting in sub-optimal use of resources and
poor experiences of care.
Table 1. Mental Health Services in Australia [3]
Type of Service Examples
Medicare subsidies services
General Practitioners
Psychiatrists
Psychologists + allied health
Specialised Mental Health Care Settings
Public and private hospitals
Community mental health care
Support Services Disability support services
Homelessness support services
Community mental health programs
In the field of health informatics, it is well established that there is a gap in the knowledge
base regarding social care services [7,8]. However, with the increasing role that social
care services play in the lives of people with complex conditions, and the move towards
more integrated services [1], it could make sense for the well-established health
informatics community to consider integrating social care informatics into its scope of
practice.
2. Research Aims
This research aims to explore information sharing between health and social care services
in Australia, specifically in the provision of care to people with a lived experience of
mental illness, and to establish the key issues that will need to be considered when trying
to improve information sharing between them. The key research question being answered
is: how does information sharing currently occur between health and social care services
in Australia? The answer may inform the Australian health informatics community of
directions for future research and practice.
T. Kariotis et al. / Mind the Gap102
3. Method
Nine participants from across health and social care were recruited (Table 2). Participants
were recruited through contacting services identified through government and service
provider websites, and advertisements shared through key bodies (e.g. Primary Health
Networks). All participants were interviewed either individually or in a focus group.
Interviews were semi-structured based around themes of collaboration, information
shared and needed, barriers and enablers, and privacy and consent. These themes have
been developed by the first author in previous research [9]. All interviews were recorded,
transcribed and thematically analysed by the first author within NVivo ver. 12 (QSR
International, Melbourne, Victoria, Australia). The Braun and Clarke [10] thematic
analysis method was used, which consists of six steps including familiarisation with data,
initial code generation, searching for themes, reviewing themes, naming themes and
reporting themes. Human research ethics approval was obtained from the University of
Melbourne.
Table 2. Participant details
4. Results
Four main themes were developed during the thematic analysis; these are outlined in
Table 3, with example quotes. Each theme is discussed in more detail below.
Table 3. Themes and example quotes
Theme Quote Example
a. Changing
Landscape of
Care
“…I've sent through a request for information with consent, the legal team from the
hospital has rung me and asked me what type of research I'm doing, and they
refused to give it to me…I think they saw that it wasn't health….” P3
b. Trust &
Relationships
“…if they’re in the inpatient psych I would assess that the doctors are acting in
their best interest and will try and cooperate with planning, giving information that
would help plan a discharge...” P1
c. Complexity “I sat down with her and showed her the form, and she was like 'why are all these
things on here I don't remember doing this' and I was just like, you just did it
yesterday, but she's on drugs and mental health and…she hadn't even really
remembered that she'd done this form” P2
d. Type of
Information
“…we will use GPs…to support…housing applications…you need to do a bit of
coaching. I would actually dot point what we need in a letter...” P4
Participant
Number
Participant Type (Clinical/non-Clinical) State
P1 Social Care (housing) VIC
P2 Health + social care (homelessness) WA
P3 Social Care (disability support) NSW
P4 Social Care (disability support) VIC
P5 Social Care (homelessness) WA
P6 Health (mental health) VIC
P7 Health (primary health care) TAS
P8 Health (primary health care) TAS
P9 Health (mental health) VIC
T. Kariotis et al. / Mind the Gap 103
“it's a pejorative description and say there are issues around the misinterpretation of
something if it's read by a non-clinical person” P8
4.1. Changing Landscape of Care
The shift towards a greater role for social care services poses a challenge for 'traditional'
health services in understanding the role of these services, and their information needs.
Three of the four social care participants raised this theme in their interviews. This issue
appeared especially pertinent for community managed organisations, many of which
have names which do not always reflect the services they provide. Participants who were
working in social care services tended to be clinicians, but they expressed that they were
treated differently by health services when they sought information as a social care
service, compared to if they were working in a health service. The concept of power is a
meta-theme that crosses all themes, in that the medical model appears to take precedence
over the recovery model that underpins support services.
“There's definitely a hierarchy in place that they'll use the medical
model…above all else.” P5
4.2. Trust and Relationships
Trust and interpersonal relationships are a major component of information sharing and
were raised by eight of the participants. Service providers were more likely to share
information with people in other services they knew. However, participants outlined that
many services in the social care sector are under-resourced and have high turn-over of
staff, which can impact the building of trusting relationships.
“…it comes down to who to trust, doesn’t it? Trust…a mutual appreciation
of each other's roles and to what extent can you share information.” P6
4.3. Complexity
Social care services, such as homelessness services, tend to operate as open doors
services, meaning people in a crisis with complex needs can walk in rather than needing
an appointment or referral. These situations pose challenges for services to access
information about people. The challenges are exacerbated because social care services
tend to be excluded from the information sharing processes in health care, such as
treatment plans. This issue was raised by two social care participants who work in high-
profile services which people know they can access in a crisis. However, this issue was
also acknowledged by three of the health service participants. There also appears to be a
number of people within the social care sector, who may have no way to share
information with the health sector, as the quote below outlines.
“So…the community driver might be worried about something, they don't
necessarily have a way of feeding that back when they're worried.” P8
4.4. Type of Information
The information collected and needed in health services may be different from the
information collected and needed in social care services. This theme emerged from
T. Kariotis et al. / Mind the Gap104
discussions with all participants about their information needs. However, though the
information collected on a day-to-day basis is different, there appears to be a shared need
for information related to risk management, early warning signs and medication
management.
“…there's information that could be shared…it might be helpful for a
housing organisation to know…when the early warning signs are…so there's an
opportunity for people to intervene early...” P6
5. Discussion and Conclusion
The results from this study point to a trust and understanding gap between health and
social care services. These gaps have an impact on information sharing between services,
which may impact the quality and experience of care [1]. These findings are reflective
of evidence that collaboration and information sharing tend to be underpinned by
established relationships between clinicians [11,12]. There have been efforts in Australia
to improve relationships between different parts of the health system, one example being
the Mental Health Professional Networks, which linked physical health and mental
health clinicians [13]. These types of programs could also include opportunities for
different service providers to develop a shared understanding of each other’s information
needs [8].
In addition to issues regarding trust and relationships, there are also issues around
the type of information and culture towards information in health compared to social care
services. Many support services do not provide health services or treatments, but rather
recovery-orientated supports [14]. Information collected in a support service may relate
more to the social, rather than the biomedical aspects of a person’s life. However, it
appears all services need information related to risk management, early warning signs,
and medication management. With the digitisation of the health system, it will be critical
to address how social care services will articulate with information sharing processes
such as shared health summaries in My Health Record. Part of this understanding will
involve mapping out the shared information needs and identifying ontologies and
standards that can cross both health and social care services [8].
Health services in Australia, to some extent, have implemented information
technology to improve information collection and sharing [15]. However, this does not
extend to all health services, for example, allied health [16]. When it comes to the social
care sector, it appears that though many have implemented information technology, it
does not always meet the needs of staff [17]. A 2013 survey of community services found
that the main area in which they needed support was information technology [18].
Technology is also one of several issues identified by Whiteford et al. [19] in a systematic
qualitative review, as a barrier to system-level intersectoral linkages.
The findings of this study as they relate to the Australian context are limited by the
breadth of jurisdictions, and types of service providers included. The findings do provide
a unique insight into the growing role of social care services and should pave the way
for future research into how information sharing could be facilitated to support the care
of those with complex needs.
In light of the growing role of the social care sector in the provision of care to those
with complex conditions, health informatics in Australia should consider its role in
contributing to the development of an Australian social care informatics movement. The
T. Kariotis et al. / Mind the Gap 105
findings from this study outline several key themes that health informaticians looking to
further this cause should consider in developing a way forward to improve information
sharing across the broad range of services people access.
References
[1] S.J. Lee, E. Crowther, C. Keating, and J. Kulkarni, What is needed to deliver collaborative care to address
comorbidity more effectively for adults with a severe mental illness?, Australian and New Zealand
Journal of Psychiatry. 47 (2013) 333–346. doi: 10.1177/0004867412463975.
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health care at the macro level, Primary Health Care Research & Information Service. (2015).
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T. Kariotis et al. / Mind the Gap 107
Minerva Access is the Institutional Repository of The University of Melbourne
Author/s:
Kariotis, T; Prictor, M; Gray, K; Chang, S
Title:
Mind the Gap: Information Sharing Between Health, Mental Health and Social Care Services
Date:
2019
Citation:
Kariotis, T., Prictor, M., Gray, K. & Chang, S. (2019). Mind the Gap: Information Sharing
Between Health, Mental Health and Social Care Services. Cummings, E (Ed.). Merolli, M
(Ed.). Schaper, L (Ed.). Digital Health: Changing the Way Healthcare is Conceptualised and
Delivered, (1), 266, pp.101-107. IOS Press.
Persistent Link:
http://hdl.handle.net/11343/227749
File Description:
Published version