Research in health

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Our approach

CMCRC's Market Quality – Health program covers the application of advanced data sciences to all public and private healthcare settings. The program has been running since 2013, with the objective of improving market integrity and efficiency.

We do this by:

  • Developing advanced analytical and performance management solutions.
  • Maximising use of the administrative and transactional data of healthcare funders and providers, enhanced by the relevant findings and metrics from Australian and international research.

The program combines elements of health policy, health economics, epidemiology, public health, data mining, predictive analytics and simulation modelling.

Collaborating partners are the private and public health organisations that account for 60 percent of Australia’s $150 billion annual health spend, together with 10 leading Australian universities.

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Program goals

  • Address the challenges and opportunities facing healthcare funders, providers and consumers.
  • Overcome data fragmentation across the health market.
  • Reduce fraud, abuse, waste and errors.
  • Empower consumers to play an active, fully-informed role in the choice, cost and quality of their healthcare.
  • Improved health outcomes for consumers.
  • Realise the commercial benefits from innovation.

The goals of the R&D program are to drive enhanced integrity and efficiency of the Health Market through development of advanced analytical and performance management solutions. These solutions will maximise use of administrative and transactional data5 of healthcare funders and providers, enhanced by the relevant findings and metrics from Australian and international research.

The program has secured multi-year funding from industry and the Government’s CRC Program as well as academic participation from the medical, health informatics and economics, data mining and information technology faculties and centres of 10 leading universities. A key requirement of the CRC program is that research has to be relevant to and driven by the needs of ‘end users’, who are termed industry participants. Our HMQ industry partners span the public health, private health and accident compensation insurance sectors. Additional health market organisations are expected to join this initiative on an ongoing basis.

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The research program is divided into five streams:

  1. Low and High Value Care
    [Partners: NSW Health, HAMBS]
    • Identify/ measure low value care
    • Measure cost-effectiveness cardiovascular procedures
  2. Consumer Empowerment
    [Partners: HAMBS / AHSA, AIHW]
    • Provide personalised information
    • Provide Analysis of provider choice
    • Improve patient centric care
    • Promote Equity and Fairness
  3. Predictive Modelling and Risk Stratification
    [Partners: NSW Health, TAC, Medibank, Health Roundtable, HAMBS]
    • Design Risk stratification tools (re-admission, chronic disease, return to work)
    • Simulate Policy (prevention / new treatments)
    • Evaluate DRG design
  4. NLP and Unstructured Data
    [Partners: CMCRC, TAC, Sintelix]
    • Design tools for analysis of clinical notes/ guidelines
    • Analyse phone calls for predictive purposes
  5. Spatio -Temporal Variation
    [Partners: AIHW / DoH]
    • Design customisable geographies
    • Clustering and analysing health trajectories

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Latest health research

 Chronic conditions can be costly but also preventable as well as predictable. We develop a model to predict in the short term (2-3 years) the onset of one or more chronic conditions.
The study illustrates a framework to predict the progression of chronic diseases from a new perspective using graph theory and social network analysis methods.
Previous studies have documented the application of electronic health insurance claim data for health services research purposes.