School of Population Health

WHO CC eHealth Projects

General Overview

The WHO Collaborating Centre (WHOCC) on eHealth (AUS-135) adopts a four-year cyclical process to support WHO activities in digital health, including strategy development, implementation, capacity building and evaluation. It has 2 terms of reference:

Term of Reference 1:  Lead and support Implementation and Evaluation activities  

  • To support WHO activities in eHealth in areas including strategy development, implementation, capacity building and evaluation.

Term of Reference 2: Capacity Building for implementation and evaluation of Digital Health

  • To support WHO regional activities in eHealth in areas such as capacity building and evaluation at the country level.

A. WHO Projects

  • WPRO literature review: mHealth for Healthy Ageing (completed)
    This research report, commissioned by WHO WPRO, was a systematic review of literature that provided evidence about the use of mHealth to support healthy ageing and age-friendly health services. Findings from this report informed the Regional Action Agenda to harness digital health, especially mHealth, to strengthen health systems and improve service delivery for older adults in the Western Pacific.
  • WPRO literature review: mHealth and Integrated Service Delivery (completed)
    This systematic review, commissioned by WHO WPRO, examined how mHealth has been used in integrated service delivery in the WHO Western Pacific Region (WPR). Report findings outlined international variations in the reporting of mHealth practices and policies, warranting further regional research and development in mHealth infrastructure, interoperability standards and digital health capability maturity and readiness. This includes capacity building in mHealth implementation and evaluation for delivering Integrated People-Centred Health Services (IPCHS).
  • WHO Geneva: Systematic review of toolkits for digital health (current)
    A systematic review on implementation and evaluation of toolkits for digital health was undertaken as the first part of a wider process to design, and pilot implementation and evaluation of a toolkit based on findings and recommendations from the systematic review. The purpose of the review is to synthesise evidence on how toolkits have been operationalised in the digital health domain, from policy to practice, and to describe the level of action (organisational-community-individual), and evidence of effectiveness. The focus is on ‘knowledge-action’ digital health toolkits and to assess whether sufficient research has been done using such toolkits.
  • WPRO project: Digital Health Profiles and Maturity Assessments for Pacific Island Countries and Territories (current)
    This is a project with WPRO and WHO officials in the Pacific Island Countries (PICs) to co-create national digital health profiles to assist the them to understand their current digital health maturity in terms of information and communication technology (ICT) infrastructure, essential digital health infrastructure, readiness for health information sharing and health system adoption. This would in turn facilitate dialogue within the countries to inform the development and scale-up of digital health solutions to address the countries’ priorities. This project is guided by the reviews on mHealth for healthy ageing (above) and integrated service delivery (above) conducted by the WHOCC team, as well as extant evidence on digital health and existing health strategies of the PICs.
  • WHO Geneva: Digital health in primary health care (current)
    Following the WHO-UNICEF Global Conference on Primary Health Care held in Astana, Kazakhstan during October 2018, the WHO is developing strategies to harness digital health to strengthen PHC systems. We are conducting a review tol synthesise global evidence on implementation (pilot testing and scale-up) and evaluation of digital health interventions in primary care, to inform global planning and progress towards building effective integrated primary health systems capable of delivering  Universal Health Coverage (UHC) for achieving the United Nations Sustainable Development Goals.
 

B. Electronic Practice-based Research Network (ePBRN)

The ePBRN data repository at the University of New South Wales in Sydney, Australia is a secure repository of general practice and hospital admissions data. This data is extracted from EHRs of 18 general practices and community and hospital services, including outpatient clinics, in health neighbourhoods in South Western Sydney. The data is pseudonymised, extracted and linked in a secure manner and includes patient demographics, medications, conditions and visits to general practices and hospitals. The linked data is used for analysis and investigation for various health research purposes.

Funding support for the ePBRN and informatics

  • Unifying and quality assuring disparate health silos with a common data model
    Funding: NHMRC Partnerships APP1192469 2021-23; $1,214,143
    Investigators: Liaw ST, Harris M, Eapen V, Liu B, Kahn M, Sitas F, Muscatello D, Sharma, A, Hall J, Jonnagaddala J.
  • Australian Health Research Alliance Transformative Data Collaborative project
    Funding: SPHERE $40K
    Investigator: Liaw ST, Jonnagaddala J.
  • NHMRC Centre for Research Excellence in Digital Health
    Funding: NHMRC#1032664  2018-2022  $2,500,000
    Investigators: Coiera E, Glasziou P, Runciman W, Hansen D, Liaw ST, Magrabi F, Sintchenko V, Verspoor K, Gallego-Luxan B, Lau A.
  • Structured data quality reports (SDQR)
    Structured data quality reports are provided to the participating practices as part of quality improvement programs to monitor and improve patient data for safety and quality monitoring, evaluation and reporting.
    Funding: UNSW Major Research Equipment & Infrastructure Initiative 2014-15

  • Observational Medical Outcomes Partnership – Common Data Model (OMOP-CDM)
    OMOP – CDM is a cost-effective methodology to map Australian datasets, such as the dataset of linked data from hospital and general practice EHRs from the ePBRN, to international EHR-derived datasets through the Observational Health Data Science Informatics (OHDSI) community. The first stage of  the data conversion was completed in 2018 with the GP dataset [5]. Data quality assessment and conversion of hospital data is being done from 2019 onwards. International health data harmonisation and benchmarking to support research across the continuum of care. International investigators include Professor Simon de Lusignan (University f Surrey, UK) and Professor Michael Kahn (University of Colorado, USA) .
    Funding: UNSW Research Infrastructure Scheme 2017-19
  • TTANGO2: Natural language processing of pathology results and progress notes to improve data quality to examine antibiotic resistance
    Investigators: Causer L, Jonnagaddala J, Guy R, Boyle DIR, Liaw ST.
    Funding: UNSW SPHERE Triple-I Clinical Academic Stream)
  • Enabling personalised cohort studies from large repositories of clinical practice data
    Investigators: Gallego-Luxan B, Dunn A, Liaw ST
    Funding 2017-19: NHMRC#1125414
 

Projects using the ePBRN linked dataset:

  • Opioid utilisation within South Western Sydney (current)
    The early identification of opioid abusers is important to prevent opioid overdoses and death. This study uses linked routinely collected primary care data to describe the use of opioids and relating it to continuity of care and doctor-shopping behaviour. Record linkage allows the monitoring of patients as they traverse the health system, attending and using services provided by different general practices, community health services, Emergency Departments and hospitals.
  • Continuity of Care: Effect of GP utilisation on hospitalisation (current)
    Unplanned secondary care such as emergency department attendances and hospital admissions are believed to be preventable with effective disease prevention and management in primary care settings.  Evidence suggests that longitudinal continuity of primary care (a patient cared by the same GP or general practice over time) can reduce hospitalization rates [6]. In this study, we investigate the association between continuity of general practice & primary care, and hospital admissions using routinely collected data in the primary and secondary care settings.

    A paediatric subset of this database will be used as a real-world cohort to test establishing an electronic data repository of real-world data from electronic health record systems in primary care, community health and Local Health Districts for child health research.
    Investigators: Eapen V, Lingam R, Jalaludin Bin, Chay P, Liaw ST.

 

C. eHealth Applications

  • Preventing falls associated with cytotoxic peripheral neuropathy (wearable)
    Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of commonly used cancer treatments. At present, there is no effective treatment or cure. The InFocus research project is working towards finding effective assessment and treatment strategies for CIPN.  CIPN patients are at high risk of falls and in this project, iPhone-based sensors are used to detect falls.
    Investigators: Jonnagaddala J, Goldstein D, Liaw ST
  • “Watch me grow” – Changing practice to improve Universal Child Health and Developmental Surveillance in the primary care setting.
    The 'Watch Me Grow’ App for identification of developmental and mental health problems in early childhood was validated in 2017-19
    Investigators: Eapen V, Liaw ST, et al.  
    Funding: Ramaciotti Health Investment Grant, 2017-2019; NHMRC Partnerships GNT1167374, 2020-25, $1,195,014
  • COPD telemonitoring for early detection of acute exacerbations pilot study
    Smart telemonitoring to predict and detect Acute exacerbations of COPD early.
    Investigators: Celler B, Jenkins C, Peiris D, Argha A, Liaw, ST.
    Funding: UNSW SPHERE Respiratory, Sleep, Environment and Occupational Health Clinical Academic Stream
  • Total cardiac care telemonitoring for early detection of cardiac failure
    Pilot project on telemonitoring and early detection of exacerbations of CHF.
    Investigators: Ooi SY, Lovel N, Delaware K, Liaw ST, Celler B, Caplan G, Gallagher R, Patel A, Brodie M, Jorm L.
    Funding: NSW Health Translational grant scheme, National Heart Foundation
  • Integrated care using Digital health in LMICs
    Digital health platforms for Integrated care in Tuberculosis and Diabetes in India
    Investigators: Narasimhan P, Hall J, Devarsetty P, Anbarasu A, Raj T, Gary K
    Funding: UNSW India Seed Grant
    • Functional integration of informal healthcare practitioners in Tuberculosis control in India using mHealth
      Investigators: Narasimhan P, Jayasuriya R, Mukherjee P, Hall J
    • Integrated care for HIV and NCD care in India
      Investigators: Narasimhan P, Joshi R, Venkataramani M, Solomon SS, Liaw ST
    • mHealth for improving adherence among hypertensive patients in Nepal
      Investigators: Narasimhan P, Jayasuriya R, Vaidya A
 

D. PhD projects

  • Digital Health, Social Enterprise & Citizen Engagement in Integrated Care: Framework development & testing (Current)
    PhD Student: Dr Myron Anthony Godinho
    Integrated care brings together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion, in order to create connectivity, alignment and collaboration within and between the cure and care sectors (on funding, administrative, organisational, service delivery and clinical levels), to ultimately improve services in relation to access, quality, user satisfaction and efficiency. This interdisciplinary project aims to understand how Social Enterprise, Digital Health, and Citizen Engagement can be used to implement the WHO Framework on Integrated, Patient-Centred Health Services.
 

E. Publications to date (from 2015)

Acrobat document  Publications can be accessed here