Healthy outlook for all

UQ's Centre for Health Services Research is paving the way to improved health services for all Australians UQ's Centre for Health Services Research is paving the way to improved health services for all Australians

Nearly half a century ago, singer-songwriter Joni Mitchell said, "Don't it always seem to go that you don't know what you've got 'til it's gone."

Although Mitchell was talking about the environment, her statement could apply equally well to health.

And the older we get, the more this realisation starts to hit.

Fortunately for us, UQ’s Centre for Health Services Research (CHSR) is paving the way to improved health services for all Australians.

Led by Professor Len Gray, geriatric specialist and long-time activist for aged care and telehealth, the Centre includes three major programs: telehealth ( Centre for Online Health), renal medicine ( the Australian Kidney Trials Network), and ageing and geriatric medicine ( Centre for Research in Geriatric Medicine). Each is supported by a team of experts in the fields of health economics, biostatistics, informatics and behavioural science – all of whom are dedicated to improving health systems and care. The Centre is located at the Princess Alexandra Hospital in Woolloongabba. 

“We want to make healthcare better for all,” Professor Gray said.

“With an ageing society, the demands on our health system are only going to increase, so the system needs to be as efficient and effective as possible."

"Our goal is to conduct research that will not only make people healthier but also to find answers on how best to streamline administrative, diagnostic and treatment delivery processes, and make health services available to more people.”

According to COH Director and CHSR telehealth program lead Professor Anthony Smith, telehealth has a very important role in the healthcare industry.

“We believe that telehealth has much to offer people who live in rural and remote communities, particularly in Aboriginal and Torres Strait Islander communities where there is little or no access to medical services. Our research work with Indigenous communities currently spans care options for those suffering from ear disease, chronic pain, hepatitis C, diabetes and dementia.”

Partnering with rural Queensland’s Cherbourg community for more than a decade, COH has seen the routine screening of Indigenous children at high risk of chronic ear disease more than double since 2009.  

“This is the result of an innovative mobile screening service, delivered throughout the community, by local Aboriginal health workers.

“By using a range of online communication methods (such as videoconferencing and email), we can reduce the cost and inconvenience normally associated with extensive travel to metropolitan areas,” Professor Smith said.

The COH continues its strong partnership with Metro South Health (MSH) by maintaining responsibility for the operation and management of the Princess Alexandra Hospital (PAH) telehealth centre – considered the finest in the country.

The partnership with MSH has resulted in the establishment of many novel telehealth services. 

“Rigorous evaluation of these services provides a strong evidence base for the effectiveness of telehealth.” 

Mental health support is another challenge for those living in isolated communities and Professor Smith’s team is leading a range of projects – such as virtual peer support for mental health wellbeing, telehealth services in child and youth forensics, and online perinatal and infant mental health support. 

In the field of health informatics – where technology is applied innovatively to improve healthcare – COH researchers are providing online support for carers of patients with brain tumours, and providing training for nurses treating cancer survivors. The COH also has a key role in the development of technical standards for digital skin imaging – linked to the use of digital imaging (teledermatology) – for the diagnosis and management of melanoma.

The CHSR has already had great success in helping people from rural and remote communities with its telehealth initiative. Through the Centre for Online Health (COH), major breakthroughs are being made in enabling access to hospital care and advice without the need to attend in person.

The COH’s tripartite mission of telehealth research, teaching and education, along with clinical service provision, makes it unique among peer university centres. COH staff are research translation experts and pride themselves on a broad range of research projects that deliver solutions to real-world clinical problems.

Another aspect is mobile health or ‘m-Health’, which involves using the computing power and internet connectivity on mobile devices to support healthcare services.

“Our researchers are working on the development of apps that can screen, assess and monitor a range of health-related issues, including weight loss, headache disorders and diabetes care.”– Professor Anthony Smith

Having a completely different health focus, another major division of the Centre is the Australasian Kidney Trials Network, a not-for-profit collaborative research group that designs, conducts and supports investigator-initiated clinical trials with the aim of improving life for people living with Chronic Kidney Disease (CKD). Network Chair Associate Professor Carmel Hawley believes their research helps bring evidence to medical practice and so improves outcomes for CKD patients.

“If we can demonstrate how and why a specific treatment works, we can apply these learnings across a broad range of patients, whether child or adult, early- or end-stage, dialysis or transplant recipient, or those suffering from other conditions such as diabetes or proteinuria,” she said.

To date, eight clinical trials have been successfully completed, with many more currently underway.

The Centre for Research in Geriatric Medicine (CRGM) works with partners across the spectrum of health professions – medicine, nursing, allied health, psychology, biomedical engineering, health economics and software development – to improve the delivery of aged care services.

And its successes have been many – from introducing telehealth consultations to initiating hospital-admission troubleshooting procedures to testing television-viewing habits – to determine links with cognitive decline.

Program lead Professor Len Gray is pleased with the Centre’s outcomes since its establishment in 2002.

“We conduct research in many areas, including ascertaining whether the act of sitting exacerbates dementia, defining the early needs of aged care clients in acute care, using telehealth for patients in nursing homes, and identifying the hierarchy of risks of older people in hospital,” he said.

“These projects build on our extensive research on the concept and implementation of telehealth, geriatric assessment and care planning, clinical guidelines for delirium, dealing with falls, and diagnosing and treating dementia.”

Home also to the interRAI Coordinating Centre and two commercial enterprises, CeGA Online and Res-e-Care, the CRGM builds on its international collaborations to deliver streamlined health and medical services to the aged in our society. CeGA Online is a web-based software solution supporting comprehensive assessment and care planning for elderly patients, applicable to the most remote parts of Australia. CRGM is also a training provider specialising in the interRAI suite of instruments. interRAI is an international collaboration of around 100 scientists and clinicians aspiring to improve the quality and efficiency of care delivery in services to older and disabled persons.

So what are the chief learnings Professor Gray can pass on to the rest of us on growing old and surviving the current healthcare system?

“We are fortunate to be living in an era in which life expectancy is increasing dramatically and we want to be sure that these extra years are spent in good health.  

“To achieve this, we need both good preventive and health care service strategies that help us to avoid or to live with the illnesses that are common in old age."

"New technologies are changing the way we can access good health care, without the usual escalation in costs associated with traditional systems of care."

“This is the focus of the work of CHSR – to provide affordable, high-quality healthcare for all.”

Learn more about the Centre for Health Services Research, or help us prevent treat and cure disease by  supporting research into an area you are passionate about.

Professor Len Gray (on screen) consulting with a medical professional via telehealth link about the care of a nursing home patient.

Professor Len Gray (on screen) consulting with a medical professional via telehealth link about the care of a nursing home patient.