Future Directions for the Linkage of Data

1

• Future Directions for the Linkage of Data
• 27 October 2003
• Tom Stubbs

2
context

• an exciting and critical time for the SA health
  system
• Generational Health Review (GHR) a blueprint for
  the next 20 years
• much of the recent focus has been on governance
• but governance changes are really only one aspect
  of removing barriers

3
features of the new regime

• a focus on promotion, prevention, early
  intervention, primary health care
• a population funding model to replace the
  historical institutional model
• a focus on integration across all aspects of the
  health sector
• a focus on a whole of government approach to well
  being
• a focus on measurement and accountability

4
nature of the health system

• most people work in a defined patch or sector
• the system has traditionally encouraged them to
  understand mainly that sector
• ultimately collaborative behaviours and mutual
  understanding the critical factors
• increasingly the understanding is that the system
  breaks down at the interfaces
• often the breakdown is associated with poor
  baton changing in terms of information

5
CLIENT
6
why link?

• a better understanding of what works and doesnt
  work in our current system
• the prospect of being able to plan a better
  system for the future
• navigation and continuity of care depend on
  information flow
• many aspects of our system are activity, input or
  process based the measurement and monitoring of
  health outcomes is much weaker
• not often but sometimes a matter of life and
  death

7
Information linking - problems

• name changes (deed poll, marriage)
• nicknames
• misspelt names
• address changes
• allocation of mothers medicare number at birth
• institutional field variation
• non-standard addresses
• naming systems for ethnic groups
• missing information

8
Australias Health 2002

• Future Directions in health information
• There is increased emphasis in the joint use of
  data from different sources for the analysis of
  issues that cut across health sectors technical
  and privacy considerations in the creation and
  use of linked data sets are being given attention
  ..

9
National Electronic Health Records Task Force

• Australia now has a unique opportunity to invest
  in the health of its people by building a
  national health information network to support a
  system of electronic health records for those who
  want to share potentially vital information with
  their various health care providers

10
the issues

• Ministerial agreement to a unique identifier but
  the spectre of the Australia Card remains
• issues of privacy and confidentiality are driving
  fundamental changes in thinking
• in the absence of a unique identifier other
  techniques for matching and linkage have to be
  adopted
• the most sophisticated of these techniques have
  demonstrated the value of matching but also that
  privacy and confidentiality are not at risk

11
the future

• never a greater need to ensure the optimal use of
  the health dollar
• data linkage offers enormous potential for
  planning and monitoring health system improvement
• it offers benefits at individual and population
  level
• in SA we have the catalyst and many of the
  building blocks (systems, people) to maximise the
  benefits