The proposed model for the collection, supply and use of health data

Please scroll down to view the preliminary recommendations and findings for this section of the review.

* The public consultation for the review of Australia’s health system performance information and reporting frameworks closed on 17 February 2017.

Have your say

To have your say on this section of the review, please click here to answer the following questions:

  1. What are your views on the proposed model for health data collection, supply and use, including the recommendations on what should be included in the model? Is there anything missing from the model? (Please limit response to 400 words or less)
  2. What are your views on the proposed tiered reporting framework for health data? (Please limit response to 400 words or less)
Recommendation 4
A national model for data collection, supply and use for health system performance information and reporting should be established.

Rationale for Recommendation 4

The review has found that establishing a national model for data collection and use will address barriers to health system performance analysis monitoring and reporting and broaden use of health information.

One national model would deliver a number of benefits, including:

  • improved consistency in data collection, supply and use across all levels of the health system
  • improved efficiency of data collection, supply and use
  • reduced duplication in data collection, analysis and reporting, contributing to the realisation of the principle, ‘single provision, multiple use’
  • more sophisticated and targeted analysis of health data, including through data linkages and longitudinal analysis
  • more timely, meaningful and tailored reporting of data to all levels of the system as well as consumers and the general public.

The national model for data collection, supply and use should be applied across all levels of the health system. This includes the Commonwealth, state and territory jurisdictions, LHNs, PHNs, public and private service providers and others involved in heath data. It is therefore critical that the design and implementation of the model is informed by the views of all relevant stakeholders.

This model would build on other current and recent efforts to develop a national model for data collection, including ongoing commitment to ‘single provision, multiple use’ from governments, and existing agreements such as the NHIA, NHRA and NHA.

The success of the national model for data collection, supply and use will be dependent on strong governance. Both NHISSC and NHIPPC will need to lead the coordination and implementation of the data model.


Recommendation 5
A national model for data collection, supply and use for health system performance information and reporting should include:
  • the principles of transparency, single provision, multiple use and fit for purpose
  • the core requirements and critical enablers for effective data collection, storage, linkage and analysis, and reporting.

The proposed model for the optimal collection, supply and use of health data

A proposed model for data collection, supply and use is provided in the figure below. It reflects the findings and recommendations of the review, which are explained further in the rationale below.

Proposed national model for data collection, supply and use of health data for health system performance information and reporting

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Rational for Recommendation 5

The review has found that a national model should cover mechanisms for the effective and efficient collection, storage, linkage and analysis and reporting of health information.

The framework should include…

The principles of transparency, single provision, multiple use, and fit for purpose

Transparency: This principle reflects the critical importance of transparency as both a purpose of the framework (to improve the transparency of the health system), as well as a principle for operationalising the organisations that support the framework. The principle of transparency should drive action and cooperation in the health system.

Single provision, multiple use of health data: This principle is outlined in the National Health Reform Agreement, and the jurisdictions have been committed to work towards it for several years. It reflects the importance of improving efficiency and effectiveness across all stages of information management. Note that this principle does not suggest that data used for the independent calculation of health financing should be incorporated within the same data collection process.

Fit for purpose: This principle reflects the necessity of designing the model to meet clear goals. This applies to all stages of data collection, supply and use.

The core requirements for effective data collection:
  • Design of data linked to purpose
  • The application of common data standards across all national datasets
  • Expanded use of digital technologies
  • Use of naturally created data (e.g. EMRs) wherever possible

Design of data linked to purpose: Data collection systems need to be clearly designed to meet specific purposes, to ensure that the efforts of collection lead to genuinely useful results. Failure to do so can result in an overabundance of information that does not aid in understanding or measuring health system performance.

Common data standards and definitions: Data standards and definitions are critical for an effective, integrated and consistent national system for health information and performance reporting. This is particularly important with the rapid expansion in the volume and diversity of health data.

However, inconsistency in data standards and data collection more broadly continues to be a significant challenge under current arrangements. Implementing new standards and definitions is costly and time consuming. Stakeholders to the review encouraged the use of existing national infrastructure where possible to improve consistency in data collection, including the National Health Data Dictionary and National Minimum Data Set. There is the need for a consensus on national data standards and definitions to ensure consistency and comparability across jurisdictions. However, there was also an acknowledgement that some organisations are reluctant to relinquish their current standards in favour of a national system. This is because organisations prefer their own standards from a technical perspective and their systems support their unique standards. Implementing common data standards will require careful negotiation and technical expertise to reach a national consensus on a uniform set of standards and definitions across the country

Digital technologies: Digital technologies are starting to increase the efficiency and quality of data collection and reporting. There has been progress in the use of eHealth to improve health system performance and information reporting frameworks. This will be critical for future data collection as eHealth expands across Australia. Some key advancements in eHealth include:

  • the expanded use of electronic medical records (EMRs)
  • live data reporting through online dashboards
  • cloud-based centralised data warehouses.

Naturally created data: The use of data that is naturally created in the health system, such as EMRs, reduces the administrative burden of data collection. Where possible, indicators should be developed that draw on existing data, provided this data is relevant for reporting purposes. However, at times there will be a need to collect additional administrative data, to ensure there is adequate coverage of information on the health system.

The core requirements for effective data storage:
  • Clear governance arrangements
  • Strict privacy and security systems
  • Processes to support the sharing of data

Governance arrangements: There is a lack of overarching governance and multiple governance layers across the health system. This contributes to the use of inconsistent and inefficient processes for the storage of data as well as unnecessary restrictions on the sharing of data.

Privacy, security and the sharing of data: Standards of privacy and security should be maintained, alongside processes to support the sharing of data. Data sharing is impaired by restrictions on access to data across jurisdictions, data custodians and sectors.

The Productivity Commission’s recent draft report on ‘Data Availability and Use’ states that: “increased sharing of data across the public and private sectors could facilitate greater leveraging of technology to improve individuals’ and entities’ interactions with government, improve the integrity of systems and increase administrative efficiency.”

The core requirements for effective data linkage and analysis:
  • A continuum of data collection
  • Expanded capabilities to link data from within and outside the health sector
  • Expanded data analytics capabilities and tailored analysis

Data linkage and a continuum of data collection: Data linkage is critical to track a patient’s progress through the health system. Australian health information organisations have made considerable progress in improving data linkage capabilities. However, data linkage continues to be impaired by restrictions on access to data, along with the need to increase linkage capabilities.

A key opportunity in cross-sectoral data linkages is the AIHW’s dual responsibilities for health and welfare statistics. The AIHW is uniquely placed to link health and non-health data and support other data linkage organisations such as the ABS.

Data analytics capabilities and tailored analysis: The capacity of health information organisations to analyse highly complex data sets has expanded rapidly in recent years, enabling a deeper and more sophisticated understanding of performance across the health system. It is important that a future framework is supported by the systems and capabilities to engage in quality data analytics.

Analysis should also be tailored to ensure it is meaningful and understandable for different users of health data. For example, Primary Health Networks require analysis on their local health data that can inform local system improvements, while consumers require analysis to guide decision making about health services.

The core requirements for effective data reporting:
  • Fit-for-purpose and timely reporting at different levels of the health system
  • Compatibility with jurisdictional performance and purchasing arrangements
  • Benchmarking against similar countries.
Fit-for-purpose and timely reporting: Organisations such as the ABS, AIHW and the former NPHA have expanded the ways they analyse and report health information to suit a wider range of audiences and purposes. Health data reporting should meet the needs of different levels of the health system, as well as different audiences. Recommendation 6 discusses this further and proposes a tiered reporting framework.

Timely collection and reporting of health information is critical to ensure health service managers can respond to urgent issues. However, the review has identified the lack of timeliness – from collection through to the publishing of reports – as a key barrier to the effective use of data. The new framework should set guiding principles on balancing quality and timeliness.

Performance and purchasing arrangements: State and Territory health authorities manage performance and purchasing agreements with Local Health Networks and certain service providers in their jurisdictions. It is important that national performance reporting is compatible with these arrangements, to reduce the need for duplicative reporting.

International benchmarking: It is important to understand the performance of Australia’s health system against other comparable countries. Comparative analysis of performance data can distil insights and best practice from other countries that can inform health policy and system performance.

Recommendation 6
A tiered reporting framework should be implemented to suit different audiences, which produces different products according to the audience and purpose of the report.

The proposed tiered reporting framework

A proposed framework for tiered reporting on health data is outlined in the figure below, based on the recommendations of this review. It captures the purposes of health data reporting for different audience groups and the level of detail required for each group.

Proposed tiered reporting framework for health data

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Rationale for Recommendation 6

The review has identified the importance of a tiered reporting framework to ensure health data is effectively used. Tiered reporting involves tailoring the content, level of detail and format of reports to suit the needs of different audiences across the system. It is adapted from the Canadian approach to health reporting. This approach acknowledges that different audiences use health information in different ways, and that the content, format and level of detail in reporting should be tailored accordingly.

* The public consultation for the review of Australia’s health system performance information and reporting frameworks closed on 17 February 2017.

Have your say

To have your say on this section of the review, please click here to answer the following questions:

  1. What are your views on the proposed model for health data collection, supply and use, including the recommendations on what should be included in the model? Is there anything missing from the model? (Please limit response to 400 words or less)
  2. What are your views on the proposed tiered reporting framework for health data? (Please limit response to 400 words or less)