Study shows eHealth improves heart patient care

About 20,000 heart attacks could be prevented using a computer to help GPs to assess and treat patients, Australian researchers have found.

The study, published in the American Heart Association’sCardiovascular Quality and Outcomes today, is a major step forward in the burgeoning health software industry, as one of the biggest studies in the world looking at what actually works to change patient care in general practice.

About 3.4 million Australians have cardiovascular disease, which is Australia’s leading cause of death at 31.8 per cent of deaths in 2010. Each heart attack is estimated to cost about $281,000 in total.

Study leader Associate Professor David Peiris, of The George Institute and The University of Sydney is a GP himself, and worked with a large team to develop HealthTracker, a computer package to help GPs access the recommended guidelines for assessing and treating patients at risk of heart disease and communicate with patients.

The George Institute in collaboration with several leading health researchers then set up a trial that tested computer-assisted GP treatment with 40,000 patients across Australia, including 7,000 Aboriginal and Torres Strait Islander people.

As the study was set up, it found that only around one half of these patients had ever been screened properly for heart disease, and only half of those at high risk of heart disease were being treated with the recommended medicines according to best practice guidelines.

“I have sympathy because I know, as a GP myself, it is easy to overlook some things because you are focussed on what the patient is seeing you about. It’s very hard to incorporate preventive care when there’s already a very packed agenda.”

The trial, which is now finished, found that the number of patients assessed properly improved by twenty-five per cent, using the computer-assisted tools. There was also a sixty per cent improvement in prescribing recommended medicines to people at high risk of heart attack who were not on these medicines at the start of the study.

“Even small improvements in health care can have a major impact. If you extrapolate these improvements across Australia, this translates to 20,000 heart attacks over five years that could be prevented, and many, many lives saved,” Dr Peiris said.

The study will be closely watched by funders and designers of healthcare systems, healthcare service managers, clinicians, pharmaceutical companies and the expanding health software industry.

Dr Peiris says, despite the “bold promise” of e-health to deliver a higher standard of healthcare at a lower cost than the status quo, there is surprisingly little research demonstrating what works. “We're starting to fill in the gaps.”

“This study shows that using software tools to help GPs access assessment and treatment guidelines and communicate with their patients, can improve performance relatively easily. It’s simple, cheap and effective and something that could be put in place right now.”

Co-author Professor Anushka Patel, of The George Institute for Global Health and The University of Sydney, also stressed that bigger changes are needed to broaden the impact of software tools – such as further work on engaging patients more actively in their health care and changes to the way we fund doctors to improve the quality of care that they provide.

Similar tools are now being adapted for use in China through The George Institute’s new China Centre for mHealth Innovation (CCmHI), and are also being trialled in rural India as researchers seek new and cheaper ways to deliver high quality healthcare to large populations.

Professor Patel said the study would help inform the activities of a new, $2million collaboration announced last year, between Telstra Health and The George Institute for Global Health to explore the impact of eHealth technologies and services in supporting healthcare delivery and outcomes and identify and develop eHealth innovations to support new models of care.