1. RANZCO Health Insights Tool Dr Brad Horsburgh and Suzanne Lyon

2. RANZCO Health Insights Tool Agenda 1.Introduction to GRAPHC. 2.Health Insight objectives 3.RANZCO Area of Need key principles 4.Atlas of Variation 5.RANZCO Health Insight tool scope 6.Demonstration of the RANZCO Health Insights tool.

3. RANZCO Health Insights Tool  Informing ophthalmology workforce planning decisions and to improve patient access to ophthalmology services in Australia and New Zealand.  Gain a further insight into public and private sector ophthalmology workforce requirements.  Facilitate the assessment of area of need applications.  Develop tailored stakeholder information to support RANZCO advocacy activities. RANZCO is the first medical College to initiate a partnership with GRAHC ANU. An interactive RANZCO web based mapping platform is being developed with the purpose of; Source: Paul Konings, GRAPHC ANU

4. ANU GRAPHC Technology Heath Landscape Tool  HealthLandscape is an interactive web-based mapping tool that allows health professionals, policy makers, academic researchers, and planners to combine, analyse and display information in ways that promote better understanding and improvement of health and healthcare. G Tag System  Developed by GRAPHC at the ANU, the G Tag systems offers a means by which precision location data can be made available to researchers.  A suite of tools allows users to link de-identified unit record data to geographies which are broad enough to protect privacy.

5. RANZCO Area of Need assessment key principles The purpose of Area of Need (AoN) locations in Australia is to address GENUINE medical workforce shortages in designated areas. Employers must apply to their relevant jurisdictional government to have a geographical location designated as an AoN. RANZCO new AoN policy seeks to ensure:  A consistent approach  Fair and transparent process. College support for an AoN Declaration is contingent upon;  Evidence of a critical ophthalmology workforce shortage.  Limited access to services.  Sufficient market testing (3 months in College classifieds). Evidence of need will be assessed using geospatial mapping technology.

6. ACSQHC Atlas of Variation  The Australian Commission on Safety and Quality in Health Care (ACSQHC) has released the first Australian Atlas of Healthcare Variation.  The Commonwealth Government is concerned by variation in cataract services: 7.2 times higher in Newcastle and Brisbane inner regions.  ACSQHC does not include publically funded cataract surgery in public hospitals and therefore is not reflective of overall services. RANZCO Health Insights Tool Seeks to consider the overall landscape

7. MBS Review RANZCO early / mid 2017 Chronic disease v FFS ……………. Initially NOT specialist practice RACS Variance Report April 2016. RANZCO data ?? display 42738 MDFA banding initiative Australian Atlas of healthcare variation

8. This is a statistical illusion !!!! Queensland ophthalmologists are not cataract bandits. Qld 38% cf Vic $$ …… ………. 90% of Vic pop’n.

9. RANZCO Health Insight Tool Scope (Australia) Ophthalmology Workforce Eye Health Demand Geospatial Mapping Hospitals and Private practice Medical and Therapeutic services Australian Geography Organisation Primary Health Care Network Advocacy: Commonwealth Electorate Local Level Local Government Area Precision location data at Hospital level Evidence based Decision making

10. RANZCO Health Insight tools Public Purpose is provide eye health information to the general community. Open access Limited information available to manage data security and use. Themes: Eye Health and Indigenous RANZCO Fellows The key purpose of this mapping tool is to provide an interactive web based mapping platform for all RANZCO fellows. This version will require secure access authentication. Themes: Eye Health, Workforce and Access to Services, Demographic information. Further information will be available to the College at a local geographical level. The release of this Information will be limited: to protect Fellow privacy, minimise conflict of interests and enhance usability of the tool.

11. Health Insights Demonstration  Go to tool Links

12. Next Steps  RANZCO and ANU are finalising the integration of the data, establishment of the geographies and documentation of methodologies.  Further collection of public hospital data will be investigated.  Fellow user guides will be developed. Final launch of the Tool will second half of 2016.

13. Back up

14. Protection of Fellow privacy The Commonwealth Australian Government has recently established 31 Primary Health Care Networks. Preliminary analysis indicates that at least 10 PHN will have Insufficient FTE ophthalmologists to support further age/gender analysis. The Fellows tool will therefore include workforce data at an organisational level. Number of FTE (clinical) ophthalmologists by Primary Health Care Network

15. Accessing additional Geospatial data Fellows may require additional information contained within the RANZCO health tool not available in the Fellows tool. Types of Requests Workforce planning:  Support regional planning by Local Hospital District  Hospital catchment planning Public Health:  Development of collaborative care models and referral pathways  Establishing eye health issues at a local level. Relevant RANZCO Committees will provide advice to the CEO for data access approval. Data research requiring Ethics approval will be managed via a separate process following establishment of the Health Insight Tool.

16. Ophthalmology workforce by Primary Health Care Network (2014 pop’n) Ophthalmology workforce per 100,000 Sourced from APHRA survey.

17. Brisbane North Opthalmology workforce Brisbane North 5 clinical FTE per 100,000 Ranked 4 across 31 Primary Health Care Networks In terms of highest workforce

18. Expected Cataract prevalence Estimated prevalence based on pooled cataract rates by age from Blue Mountains Eye Study and Melbourne Eye Study. Higher expected prevalence in pale blue cells. Outer QLD regions have higher expected rates of cataract prevalence. 2013 base population year selected to coincide with Atlas of Variation.

19. Brisbane inner North cataract services ASR (MBS item 42702) Cataract 42702 Services in Brisbane North based on patient location. Higher service rates in darker blue regions.

20. Hospital precision level data Inclusion of links to my Hospitals Website. Over additional workforce information will be added to pop up box.