A patient-focused learning health system, using integrated data sources, will facilitate optimal care of individuals and result in better care of our populations and society
In this issue of the Journal, two articles report strikingly high use of health services in Australia.1,2 Lowthian and colleagues document a 75% increase in emergency ambulance transportations, and forecast another 46%–69% increase by 2015.1 Rosenwax and colleagues demonstrate that 96% of Western Australians dying of life-limiting illnesses were admitted to hospital in their last year of life.2 These authors raise three points: use of health care is expanding; solutions are needed to care for people with chronic complex illness; and we can improve understanding and solutions through analysis of growing datasets.
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- 1 Division of Medical Oncology, Duke University School of Medicine, Durham, North Carolina, USA.
- 2 Department of Palliative and Supportive Services, Division of Medicine, Flinders University, Adelaide, SA.
- 1. Lowthian JA, Jolley D, Curtis AJ, et al. The challenges of population ageing: accelerating demand for emergency ambulance services by the very elderly, 1995–2015. Med J Aust 2011; 194: 574-578. <MJA full text>
- 2. Rosenwax LK, McNamara BA, Murray K, et al. Hospital and emergency department use in the last year of life: a baseline for future modifications to end-of-life care. Med J Aust 2011; 194: 570-573. <MJA full text>
- 3. Olsen LA, Aisner D, McGinnis JM, et al, editors; Institute of Medicine. IOM roundtable on evidence-based medicine: the learning healthcare system workshop summary. Washington, DC: National Academies Press, 2007. http://www.nap.edu/openbook.php?record_id=11903&page=1 (accessed May 2011).
- 4. Sox HC, Greenfield S, Cassel CK, et al; Committee on Comparative Effectiveness Research Prioritization; Institute of Medicine. Initial national priorities for comparative effectiveness research. Washington, DC: National Academies Press, 2009. http://www.nap.edu/openbook.php?record_id=12648&page=1 (accessed May 2011).
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- 6. Abernethy AP, Ahmad A, Zafar SY, et al. Electronic patient-reported data capture as a foundation of rapid learning cancer care. Med Care 2010; 48(6 Suppl): S32-S38.