Role of Data in Improving Care within a Health System

A Case Study of the Australian Health System

by Lopamudra Das

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Health information technology (HIT) has been an emerging solution to reducing some gaps in care. Several nations have implemented expensive, large-scale, HIT projects; most have struggled with poor uptake, interoperability, and low sharing and reuse of data. Lack of understanding of complex "multilevel tensions" was a common reason for failure.

This study aims to understand how organizational context and interfaces affect the collection, management, and use of data for care improvement (CI).

The case study consisted of 33 hour-long semi-structured interviews with 38 informants from 27 organizations from 2 states. Primary data collected using snowball sampling in 2007-08 and elicited information on the use of data for improving quality of colorectal cancer care. Data were supplemented using publicly available organizational information. Data analysis included coding to identify themes and converting data into thematic matrices to enable the detection of patterns and comparative analysis.

Table of Contents

  • Chapter One

    Executive Summary

  • Chapter Two

    Introduction

  • Chapter Three

    Background

  • Chapter Four

    Methods

  • Chapter Five

    Actors, roles, and care improvement

  • Chapter Six

    Data and Care Improvement

  • Chapter Seven

    Synthesis of Findings

  • Chapter Eight

    Discussion

  • Chapter Nine

    References

  • Appendix A

    Assessments for condition selection

  • Appendix B

    Interview protocol

  • Appendix C

    Participation request email

  • Appendix D

    Sample performance measurement data

  • Appendix E

    Description of the primary project

  • Appendix F

    Supporting graphs and tables for Chapter 5

  • Appendix G

    Supporting graphs and tables for Chapter 6

  • Appendix H

    Framework for classifying CI interventions

This document was submitted as a dissertation in May 2017 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Gery W. Ryan (Chair), Karl A. Lorenz, and Brian S. Mittman.

This report is part of the RAND Corporation dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

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