Chronic disease rates are on the rise and, over the last 10 years at Western Health, the care dialysis population has grown from 65 to 400.
“That’s why we need people to get tested and treated early,” says Associate Professor Craig Nelson, Future Health Today co-lead and Head of Nephrology at Western Health.
Statistics like this motivated Associate Professor Nelson and his team at Western Health to develop a tool to assist primary care clinicians in detecting and managing chronic kidney disease (CKD) in patients before they required acute care.
During this concept phase, we increased the diagnosis and management of chronic kidney disease by about 300% over 18 months,” says Associate Professor Nelson.
Building on this concept, Associate Professor Nelson collaborated with Associate Professor Jo-Anne Manski-Nankervis and her team at the Department of General Practice at University of Melbourne to develop a scalable software tool that could integrate seamlessly into the general practice workflow.
“This type of tool needs to be led by primary care for primary care, and the Department of General Practice has been valuable to the success of Future Health Today,” says Associate Professor Nelson.
By primary care for primary care
At the end of 2018, the team commenced co-design of the Future Health Today software tool with general practice.
“The funding from MACH enabled us to successfully pilot Future Health Today in two practices – one in Melbourne’s western suburbs and another in regional Victoria – before expanding to another 12 practices,” says Associate Professor Manski-Nankervis.
The success of the CKD prototype led to additional funding and the software was expanded to include diabetes and heart disease.
“The combined funding from MACH and the Paul Ramsay Foundation enabled us to develop this streamlined software, which is far superior to the previously used products.”
The Future Health Today point-of-care tool sits atop the primary care software and identifies patients who are at risk of developing CKD, diabetes and heart disease – providing tailored treatment recommendations for patients who already have these conditions or who are at risk of these conditions.
The tool searches the patient’s existing medical record information and alerts the clinician with a recommendation that is aligned with national guidelines.
“However, the appropriate decision is left with the primary-care clinician,” says Associate Professor Nelson.
Associate Professor Manski-Nankervis, who led the implementation and evaluation of the tool, says: “Given the increased demands on general practice, having an unobtrusive tool that fits within their workflow has resulted in very positive feedback.
“We’re incredibly thankful that around 42 general practices in the middle of the pandemic were motivated to work with us in our clinical trial.”
Expanding the program’s reach
Associate Professor Manski-Nankervis aims to continue building on Future Health Today with Western Health.
“Our initial funding was for chronic kidney disease, and then type two diabetes and cardiovascular disease, but we’re adding more conditions,” she says.
“Western Health cares about the positive impact primary care can have on the community by reducing hospital presentations, and we want to make Future Health Today available to more general practices in their region to address the challenges of increased chronic disease rates.”
Associate Professor Nelson aims to launch the software platform at Western Health as a permanent solution for primary care.
“We can stop people becoming hospital admitters in the next five to 10 years by installing this program and monitoring the outcomes over time,” he says.
“I would eventually like to see Future Health Today become a part of routine practice across Australia.”
This project is supported by MACH through the Australian Government’s Medical Research Future Fund (MRFF) as part of the Rapid Applied Research Translation program.