In January 2016, National Health and Medical Research Council (NHMRC) CEO Professor Anne Kelso announced a review of the structure of NHMRC’s grant program. The review aimed to determine if restructuring existing programs could optimise the significant public investment (approx. $800 million per annum) disbursed through NHMRC grant programs. Government funding for NHMRC programs quadrupled between 2000-1 ($185 million) and 2010–11 ($750 million). This increased investment produced major benefits to the health and medical research (HMR) sector in terms of size and productivity. However, the corresponding increase in volume of grant applications presented an ‘unsustainable burden’ for reviewers and researchers with overall success rates reaching historic lows.
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Data is the primary resource - the life blood - that drives evidence-based health and medical (H&M) research. Traditionally, data collected explicitly for a clinical trial, designed to answer specific questions on behavioural or bio-medical questions, served as the primary research data for H&M researchers. This practice started when administrative health data was not readily available in computable electronic format. However, in the current digital health environment, administrative health data collected and aggregated in electronic form has become a veritable gold mine for stakeholders in the healthcare environment. As a consequence, administrative data is increasingly becoming the primary data source for many H&M researchers.
The purpose of collecting administrative health data are manifold:
Could you tell the triage nurse in the emergency department all the medications your elderly parent is taking? Before you go to Bali this winter, do you know whether you’ve ever been vaccinated against hepatitis A? And what was the name of that antibiotic you were allergic to years back?
All this information exists, most likely in the files of a GP or specialist, or a hospital you went to for treatment a couple of years ago. It is probably even stored electronically, but can you get it when you need it?
We’ve already had a look at the vast array of different problems associated with attempting to track Australian health and medical research (HMR) spending. We’ve also explored the hoops that researchers have to jump through when they apply for grants or seek to gain approval from ethics committees, not to mention when they make requests for access or linkage from custodians and data gatekeepers. One might be tempted to think that no matter where Australian HMR researchers turn, the data they need is locked behind bars that are almost impossible to open – so much so that it almost takes a special kind of resilience to finish their projects.
Health matters to Australians. Health and medical research (HMR) does too. In 2016, Research Australia polled public opinion on national priorities. Eighty eight percent of respondents highlighted improving hospitals and the health system. Seventy nine percent of respondents favoured increased HMR funding. Indeed, these objectives converge; an effective HMR sector is fundamental to sustaining our world-class health system. To meet the challenges and opportunities of the future, both social and economic, we need to invest in achieving these goals. This is not a new perspective. In fact, it’s the reason HMR has been everything from a political football to a public-good panacea.