CogStack to improve access to patients’ electronic health records in Australia

New technology will shortly be trialled across health centres in Victoria, Australia to improve access to patients’ electronic health records optimising healthcare delivery and health outcomes.

CogStack, an information retrieval, extraction and natural language processing platform, developed by researchers at the NIHR Maudsley Biomedical Research Centre will be trialled in Australia. It will be tailored for the Australian context by a team led by Helix, a Monash Technology Research Platform, at Monash University.

COVID-19 has shown that capturing health related data and embracing digital health innovations is crucial to capitalise on opportunities to support and enhance healthcare.

National Learning Health System (LHS) Data Management Platform

Led by Monash Partners Academic Health Science Centre, Monash University is working directly with their healthcare partners and is linking nationally through the Australian Health Research Alliance. This innovative project titled National Learning Health System (LHS) Data Management Platform has received $1.9million in MRFF funding to enable our health system to learn and be responsive to community need, during a crisis and beyond.

Respecting ethics, privacy and consent, this platform will allow healthcare leaders and researchers to harness the power of health information in electronic health records to improve healthcare quality, health outcomes and enable innovative research. This information can be extracted, regardless of the format, whether it be structured information or within a scanned document and/or image.

Hear from the creators

Professor Ross Coppel, Senior Deputy Dean and Deputy Dean (Research) of the Faculty of Medicine, Nursing and Health Sciences at Monash University and the Chair of the Helix Steering Committee, said:

“Helix is committed to the implementation and integration of world-leading technologies, like CogStack and Secure eResearch Platform (SeRP), to assist the health services in using their data to improve care and outcomes for patients.”

Monash Partners Academic Health Science Centre Executive Director and lead investigator, Professor Helena Teede said this will allow access to information that was previously not accessible and will deliver unprecedented ability to improve healthcare and rapidly link Australians to cutting edge clinical trials.

“In the past we have only been able to examine the smallest amount of information entered into a patient’s health record. This was limited to information, known as structured data, such as that contained within drop down boxes, such as age, what unit someone was admitted into, and how long their stay was. This technology is a game changer,” said Professor Teede.

“With consent we will now have visibility of all notes within a health record. Health services will be able to identify people that might benefit from a particular clinical trial, based on their diagnosis and test results. This system would replace the current manual one and is expected to reduce the number of people who are missing opportunities to access innovative advanced treatments at present. Hospitals will be able to rapidly identify symptoms and patterns for conditions, such as COVID-19, and set up prompts and processes to check test results, identifying those at highest risk and reducing disease spread.

“This work builds on considerable momentum, infrastructure, expertise and activity to date within the data platform space and works to integrate into core systems level activities in Australia’s digital health journey. Monash University houses the only Faculty of IT nationally and has invested strongly in the Helix data platform and international partnerships. Here we integrate and advance this capability with our health service partners, primary care and our community and link nationally through the Australian Health Research Alliance.

“We look forward to engaging in partnership with acute, primary and aged care, academic, government, community and industry to accelerate development, adaptation and implementation of innovative data management approaches and digital health tools to improve healthcare and health for our community,” said Professor Helena Teede.

Professor Richard Dobson, Professor of Medical Informatics at King’s College London, said,

"Really pleased to see homegrown NHS-academic innovation through the CogStack platform bring capacity for search and natural language processing to health systems outside of the UK".

Dr James Teo, Clinical Director of AI at King’s College Hospital and Guys’ and St Thomas Hospital said,

“It is gratifying that innovations developed in King’s College London and nurtured in Kings’ Health Partner NHS Trusts will soon be bring benefits to healthcare systems around the world”.

Alfred Health pilot

The first health centres to pilot the system will include Alfred Health, Peninsula Health (National Centre for Healthy Ageing) and Outcome Health. Their work will be supported by and developed in conjunction with Monash University.

At Alfred Health it will be used for clinical trial participant identification, which is presently done case by case and by hand.

Alfred Health’s Information Development Division Executive Director said the health service has been investing in the power of digital platforms for many years, and the team is excited to partner on this intelligent initiative.

“A system that can proactively match a patient to a clinical trial, and alert the treating doctor to that opportunity, has the real potential to save lives,” Ms McKimm said.

“Having more patients involved with clinical trials, as early as possible, is our aim and Cogstack will become another significant tool in Alfred Health’s Trial Hub and research program.”

National Centre for Healthy Ageing

At Peninsula Health (National Centre for Healthy Ageing) it will be used for identification of dementia and other chronic diseases of ageing. The system will identify key words and phrases within the context of the surrounding text in medical records that suggest that a person may be presenting with signs and symptoms that are consistent with early dementia. This is hoped to improve early identification to improve health care at a much earlier stage.

“CogStack will help us detect conditions such as dementia, that are often poorly documented and difficult to identify in structured electronic health records. This work will allow us to generate high-quality nationally relevant data on dementia prevalence, incidence, geospatial distribution, risk factors and comorbidities, management, and outcomes. These techniques will also be applicable to a range of other complex chronic conditions that will help advance the vision of the National Centre for Healthy Ageing,”

- Associate Professor Nadine Andrew, Research Data Lead, National Centre for Healthy Ageing.

Outcome Health aims to explore alternatives to their current systems, and share learnings and work collaboratively across the care continuum, including with partners from the ambulatory, acute and aged care settings and government.

Funders and collaborators

This project will be supported by the Monash Partners Learning Health System, which will provide a methodological approach to implementation at the different sites. The Learning Health System, which provides a system that leads to iterative cycles of new knowledge generation and improvement in healthcare, along with consumer and community involvement, are also key to this project and will focus on the value of data in driving improvement, equity and access both to clinical care, and also to cutting edge new treatments via clinical trials.

The project is a joint collaboration between Alfred Health, Monash University, the National Centre of Health Ageing (Peninsula Health), Outcome Health, Sydney Health Partners, Health Translation South Australia, King’s College London, Brisbane Diamantina Health Partners, Western Australia Health Translation Network, Australian Digital Health Agency, Digital Health CRC and Safer Care Victoria.

For an introduction to CogStack, watch our short fim on YouTube below

Edited story from Monash Partners Academic Health Science Centre

For Australian media enquiries please contact:  Amanda Boshier, Monash Partners Academic Health Science Centre, Media and Communications Manager, 0412 224 729, amanda.boshier@monash.edu