Tim Shaw

• Professor at The University of Sydney

Background The rapid digitisation of healthcare has resulted in the capture of a vast amount of health data, which are increasingly being used for secondary purposes, such as quality improvement and performance management. Objectives This study examined the legal and ethical considerations that affect if and how health professionals and administra...

Background: Despite their potential, Clinical Decision Support (CDS) systems often lack alignment with clinicians’ needs and are underutilised in practice. Pilot implementations can help to improve the fit between systems and local needs by engaging users in real-world testing and refinement. Although pilot implementations of CDS have been reported...

Background Conversational artificial intelligence (AI) allows for engaging interactions, however, its acceptability, barriers, and enablers to support patients with atrial fibrillation (AF) are unknown. Objective This work stems from the Coordinating Health care with AI–supported Technology for patients with AF (CHAT-AF) trial and aims to explore...

Objective To describe the barriers to and facilitators of implementing and delivering virtual hospital (VH) services, and evidence and practice gaps where further research and policy changes are needed to drive continuous improvement. Study design Qualitative descriptive study. Setting, participants Online semi‐structured interviews and a focus g...

Objectives To identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics). Design Qualitative study using a modified nominal group technique. Setting Online semi‐structured interviews and workshops held i...

Background To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the suppo...

Introduction Cardiac implantable electronic devices (CIED) can transfer data to the healthcare team, remotely. National and international cardiac organisations recommend all patients use this technology, however patient engagement is suboptimal. Previously, in cardiovascular patients, SMS messaging services have shown improvements in patient engage...

BACKGROUND The HeartHealth program is a six-month SMS message-based support program offered to patients with a recent cardiovascular hospitalisation or recent cardiovascular clinic visit in Western Sydney, Australia. Its customised content focuses on cardiovascular risk factors, with a focus on lifestyle, treatments and general heart health informa...

BACKGROUND Community-based health check kiosks provide opportunities to improve the detection and long-term monitoring of hypertension. We describe the sociodemographic and cardiovascular characteristics of first-time and repeat users of these kiosks. METHOD This was an observational study. Deidentified data collected from 430 SiSU Health consumer...

Background The Stop Cancer PAIN Trial was a phase III pragmatic stepped wedge cluster randomised controlled trial which compared effectiveness of screening and guidelines with or without implementation strategies for improving pain in adults with cancer attending six Australian outpatient comprehensive cancer centres (n = 688). A system for pain sc...

Background Electronic health records and other clinical information systems have crucial roles in health service delivery and are often utilised for patient care as well as health promotion and research. Government agencies and healthcare bodies are gradually shifting the focus on how these data systems can be harnessed for secondary uses such as r...

BACKGROUND Background: Electronic Medical Records (EMR) are a potentially rich source of information on an individual healthcare providers’ clinical activities. These data provide an opportunity to tailor online learning for healthcare providers to align closely with their practice. There is increasing interest in the use of EMR data to understand...

BACKGROUND Conversational artificial intelligence (AI) allows for engaging interactions, however, its acceptability, barriers, and enablers to support patients with atrial fibrillation (AF) are unknown. OBJECTIVE This work stems from the Coordinating Health care with AI–supported Technology for patients with AF (CHAT-AF) trial and aims to explore...

Objectives The study explored the perceived impacts of COVID-19 and its associated policies and social restrictions on health, self-management and access to healthcare. Design Cross-sectional observational (online survey) and qualitative study (semi-structured interviews and thematic analysis). Setting Australia. Participants People with self-re...

Background Implementation strategies are crucial to facilitate implementation success. To prepare and support implementation of a clinical pathway for screening, assessment and management of anxiety and depression in cancer patients (the ADAPT CP), six broad categories of implementation strategies; (1) Awareness campaigns, (2) Champions, (3) Educat...

Objective: This study explored factors that may influence blood pressure (BP) control in patients with atrial fibrillation (AF) with hypertension. Methods: Cross-sectional retrospective analysis of the MedicineInsight database which includes de-identified electronic health records from general practices (GPs) across Australia. BP control was ass...

UNSTRUCTURED The health sector is highly digitised. This digitisation is enabling the collection of vast quantities of electronic data about health and wellbeing. The Information Communication Technologies collecting these data are varied depending on the area of healthcare but can include systems used by healthcare organisations, consumer and comm...

The health sector is highly digitized, which is enabling the collection of vast quantities of electronic data about health and well-being. These data are collected by a diverse array of information and communication technologies, including systems used by health care organizations, consumer and community sources such as information collected on the...

Background About 70% of patients with advanced cancer experience pain. Few studies have investigated the use of healthcare in this population and the relationship between pain intensity and costs. Methods Adults with advanced cancer and scored worst pain ≥ 2/10 on a numeric rating scale (NRS) were recruited from 6 Australian oncology/palliative ca...

Objective: Gaps and complexities exist in cancer referral and diagnosis in Australia, leading to delays in cancer treatments. Developing evidence-based referral pathways is important for promoting better and more timely cancer diagnosis and care. Type of program or service: This paper describes a toolkit endorsed by the Cancer Institute NSW as a g...

Aim: To develop a priority set of quality indicators (QIs) for use by colorectal cancer (CRC) multidisciplinary teams (MDTs). Methods: The review search strategy was executed in four databases from 2009-August 2019. Two reviewers screened abstracts/manuscripts. Candidate QIs and characteristics were extracted using a tailored abstraction tool an...

Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are resource-intensive, time-delayed, and often lack clinical relevance. Electronic Medical Records (EMRs) have increased data availability and opportunities for quality measurement. However, little is...

Background: The widespread adoption of Electronic Medical Records (EMR) and digital technologies provides an opportunity to tailor online learning for healthcare providers. This is because EMRs contain a rich source of information on an individual’s clinical activities, providing an opportunity to tailor online learning for healthcare providers. Th...

The abundance of digital health technologies used within modern healthcare organisations results in the collection of a large amount of data on the health and wellbeing of individuals. Digital technologies commonly used by healthcare organisations to collect electronic health data include patient administrative systems and electronic health records...

Background: Medical practitioners are important facilitators of advanced care planning but are often reluctant to engage in these conversations with patients and their families. Barriers to participation can be addressed through medical education for medical practitioners. Introduction: The primary objective was to examine the extent to which di...

The information systems designed to support clinical care have evolved separately from those that support health professions education. This has resulted in a considerable digital divide between patient care and education, one that poorly serves practitioners and organizations, even as learning becomes ever more important to both. In this perspecti...

Background Clinical pathways (CPs) are intended to standardise and improve care but do not always produce positive outcomes, possibly because they were not adapted to suit the specific context in which they were enacted. This qualitative study aimed to explore staff perspectives of implementation of a CP for routine screening, assessment, referral...

Background Anxiety and depression screening and management in cancer settings occurs inconsistently in Australia. We developed a clinical pathway (ADAPT CP) to promote standardized assessment and response to affected patients and enhance uptake of psychosocial interventions. Health professional education is a common strategy utilised to support imp...

Background: There is an increasing amount of electronic data sitting within the health system. These data have untapped potential to improve clinical practice if extracted efficiently and harnessed to change the behavior of health professionals. Furthermore, there is an increasing expectation from the government and peak bodies that both individual...

Background Clinical pathways (CPs) can improve health outcomes, but to be sustainable, must be deemed acceptable and appropriate by staff. A CP for screening and management of anxiety and depression in cancer patients (the ADAPT CP) was implemented in 12 Australian oncology services for 12 months, within a cluster randomised controlled trial of cor...

Background: Individuals undergoing cancer treatment often receive a large amount of information about their condition very quickly after diagnosis. It can be challenging for patients to retain key information about managing their condition, or side-effects of their treatment as a result. Digital technologies can provide an invaluable mechanism for...

Background The high prevalence of malnutrition in patients with head and neck cancer (HNC) negatively impacts outcomes. The best-available evidence has been published in clinical nutrition guidelines; however, translation into practice has lagged. Aim This project aimed to explore multidisciplinary team (MDT) clinicians’ perspectives regarding bar...

BACKGROUND Atrial fibrillation (AF) is an increasingly common chronic health condition in which integrated care, that is multidisciplinary and patient-centric, is recommended yet challenging to implement. Methods and analysis: CHAT-AF is a 6-month randomised controlled trial of adult patients with AF (n=385) allocated in a ratio 4:1 to AF-support o...

Background: Atrial fibrillation (AF) is an increasingly common chronic health condition for which integrated care that is multidisciplinary and patient-centric is recommended yet challenging to implement. Objective: The aim of Coordinating Health Care With Artificial Intelligence-Supported Technology in AF is to evaluate the feasibility and pote...

BACKGROUND Heart failure is a common cause of hospitalization and patient self-management is essential to avoid decompensation and readmissions. Mobile applications (apps) seem promising in supporting heart failure self-management. OBJECTIVE This study systematically reviews the evidence on the impact of heart failure self-management apps on healt...

Background: Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote monitoring interventions using nonapp types of mo...

Background: Individuals undergoing cancer treatment often receive a large amount of information about their condition very quickly after diagnosis. It can be challenging for patients to retain key information about managing their condition, or side-effects of their treatment as a result. Digital technologies can provide an invaluable mechanism for...

Background With the increasing use of digital technology in society, there is a greater need for health professionals to engage in eHealth-enabled clinical practice. For this, higher education institutions need to suitably prepare graduates of health professional degrees with the capabilities required to practice in eHealth contexts. Objective Thi...

Background: Anxiety and depression screening and management in cancer settings occurs inconsistently in Australia. We developed a clinical pathway (ADAPT CP) to promote standardized assessment and response to affected patients and enhance uptake of psychosocial interventions. Health professional education is a common strategy utilised to support im...

Background Using electronic data for cardiovascular risk stratification could help in prioritising healthcare access and optimise cardiovascular prevention. Aims To determine whether assessment of absolute cardiovascular risk (Australian Absolute Cardiovascular Disease Risk, ACVDR) and short-term ischaemic risk (HEART Score) are possible from avai...

Patient portals are websites or apps that provide patients with tools to manage healthcare appointments, access their health records, and communicate with clinicians. Patient portals have been demonstrated to be beneficial for improving communication between patients/carers and their healthcare team in a range of health settings. However, there is...

Background Electronic Medical Records (EMRs) are one of a range of digital health solutions that are key enablers of the data revolution transforming the health sector. They offer a wide range of benefits to health professionals, patients, researchers and other key stakeholders. However, effective implementation has proved challenging. Methods A q...

Background Malnutrition is prevalent in patients with head and neck cancer (HNC), impacting on outcomes. Despite publication of best-practice nutrition care clinical guidelines, evidence-practice gaps persist.AimThis project aimed to understand the perspectives of patients and their caregivers about nutritional care and how their unmet supportive c...

BACKGROUND While relatively new, digital health interventions are demonstrating rapid growth due to their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the provision o...

Background Although relatively new, digital health interventions are demonstrating rapid growth because of their ability to facilitate access and overcome issues of location, time, health status, and most recently, the impact of a major pandemic. With the increased uptake of digital technologies, digital health has the potential to improve the prov...

Multidisciplinary care in is widely recommended as best practice for lung cancer in many countries and jurisdictions. A number of studies suggest multidisciplinary care benefits patient outcomes, with analyses based on a range of data sources including national, state and local registries as well as multidisciplinary team meeting (MDT)-based data c...

Malnutrition is prevalent in patients with head and neck cancer (HNC), impacting outcomes. Despite publication of nutrition care evidence-based guidelines (EBGs), evidence–practice gaps exist. This study aimed to implement and evaluate the integration of a patient-centred, best-practice dietetic model of care into an HNC multidisciplinary team (MDT...

Background: A large quantity of data is collected during the delivery of cancer care. However, once collected, these data are difficult for health professionals to access to support clinical decision making and performance review. There is a need for innovative tools that make clinical data more accessible to support health professionals in these a...

Background Opioids are high-risk medicines used in high doses and volumes in specialist palliative care inpatient services to manage palliative patients’ pain and other symptoms. Despite the high volume of opioid use in this care setting, serious errors with opioids are exceedingly rare. However, little is known about the factors that mitigate opio...

Background Primary care has been advocated as an ideal setting to initiate advance care planning (ACP). Few studies have examined the role of general practice nurses (GPNs) in promoting/initiating ACP. The Advance Project evaluated initiatives to address this gap. Methods This Australian Government-funded program aims to increase GPNs’ confidence...

Aim: Multidisciplinary team (MDT) meetings can facilitate optimal lung cancer care, yet details of structured data collection and feedback remain sparse. This study aimed to investigate data collection and the impact of feedback to lung cancer MDTs. Methods: A mixed-methods study using pre and post-test surveys, semistructured interviews, and ob...

Objective and Study Setting: Research efforts to identify factors that influence successful implementation are growing. This paper describes methods of defining and measuring outcomes of implementation success, using a cluster randomized controlled trial with 12 cancer services in Australia comparing the effectiveness of implementation strategies t...

BACKGROUND As digital technology use in society increases, so does the need for health professionals to engage in eHealth-enabled clinical practice. To do so, higher education institutions need to suitably prepare graduates of health professional degrees with the capabilities required to practice in eHealth contexts. OBJECTIVE This study aimed to...

Background: EMRs are one of a range of digital health solutions that are key enablers of the data revolution transforming the health sector. They offer a wide range of benefits to health professionals, patients and other key stakeholders. However, effective implementation has proved challenging. Method: A qualitative methodology was used in the...

BACKGROUND Digital health interventions, including the use of patient portals have been shown to offer benefits to a range of patients including those with a diagnosis of cancer. OBJECTIVE We aimed to explore the participant experience and perception of using an interactive web-based portal for monitoring physical activity, remote symptom reportin...

Background Digital health interventions, such as the use of patient portals, have been shown to offer benefits to a range of patients including those with a diagnosis of cancer. Objective This study aimed to explore the participant experience and perception of using an interactive Web-based portal for monitoring physical activity, remote symptom r...

Context Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, ident...

Background Opioid errors are a leading cause of patient harm and adversely impact palliative care inpatients’ pain and symptom management. Yet, the factors contributing to opioid errors in palliative care are poorly understood. Identifying and better understanding the individual and system factors contributing to these errors is required to inform...

Objectives: To learn the attitudes of health professionals, health informaticians and information communication technology professionals to using data in electronic health records (eHRs) for performance feedback and professional development. Design: Qualitative research in a co‐design framework. Health professionals’ perceptions of the accessibili...

Background Variations in care models contribute to cancer pain being under-recognised and under-treated in half of all patients with cancer. International and national cancer pain management guidelines are achievable with minimal investment but require practice changes. While much of the cancer pain research over the preceding decades has focused o...

BACKGROUND A large quantity of data is collected during the delivery of cancer care. However, once collected this data is difficult for clinical teams to access to support their clinical decision making or reviewing performance. There is a need for interfaces that make clinical data more accessible to support clinicians in these activities. One app...

Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base...

Background and objective While multidisciplinary team (MDT) care in lung cancer is widely practiced, there are few guidelines for MDT on best data collection strategies. MDT meetings need ready access to information for the provision of optimal treatment recommendations (the primary purpose of the meeting), audit of team performance and benchmarkin...

Introduction There has been no systematic attempt to enhance leadership capacity within radiation oncology as an integrated component of training. This pilot study examines an intervention to introduce basics of leadership learning to radiation oncology trainees. Methods A case‐based learning tool was designed for delivery via trainees’ personal e...

Background Multidisciplinary team (MDT) presentation in lung cancer has the potential to improve longterm outcomes, although this varies between studies. This study aims to evaluate outcomes including survival, according to MDT presentation and to explore the utility of data obtained from local clinical sources. Patients and methods Prospective ca...

Background: Multidisciplinary teams (MDTs) are an integral component in the delivery of health care. This is particularly evident in the delivery of cancer care, where multidisciplinary teams are internationally recognized as the preferred method for service delivery. The use of health information systems and technology are key enabling factors fo...

Providing coordinated care remains a challenge for cancer services globally. There is a lack of consensus in the literature about what constitutes successful coordinated care. This study aimed to define and prioritize a set of consensus-driven success factors that can lead to coordinated care. A mixed-methods approach was used that included literat...

Open Access: https://www.jmir.org/2018/5/e10229/ Background: The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective: This study aime...

Background: Significant benefits accrue from increasing physical activity levels in people with a history of cancer. Physical activity levels can be increased using behavioral change interventions in this population. Access to Web portals and provision of activity monitors to provide feedback may support behavior change by encouraging patient enga...

This paper reports the findings of a priority setting process, undertaken with cancer and palliative care clinicians, to better understand the characteristics of medication errors with opioids within their services. Participants representing six public hospitals in one Australian state took part in a series of priority setting workshops and, drawin...

Introduction: Online learning has become an increasingly common means of delivering healthcare professional education. Case-based scenarios are the foundation of many continuing professional development (CPD) activities. No framework currently exists to ensure the development of quality, evidence-based cases despite the weighted importance case-bas...

Despite the shift towards collaborative healthcare and the increase in the use of eHealth technologies, there does not currently exist a model for the measurement of eHealth readiness in interdisciplinary healthcare teams. This research aims to address this gap in the literature through the development of a three phase methodology incorporating qua...

Background: Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorb...

Introduction: Significant benefits accrue from increasing physical activity levels in people with a history of cancer. Physical activity levels can be increased using behavioural change interventions in this population. Access to web-portals and provision of activity monitors to provide feedback may support behaviour change by encouraging patient e...

Opioids are a high-risk medicine frequently used to manage palliative patients’ cancer-related pain and other symptoms. Despite the high volume of opioid use in inpatient palliative care services, and the potential for patient harm, few studies have focused on opioid errors in this population. Objectives To (i) identify the number of opioid errors...

BackgroundeHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals’ experiences of,...

This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research d...

Background: Interest in electronic health (eHealth) technologies to screen for and treat a variety of medical and mental health problems is growing exponentially. However, no studies to date have investigated the feasibility of using such e-tools for older adults with mild cognitive impairment (MCI) or dementia. Objective: The objective of this...

Background: Despite rapid growth in eHealth research, there remains a lack of consistency in defining and using terms related to eHealth. More widely cited definitions provide broad understanding of eHealth but lack sufficient conceptual clarity to operationalize eHealth and enable its implementation in health care practice, research, education, a...