Three years ago, Monash University and Peninsula Health’s National Centre for Healthy Ageing (NCHA) inaugurated a pioneering digital library in Australia. This unique repository, located at Monash’s Peninsula campus, captures video-recorded interactions from various healthcare settings, including community health, primary care, hospitals, aged care facilities, telehealth, and outreach services. The library serves as a substantial research infrastructure aimed at enhancing healthcare communication research and education, ultimately improving consumer satisfaction, healthcare safety, outcomes, and quality.
Recently, a study published in the Australian Journal of General Practice utilized this digital library to explore the intricacies of general practice and its connection to “whole-person care.” Researchers examined 54 patient-GP consultations, categorizing multiple health topics discussed as either in-depth or merely mentioned. These items were recorded following the International Classification of Primary Care system. The study revealed that most patients were over 45 and predominantly women (51.9%). On average, consultations lasted 19 minutes, with eight different health issues addressed per session. The duration of consultations varied significantly, ranging from a brief three-and-a-half minutes to nearly 40 minutes. Notably, half of the consultations addressed cardiovascular health and musculoskeletal problems, while one-third involved psychological health.
Supporting the Clinical Workforce
Dr. Kimberley Norman, a research fellow at the School of Primary and Allied Health Care, emphasized the library’s value in understanding clinician-patient consultations to enhance patient care and support the clinical workforce. “It is unique in Australia and brings new possibilities for improving healthcare communication,” she remarked.
This world-leading research infrastructure provides a window into real-life consultations, and that was crucial for our research objectives.
The Digital Library also includes anonymous transcripts, demographic data, and post-consultation surveys where patients rate their consultation experience. The research was led by Adjunct Professor Liz Sturgiss, a general practitioner and academic, with Nilakshi Gunatillaka and Dr. Kimberley Norman as joint lead authors alongside Dr. Kellie West, a practising rural GP and researcher.
While this library is unique to Australia, similar archives exist globally, with the largest in the Netherlands at the Nivel Research Communication Center in Utrecht. Other countries, such as the UK and New Zealand, have also established similar resources. The researchers highlight that these archives mitigate “recall bias,” where research is compromised by inaccurate recollection of events or experiences.
The Healthcare ‘Dual Crisis’
The study underscores the complexity of standard GP appointments, noting that they should be viewed in the context of a potential 144 consultations per week per full-time GP.
These study findings are consistent with existing literature on the consistently evolving and complex nature of GP-patient interactions.
The paper highlights the “intense cognitive load” faced by GPs and medical students, contributing to the “dual crisis of high GP burnout and low medical student recruitment” in Australian primary healthcare.
This “strained” workload results in high levels of GP burnout and a global shortage of new medical trainees in primary healthcare. “We, and others, anticipate widespread future workforce issues,” the paper warns,
if no substantive action is taken by policymakers to address these concerns.
NCHA Director Professor Velandai Srikanth asserts that the research demonstrates how the Digital Library can illuminate the complexities of GP healthcare. “Through such research and knowledge translation, it has the potential to enhance interactions in a number of areas relevant to healthy ageing and beyond, from primary care right through to complex specialist care,” he stated.
The ultimate beneficiaries will be both the provider and recipient of healthcare.
Implications and Future Directions
The establishment of Australia’s first digital library of healthcare interactions marks a significant step forward in understanding and improving healthcare delivery. By providing a comprehensive view of real-world consultations, it offers invaluable insights into the dynamics of GP-patient interactions and the multifaceted nature of whole-person care. As the healthcare sector grapples with workforce challenges and evolving patient needs, such innovative research tools will be crucial in shaping effective policies and practices for the future.
Moving forward, the insights gained from this digital library could inform training programs for medical professionals, ensuring they are better equipped to manage the complexities of modern healthcare. Moreover, as the library continues to grow, it could serve as a model for similar initiatives worldwide, fostering global collaboration in healthcare research and education.
