What can GRHANITE™ do for me?
GRHANITE™ provides tools that solve a variety of data acquisition problems. Typical scenarios are below:
- GRHANITE™ providing person-level or aggregated data
- General practice data
- Aboriginal Community-Controlled Medical Services
- Laboratory data
- Community data including pharmacy and optician data
- Hospital data
- Cross-jurisdictional data access and data held and protected by government organisations
- Projects requiring patient re-identification
GRHANITE™ providing person-level or aggregated data
- GRHANITE™ can extract individual level data or aggregated data. GRHANITE™ can perform the aggregation within the general practice, clinic or lab ensuring the researcher sees the minimum amount of data necessary to answer the audit or research question.
- Because GRHANITE™ interfaces are custom interfaces, you are able to specify EXACTLY what you want aggregated. As an example, instead of determining the number of people in a practice with type 2 diabetes, you may wish to see the type 2 diabetes figures in 5-year age-bands split by sex where the patient has been seen at least once in the last two years and they have had a prescription for an oral hypoglycaemic drug.
General practice data
The HIU have experience working with many GP computer systems and are happy to consider working with new ones not in our portfolio. We have liaised and often contracted with GP system suppliers to obtain dummy or demonstration copies of their databases. We use these demonstration databases to develop our GRHANITE™ interfaces and we are transparent in our intent.
- The HIU produce interfaces for audit, research and health surveillance only - we do not migrate data or use these databases for any purpose other than interface development for audit, research or health surveillance.
- We do not develop interfaces for clinical purposes
- Because we work directly with the GP database system there is no need to liaise with the GP system supplier. This helps keep your project costs down.
- We have a process of interface certification to insure the interface extracts the data exactly as requested before it is rolled-out generally for a project.
- We can remotely update study protocols so that a change to the protocol does not require a visit to multiple GP sites. This is especially important where sites are large in number or geographically widely distributed.
- Practices often change computer systems or upgrade their computers. GRHANITE™ Heartbeat allows users to dynamically monitor GRHANITE™ interfaces at their project sites to identify and resolve any problem as soon as it occurs.
What data can GRHANITE™ extract?
- GRHANITE™ can extract most data recorded in a GP computer system. Unstructured data can be very difficult to interpret. Items that have a financial incentive for the GP to record are not surprisingly the best recorded! Typically consultation records, prescribing data and main diagnoses are recorded well. Pathology data can be very reliable also so long as practices use an automated electronic transfer of pathology data from path labs. The researcher should discuss the data recording methods used by practices they wish to recruit. If resources are available, good epidemiological practice is to do a manual case-note validation on a population subset.
- GRHANITE™ is unique in Australia in having a systematic technique and tool for parsing textual data returned from pathology laboratories (GRHANITE™ Pathology Parser).
- In most cases we will not extract data from free text notes as these frequently contain names and other confidential information.
Aboriginal Community-Controlled Medical Services
The privacy and confidentiality provided by GRHANITE™ offer a capability to researchers to work in this area. We are currently working with experienced research groups with aboriginal representation and oversight to undertake crucial work involving Aboriginal Medical Services.
GRHANITE™ interfaces have been developed for Communicare, Best Practice and Medical Director v3 computer systems installed at AMS clinics across Australia.Back to top
GRHANITE™ provides unique power in the collection and interpretation of pathology lab results.
We have experience interfacing to data extracts provided by about 60% of pathology laboratories nationally. We can work with you to determine how best to work with the laboratories to collect the information you require.
Laboratories do not maintain patient case records - each test request is treated independently. If a patient has five tests done over the course of two years, the laboratory is not normally able to determine that the tests done were for the same individual. GRHANITE™ Privacy-Protecting Record-Linkage allows the data to be linked without exposing identity.
By obtaining data from multiple labs, we are able to build a complete picture of testing regardless of which pathology lab provider the patient uses.
Using the same privacy-protecting linkage capability, GRHANITE™ can link other data to laboratory data for example linking lab data to GP care episodes or hospital admissions.Back to top
Community data including pharmacy and optician data
GRHANITE™ interfaces can be written for pretty-much any database so long as we are able to use a demonstration copy of the database that does not contain real patient data. In some cases we (or our clients) have contracted a system supplier to write code that produces a data extract where we have been unable to obtain a demonstration copy of the database.Back to top
GRHANITE™ will not normally interface directly to hospital systems for security reasons. We work with hospital IT departments so that they can provide a data extract containing the required data. GRHANITE™ is then installed in the IT department to de-identify the data and provide it to the researcher in a privacy-protected, record-linkable form.Back to top
Cross-jurisdictional data access and data held and protected by government organisations
Data held by government organisations is very tightly controlled. Unless allowed by legislation, it is normally impossible for a government department to release data that contains person identifiers. In many cases they would be breaching several laws if they were to do so.
GRHANITE™ privacy-protecting record linkage can provide a mechanism to legally and ethically access such data by ensuring that identifiers never leave the government organisation and even when record linkage allows, the researcher (and the HIU) at no time are able to identify the individual. This relies on GRHANITE™ being used in all parts of the data collection process to ensure GP or community data is similarly de-identified before it leaves the practice or clinic.
Record linkage work using GRHANITE™ has been undertaken or negotiated previously to arrange for access to data from the Australian Institute for Health and Welfare (AIHW), Medicare and the Victorian Department of Health.Back to top
Projects requiring patient re-identification
GRHANITE™ can export patient identifiers but this in not normally done unless opt-in consent for each individual can be guaranteed.
GRHANITE™ has another process for ethically dealing with patient re-identification:
- Each patient is allocated a unique 36-digit number for example 'A20A34AF-1CD2-4629-AAF7-D8C867B435C1'. This number is exported by GRHANITE™ along with the required project clinical data.
- The data custodian of original data (for example a GP) is able to access a secure mapping held within their practice or clinic between these numbers and the identity of their patients.
- If required, the data custodian can re-identify the patient. Because a data custodian is the only individual able to access this mapping, they are able to protect the identity of the individual and ensure appropriate protocols are followed in any follow-up.
This procedure allows GRHANITE™ to offer researchers the best possible means of protecting individuals as supported by the National Statement on Ethical Conduct in Human Research (NSECHR) section 3.2.6
'Whenever research using re-identifiable data reveals information that bears on the wellbeing of participants, researchers have an obligation to consider how to make that information available to the participants. Where individual notification is warranted, the custodian of the data will need to take all reasonable steps to re-identify those data'.
GRHANITE™ data is commonly referred to as being de-identified. This term is not recommended by the NSECHR unless clearly defined:
'De-identified in the context of GRHANITE™ extracted data refers to records in which identifying information has been removed but the means still exist to-re-identify an individual by the original data custodian only. Because a data custodian can re-identify GRHANITE™-protected patients, GRHANITE™ data is re-identifiable.'
Researchers should make their own judgement on their use of the appropriate terminology.Back to top