The NSW Health COVID-19 Critical Intelligence Unit was set up to meet an unprecedented demand for timely COVID-19 evidence and data. This has led to a dynamic ecosystem of evidence generation, dissemination and translation that is driving clinical best practice. Could this approach benefit other areas of the health system dealing with complex challenges?
Australian clinicians have a long history of translating evidence into practice, but the process can often take a long time and there is rarely a straight line between evidence and action.
In the course of the COVID-19 pandemic this has changed significantly for many clinicians; with a rapid evolution in evidence systems and a shift in how quickly evidence can be translated into practice.
We recently wrote in the Medical Journal of Australia's Insight+11 that Australia and NSW now has an unprecedented opportunity to retain and strengthen what has worked, in terms of working with evidence and data during the pandemic; and create a foundation for a national evidence ecosystem to benefit other areas of the healthcare system.
Seizing the opportunity
This once-in-a-lifetime opportunity can build on the gains we’ve made throughout the pandemic, in the areas of:
- evidence generation and synthesis
- knowledge distribution to support timely clinical, policy and managerial decision making
- collaborative approaches to data sharing, analysis and modelling.
We have clearly demonstrated that when we provide sound and timely evidence, debates about what works can be settled quickly, decision making can be rapid and responsive and efforts can quickly turn towards action.
Evidence can help bring clinicians, health managers and policy makers to a shared understanding and help solve complex problems affecting the healthcare system.
We have the opportunity to shift the way we generate, disseminate, synthesise, use and communicate evidence for the wider benefit of the health system, clinicians and patients.
The final report of the Global Commission on Evidence to Address Societal Challenges makes 24 recommendations to reshape the evidence ecosystem, including:
- a formal resolution from the United Nations, G20 and other international bodies committing them to better use of evidence
- a World Bank World Development Report dedicated to evidence
- a review among governments (at all levels) on how they use evidence and evaluate programs
- initiatives to support better use of evidence by citizens, such as those addressing misinformation and making everyday decisions.
The role of national coordination and local knowledge
National and local roles and responsibilities are important to ensure research evidence that is often widely applicable can be synthesised and applied at the international, national and local level.
Strong national coordination by the National COVID-19 Clinical Evidence Taskforce has been key throughout the pandemic (particularly for clinical guidelines). The taskforce:
- supports a unified set of rapidly evolving national guidelines
- produces high quality syntheses of evidence and national clinical care recommendations
- links in with state evidence systems, such as the NSW Health COVID-19 Critical Intelligence Unit (CIU).
Moving forward, a national collective commitment will be central to capitalising on these gains to benefit other areas of health.
Important knowledge also often emerges when evidence is applied at a local level. This is where clinicians' voices are essential, so that evidence and data can be applied most effectively in local contexts.
Embracing the future of evidence
The processes for rapidly updating evidence summaries and guidance using a living evidence model were originally developed in Australia and are being taken up around the world, including by the World Health Organization and the United Kingdom’s National Institute for Health and Care Excellence.
Australia has established some foundations for a modern, fit-for-purpose evidence ecosystem. However, the systems and structures required to support evidence-based policy and practice need to be established consistently across the country and for different medical conditions.
In NSW, the Agency for Clinical Innovation (ACI) has embedded evidence-based innovation in our work. We are also championing a collective commitment to support the delivery of effective evidence models and systems on a broader scale.
Identifying and developing new ways for evidence to inform healthcare policy and planning is a key focus for the ACI Evidence team. Integrated data and evidence are vital to ensure a holistic view, robust intelligence and sound advice is being provided to decision makers and clinicians working to resolve healthcare challenges.
In health, we often range between being generators, synthesisers and users of evidence. We all have an opportunity to affect the emerging evidence ecosystem – building and leveraging the resources available to translate evidence into practice and policy.
Learn more about the Critical Intelligence Unit
Subscribe to stay informed about healthcare innovations
1 Sutherland K, Levesque JF, McGloughin S and Elliot J. Building an evidence ecosystem: what's worked in the pandemic. Medical Journal of Australia’s Insight+. 2022; 31 January. Available from: insightplus.mja.com.au/2022/3/building-an-evidence-ecosystem-pandemic-reflections