When Optometry Australia embarked on the Optometry 2040 project in 2018, we identified significant trends that will shape the future of our profession. One of these trends was ‘big data’ which is being used increasingly around the world to drive decision-making.
In Australia, optometry currently does not have a comprehensive large-scale national dataset and we are setting out to change that. We’ve spent significant time investigating how to extract de-identified clinical data which we can use to create a national optometry dataset, keeping issues such as privacy protection and patient confidentiality top of mind.
To achieve this, we have worked with a small number of practices in a pilot program to securely connect to their practice software to extract a range of de-identified clinical data. This first phase was successful, giving us confidence that with extracted data, we can track what occurs in individual consultations, as well as their outcomes.
There are pearls of wisdom that lie within optometry’s practice management systems and which, once combined, will translate to genuine improvements in advocacy, funding eye care standards and patient wellbeing.
Optometry Australia is now commencing the project’s second phase, to test whether the software download and data extraction can be effectively scaled up to work with several practices concurrently.
If you’re a practice owner, Optometry Australia would welcome your expression of interest in joining this trail-blazing project.
To be involved, submit your expression of interest to policy@optometry.org.au, confirming that your practice is supported by the most-used community optometry practice software systems: Sunix or Optomate.
Then, you will work with Optometry Australia to install our data extraction software – which has been created using best practice industry standards – and which will sit in the background of your practice’s computer and won’t disrupt the flow of your practice in any way.
Please find answers to some frequently asked questions below. If these do not provide the information you’re looking for, please contact us at national@optometry.org.au or call us on (03) 9668 8500.
At Optometry Australia, we recognise the gravity of data as a tool. As part of the Optometry 2040 project, our roadmap for the future of eye care, we acknowledge big data is driving decision-making all over the world, including in healthcare. If we’re going to move the profession forward, big data needs to be in the picture, yet optometry currently does not have a comprehensive large-scale national dataset. It is imperative that we change that.
Optometry sits in a unique position across the allied health sector in this country, with only a small number of practice management software programs used in the profession. The ability to rapidly extract de-identified information from practice management software and the potential to collate this with corporate-collected datasets positions optometry to be leaders of big data within Australian healthcare. We know there are pearls of wisdom that lie within optometry’s practice management systems and which, once combined, will translate to genuine improvements in advocacy, funding eye care standards and patient wellbeing.
We are inviting practice owners to be a part of achieving our vision for the future of optometry by supporting us in the next phase of this project.
Firstly, you will need to submit an expression of interest form to Optometry Australia. This can be found on our website, here. Then, with support from Optometry Australia, you will install a piece of bespoke software which will routinely extract data from your practice’s patient management system.
The practice owner is required to approve the involvement of each practice to participate in the project. This is due to the practice owner being the legal owner of the data in the practice management software programs.
Once installed, the software uses complex algorithms and best-practice protocols to de-identify and extract data from either Sunix or Optomate. The software then encrypts the data and transmits it securely to a high-security Australian data warehouse.
The software will extract de-identified clinical information from your practice’s patient management system. The project will not collect any practice data related to areas such as retail sales, patient billing, or staffing.
De-identification means that the person’s identity is no longer apparent and cannot be reasonably ascertained from the data. Where information/data has been appropriately de-identified, it is no longer considered personal information and can therefore be used or shared in ways that may not otherwise be permitted under the Privacy Act.
Overall, the project aims to establish a national data set which can be analysed nationally using a set of clinical indicators focused on measuring common community diseases. Doing so will provide answers to key questions about how and why people use and access primary eye healthcare provided by optometrists.
Data extraction will occur every six months. The longer a practice participates, the more robust the national dataset becomes and the greater the benefits to the profession.
The Privacy Act 1988 permits the handling of de-identified health and personal information for health and medical research purposes, and legally, the patient record card is a product of the optometrists’ work and therefore is owned by the practice. This means that de-identified data held within patient record cards can be submitted to Optometry Australia without specifically asking the patient if they wish to be involved.
Optometry Australia will provide participating practices with updated privacy policy templates to specifically cover this use of patient information.
If you would like to pause, or cancel, your practices’ participation, there are a few options. Within the software, you can suspend (or pause) extraction of data from your practice at any point in time and recommence at any time. During the time that you have paused data extraction, no data will be extracted from your practice. You can also uninstall the software on your practice computer, and this will mean no future data extraction can occur.
Alternatively, you may contact us at policy@optometry.org.au to request your practice’s removal from the project. This will be processed and confirmed within five business days by email. At this point, you can choose to uninstall the software or leave it on your practice computer, but in either instance, the software will no longer be able to extract data unless you re-enrol in the program.
If you choose to pause data extraction or remove your practice from the project, no further data will be extracted from your practice. You can also request to have your practice data removed from the warehouse.
The team at Optometry Australia is critically aware of privacy concerns people may have around data collection and we understand that the need for well thought out de-identification of data has never been more acute. Optometry Australia has ensured the extraction of data meets our responsibilities under the Australian Privacy Principles and Privacy Act 1988 and is aligned with all best practice standards.
Below is an outline of the security measures in place from the perspective of the data and its journey from beginning to end:
Creation of the data – Legally, the patient record card is a product of the optometrists’ work and therefore is owned by the practice. When de-identified and encrypted, the data held within patient record cards can be submitted to the project without specifically asking the patient if they wish to be involved.
Optometry Australia will provide participating practices with updated privacy policy templates to specifically cover this use of patient information.
Extraction of the data – The software is compliant with all applicable laws, including the Privacy Act 1988. All data will be de-identified at the point of extraction from the practice computer, and it will remain in a de-identified format during transmission and storage in a secure data warehouse which is only accessible by approved parties.
As an additional layer of security, the software will ensure no identifying information is extracted from free text fields on the patient record card.
The level of encryption employed by the software is compliant with best practice industry standards and will be routinely reviewed and updated to ensure that it remains compliant with relevant privacy legislation.
Warehousing (storage) of the data– The secure data warehouse was designed using best practice industry standards to ensure no de-identified data is capable of being easily accessed nor reidentified. The de-identified data will not be stored in any cloud system or publicly accessible data centre. The warehouse server is stored within a high security complex in Melbourne that ensures physical security measures are incorporated along with best practice industry standard technological security measures.
Analysis of the data – The data can only be accessed or analysed by Optometry Australia and its approved representatives, in accordance with strict security protocols. To bolster this, Optometry Australia will establish a data governance framework to ensure use of the data is legal, ethical and the project will sustainably deliver benefit to the public and profession.
Once a national optometry dataset is established, Optometry Australia aims to use a set of clinical indicators to analyse the extracted data. The clinical indicators will focus on measuring common community diseases and measuring these indicators will enable us to answer key questions about how and why people access primary eye healthcare provided by optometrists.
It is very unlikely that the software will cause any interruptions to your practice flow, or risks to your current practice cyber security measures.
The software can only extract data from Sunix or Optomate – it cannot extract data from other programs used on your computer.
When installing the software, the computer of choice should be the computer running the central server for the practice management software. The software will only need to be installed once and does not need to be installed on every computer in the practice. It is important to note that if one person owns multiple practices and they use one central storage location that collates data across all practices, all practices that link to this storage location will be involved in the project.
The software installation is simple and quick. Similar to installing other software on your computer you will be taken through a few screens and then depending on internet availability and computer speed the install should take no longer than a few minutes. Updating the software will occur automatically in an effort to save you any further interruptions.
Sunix and Optomate will run on PCs but are not compatible with Apple. We recognise that there may be practices running Microsoft on Apple devices using an emulator. In this instance there is no reason to believe the software should not work. However, we have been unable to test the software in this environment and can provide additional support if you have any issues running the software in this way.
More information about the project can be found on Optometry Australia’s website, here. If you have any other questions, our team are more than happy to assist. Please contact us at national@optometry.org.au or call us on (03) 9668 8500.
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In the spirit of reconciliation Optometry Australia acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respects to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.