Applied Medical Intelligence® (AMI) Project Update

Completion of Final Milestone:
SAMI has now completed the 7th and final milestone of the major 3-year Applied Medical Intelligence® Project funded by the Queensland Government Smart State Initiative (RIPP). The achievements from this project include:

- development and implementation of a comprehensive clinical outcomes monitoring and improvement system and research framework
- successful implementation of SAMI-Net® registries for Radiation Metrics, Percutaneous Coronary Intervention (PCI), Electrophysiology (EP) and Cardiac Implantable Devices (CID) and capture of procedural data in cardiac catheterisation theatres at SAWMH following testing of methods and consultation with lead clinicians.
- mapping and migration of hospital legacy data into the SAMI-Net registries (involving procedural data from the past 15 years including Radiation Metrics/PCI and EP/CID)
- generation and implementation of appropriate control charts for the monitoring of Clinical Outcome Indicators in PCI, EP and CID.
- development of risk adjustment models using clinical data e.g. lesion failure.
- development of quality assurance and control processes
- development and implementation of procedures to assess data quality (through internal sampling, external audit processes and data quality reports).
- Bayesian networks to determine the cause-effect relationships between factors which contribute to improved clinical practice (e.g. through reduction of radiation usage).
- protocols related to the use of control charts for quantification of clinical performance e.g. signal investigation and response, feedback and data quality for application across all registries.

The outcomes of this project have led to the publication of eleven scientific articles in peer-reviewed journals and thirteen conference presentations at annual scientific meetings of professional bodies (the Cardiac Society of Australia and New Zealand, Health Informatics Society of Australia, Engineering and Physical Sciences in Medicine and Australian Biomedical Engineering, Australasian Conference on Safety and Quality in Health).

Going Forward:
The success of this project has strengthened our position to scale the unique research methods and technologies of AMI as a clinician-led clinical outcomes monitoring and quality improvement system to other clinical domains (i.e. in other specialties and in a whole-of-hospital setting). The initial cycle of integrating AMI into the neurology sub-specialty of deep brain stimulation at SAWMH has already been completed. The application of AMI at a whole-of-hospital level has formed the basis of applications to relevant grant bodies with which we propose to translate existing experience with data collection, monitoring and analysis into an integrated quality improvement process that is based on a complex systems approach at a medium-sized regional private hospitals.