NCRI conference

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NCRI conference

• Dr Davida De La Harpe
• Assistant National Director of Population Health

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• A Population Health approach is one which
  promotes and protects the health of the whole
  population or sub-groups, with particular
  emphasis on reducing Health Inequalities

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Our Mission OurFundamental Purpose

• To enable people
• live healthier and
• more fulfilled lives

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Population Health Function

• A Population Health Approach includes the
• Following
• Using the best health intelligence for planning,
  evaluation and performance management
• Planning for health and not just health services
• Promoting equity as a strong value in the health
  system
• Applying research evidence to improve health
  outcomes
• Adopting a formal approach to needs assessment to
  identify gaps in the service
• Re-orientating service delivery from hospitals to
  primary care and health promotion
• Providing services which are integrated within
  the health sector and with those of other sectors
• Working with other sectors to improve health to
  include public involvement
• Demonstrating a better return for society from
  investment in health

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Population Health Structure
Population Health
HR
Health Intelligence
Health Promotion
Health Protection
Emergency Planning
Strategic Planning
Environmental Health
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Cancer story from registry data

• Improvement in survival from some cancers,
  regional variations, international benchmarking
  of services
• Quality and access issues

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Cancer-related health disparities occur among all
people

• Combination of factors - genes- individual
  behaviours- social and environmental
  circumstances.
• How biological and behavioural factors determine
  risks for developing or dying from cancer?
• How interventions can modify these risks?
• We know much less, especially in Ireland, about
  the effects of social position, economic status,
  cultural beliefs and practices, and environmental
  exposures on cancer risk and outcomes

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Population healthparticular interests

• population-based research in cancer epidemiology
• surveillance and modelling
• behavioural aspects of cancer prevention and
  screening,
• use of preventive and screening strategies.
• Public health queries- clusters
• Exposures?
• Health atlas

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PHIS

• PHIS. Currently we have data available on all
  cancers registered between 1994-2002 inclusive by
  gender, by county, by site of cancer (eg,breast)
  and by ICD-10 code.

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Immediate issues

• NCR data invaluable for clusters/planning.
• bring ED coded data into the Atlas and allow
  selective access etc.
• current geocoding and the absence of a sensible
  address zip code a real problem
• (Huge effort to overcome that is not
• really sustainable on a national basis)

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Registry data

• population-based research into the causes,
  prevention and early detection of cancer,
  including surveillance and monitoring studies

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Registry data linked to population health

• new knowledge about the impact and causes of
  cancer, including a further understanding of
  attitudes, behaviours and beliefs about cancer
  that can be addressed through public education
  and prevention campaigns
• Health promotion links

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Quality of cancer care

• defining, measuring, monitoring, and improving
  the quality of cancer care, decision making on
  cancer care delivery, coverage, regulation, and
  standards setting.
• staging data- is it done quality of care ?
• - also may reflect awareness and access issues
• registry as basis for qualitative work with
  staff and patients

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Health intelligence role

• enhance information, knowledge and resource
  exchange among researchers, care providers and
  policy makers and the public
• Feed in directly to reviews, service planning,
  horizon scanning

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Health intelligence

• Intelligence is experience integrated and
  realised. Our journey involves unlearning what we
  know, seeing things in new ways and engaging
  dynamically in evolving how we perceive
  everything. It starts by knowing where we are and
  where we want to go. Knowledge is having
  information. Intellect is the ability to use it.
• Intelligence is the gift of seeing beyond it,
  seeing new relationships and thinking laterally,
  outside the box, it is the power of applying and
  abstracting dynamically. (M. E. Meegan)
• Applying this to our services and a population
  health approach

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Things we need to do

• Enhance capacity
• work across boundaries within and outside the HSE
• use the information we have in a better way
• Develop more innovative approaches to
  information and knowledge management
• Addresses -coding
• Health identifier? (UKCRC)
• ? Legislation to allow better linking of patient
  information ( UKCRC Report -UK clinical
  research collaboration)

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NCRI and Cancer Programme

• Enhanced working relationships
• Under one roof
• Reduction of duplication
• Sharing of resources and knowledge
• Enhanced capacity
• An intelligent approach

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Summary

• Population health / health intelligence
• Current and future linkages with NCRI
• Greater opportunities to work together and build
  on existing good working relationships
• Thank you