November 15, 2018

Health hubs: the changing face of Australian healthcare

Thanks to collaboration, groundbreaking hubs are connecting community, medicine, industry and academia – and creating opportunity.

Healthcare is on the edge of a frontier right now as, across the nation, a range of new and established health hubs work to design a future bringing together research, industry and community.

Despite Australia’s much reported healthcare issues (a rapidly ageing population and a health system groaning under the pressure), collaborative health and science clusters are creating a wealth of opportunity according to NAB’s Head of Corporate Health John McCarthy.

It’s big-picture thinking, he says, as well
as a willingness to collaborate to create an ‘ecosystem of healthcare’ rather than just individual siloed parts – managing the coordination of care across primary care, allied health, hospitals and other sectors.

“We’re not fully there yet but we’re seeing business models trying to do it more,” McCarthy explains, “and I think businesses get really enthused when they see health hub models and big institutions collaborating. It provides a lot of business confidence.”

The pioneers

Hunter Medical Research Institute (HMRI) was an early pioneer of this collaborative model between the University of Newcastle, the local health district and the community as a whole. Its achievements have placed the Hunter region on the global stage.

In New South Wales’s Illawarra, Wollongong University is building Australia’s first ever university-based retirement community – an innovation inspired partly by the patient- focused Mayo Clinic in the US and designed to be a hub for learning, research and preventative healthcare.

Down south, Adelaide is fast becoming a life sciences hotspot thanks to a new hi-tech health and medical precinct with state-of-the-art research facilities and strong ties to local hospitals and academia.

The idea that research is confined to labs
and hospitals is clearly starting to shift with this new wave of innovation and collaboration, providing health hubs that embed into the community. For many industry leaders, the idea is to bring key stakeholders together to form a future focused on preventative medicine.

HMRI in particular has grown hugely in 20 years – from a small regional centre to a world-class institute with 1,500 medical researchers, students and support staff.

“We’ve always had a strong focus on translational research, where you aim
to fast-forward selected scientific discoveries into clinical application and innovations as well,“ says former HMRI Director Professor Michael Nilsson. “Having the major players and partners integrated in our institute’s model has really facilitated those processes. It’s an important part of our DNA.”

He cites the recent sale of Viralytics – a cancer research firm originating at the University of Newcastle, supported by
HMRI and sold to pharmaceutical company Merck – as a major success story and one ofthe biggest biotech transactions in Australian history. Other examples include the areas of stroke and asthma, where leading research has been translated into new clinical applications and changed clinical practice. As further recognition of collective achievements, a group of interlinked partners including HMRI (NSW Regional Health Partners) earned recognition as an NHMRC Centre for Excellence in Regional Health.

“I’m proud of what HMRI has achieved, and the fact that colleagues from other countries often turn to us for discussions and collaboration,” Nilsson says. “Our healthcare issues and the increasing cost of healthcare makes it clear that we need this kind of research, new solutions and new models of care. I also think for the future we need to have a much more productive and developed collaboration between private and public providers, to solve problems and take on the challenges our society is facing.”

Increased pressures

One of the key challenges for Australian healthcare is our ageing population. By
2056, it’s projected there will be 8.7 million Australians over 65 (22 per cent of our population) and healthcare, aged care and the Age Pension will be the top three pressures over the next 50 years, according to the federal government’s 2013 An Ageing Australia: Preparing for the Future report. There are some health hubs, however, making aged care research, development and healthcare a priority.

Professor Alison Jones, Deputy Vice Chancellor (Health and Communities) at Wollongong University, is one of them. She’s heading up a project to build Australia’s first university-based retirement community.

“It’s a whole new health precinct that will include a primary community health centre with brand new models of patient-centred care,” Jones explains. “We’ll be building some independent living units, nursing home care
– and those residents will get the benefits of a university plus the opportunity for the very best healthcare. The new models of care will be used to teach our students, who’ll be exposed to very different forms of practice – much more allied health-led and doctor-enabled, and not so medically driven.”

Jones believes there’ll be a shift to smaller hospitals and more community-based care in the future. “What we want to do is really look at those modern opportunities around care, by designing the healthcare of the future, trying what works and what doesn’t, making that knowledge and information available to everyone. I think universities are just beginning to fully engage with the possibilities that come from interactions with industry, and we’ll be looking at bringing in commercial partnerships and developing strategic partnerships with other areas of best practice – both locally and internationally.”

A biomedical boom

Once known largely for its beautiful churches and great wine, the city of Adelaide is making a new name for itself thanks to its new state- of-the-art biomedical and life sciences health hub. Government-funded incentives and faster ethics approvals are also driving foreign investment from companies keen to do phase one clinical trials here – and the precinct is bolstering a local economy that’s struggled since the state’s car manufacturing decline.

As South Australia’s economy transitions, it’s moving in the direction of more knowledge- based activities and creating more sustainable jobs, says Marco Baccanti, Chief Executive of Health Industries South Australia. “Effectively, we have to move to sectors that are more sustainable,” he explains, “and life sciences is an obvious one to target; it’s a chapter in our bigger vision.”

Adelaide BioMed City is a $3.8 billion investment. It comprises the new Royal Adelaide Hospital, the South Australian Health and Medical Research Institute, and medical science research centres at the University of Adelaide and the University of South Australia. Next to join the precinct will be Australia’s only proton therapy unit, currently in development. The science and medical-focused Tonsley Innovation District – built on the former Mitsubishi manufacturing site – is a 61-hectare precinct where medical device companies collaborate with the Medical Devices Research Institute at Flinders University.

“In the past, Adelaide wasn’t your first thought for development or research – it’s not Sydney or Melbourne or Singapore,” Baccanti says, “but that’s changing. Because our regulatory framework is extremely fast and is paired with federal government incentives, we’re becoming extremely attractive for clinical trials, in particular for phase one.

“We’ve had a company that established
the manufacturing of miniaturised X-ray devices and we have a leading pharmaceutical company producing biologic drugs for chemotherapy by fermentation.”

McCarthy says Adelaide BioMed City is
one he’d love to see replicated in other states. “South Australia as a state had a problem – they needed to create jobs and boost the economy and the state government was put in the position where they said, ‘we’ll make this work, we’ll provide the incentives and we’ll provide the enabling tools to bring big business into South Australia’.”

A very different future

The healthcare space will look quite different in 10 years and the collaborative ‘health hub’ model can only be a good thing in bringing forth new models of care, industry leaders say.

“Think about the evolution of epidemiology and demography,” Baccanti says. “People are getting sick and dying from diseases related to their lifestyle, not to pathogens.
I mean metabolic, cardiovascular and neurodegenerative diseases, and the chronic characteristic of these diseases is affecting the sustainability of our healthcare systems, globally.

“It’s important to establish a strong, multi- stakeholder collaboration between academia, where the knowledge is generated; industry, where the knowledge becomes a product; and government, where the product is made legal and available in the community.”

Working to create better models of community-based care is also key, Nilsson adds. He has recently moved to a new position as the Director of the Centre for Rehab Innovations (CRI) at the University
of Newcastle. The centre will focus on technologies and methods to keep people out of hospital and support rehabilitation within the home.

“CRI will also synergise with a recently launched unique HMRI initiative on out-of- hospital care, working with ambulance staff and services to further develop their skills,” he explains.

“It’s our hope that new home- and community-based models of care, services and rehabilitation will help lessen the burden on the healthcare system.”

That’s Jones’s hope, too. “I think we’re just at the cusp of a new revolution in healthcare, and the lovely thing about it is that it will be delivered at the local community level, not in big ivory towers,” she says.

“It’s about serving the needs of our community close to where they live and where their families are.”

McCarthy is also positive about the future, hoping that Australia will attract more foreign investments to healthcare, bringing more money into the country.

“I think whenever you’ve got a problem it creates opportunity – and we need the state and federal governments to work together with the local community and with healthcare businesses, to enable them. If we can get that happening, then the future’s really bright.”