I am a geographer with experience in health, ageing, disability and multicultural issues. My PhD research was on the geography of Alzheimer's disease and I am interested in spatial science applications in the health, ageing and disability sectors including spatial visualisation as a tool for collaborative research and analysis. I am also writing in the areas of big data, health informatics, 'race', diversity and cultural heritage issues.
Can supervise: YES
Carnemolla, P, Srasuebkul, P, Robertson, H, Trollor, J & Nicholas, N 2020, 'Prevalence of intellectual disability in New South Wales, Australia: a multi-year cross-sectional dataset by Local Government Area (LGA)', Data in Brief, vol. 31.View/Download from: Publisher's site
© 2020 The Author(s) The presented dataset relates to a research project titled "My Home My Community" undertaken at University of Technology Sydney (UTS) which has been funded by the National Disability Insurance Agency (NDIA) Australia. The dataset reports estimated prevalence rates of Intellectual Disability in NSW by local government area (LGA) from 2010 – 2015. The dataset is a re-examination of a cohort of 92, 542 people with intellectual disability from a larger linked research dataset built by the Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW. The dataset in this paper is presented in a multi-year cross-sectional format. The cohort of people with Intellectual Disability was analysed to estimate, quantify and visualise where people with intellectual disability live in New South Wales (NSW). The cohort analysed in this dataset had been generated in an earlier project undertaken by the UNSW-based authors. This dataset was generated to share with local governments in Australia and has the potential to be more widely used in a range of health policy and planning research, and city and regional planning research environments. It represents one of the only datasets currently available in Australia on Intellectual Disability describing prevalence rates at a local government area level. This dataset allows for population comparisons in other Australian states and internationally and can be examined in combination with other social and economic datasets to continue to build evidence about disability, planning and geography.
Hinchcliff, R, Debono, D, Carter, D, Glennie, M, Robertson, H & Travaglia, J 2020, 'Options to enhance the veracity of Australian health service accreditation assessments', HEALTH INFORMATION MANAGEMENT JOURNAL.View/Download from: Publisher's site
Power, T, Kelly, R, Usher, K, East, L, Travaglia, J, Robertson, H, Wong, A & Jackson, D 2020, 'Living with diabetes and disadvantage: A qualitative, geographical case study.', Journal of clinical nursing, vol. 29, no. 13-14, pp. 2710-2722.View/Download from: Publisher's site
AIMS AND OBJECTIVES:To elucidate the experiences of people living with diabetes, residing in an urban diabetogenic area. BACKGROUND:Community-level social and environmental factors have a role to play in the development of type 2 diabetes mellitus. Socio-economic deprivation; high obesity rates; high access to fast foods; and multiculturalism contribute to higher rates of diabetes in some geographical areas. However, there is a lack of research examining people's experiences of living with diabetes in diabetogenic areas. The word diabetogenic implies that the phenomenon of interest contributes to the development of diabetes. DESIGN:Qualitative, geographical case study approach. METHODS:A convenience sample of 17 people living with diabetes in a diabetogenic, low-socio-economic urban area participated in face-to-face, semi-structured interviews. Interviews were audio-recorded, transcribed and analysed thematically. This paper adheres to the COREQ guidelines. FINDINGS:Four main themes were identified: 1. Diabetes fatalism: Inevitability and inertia; 2. Living with Inequity: Literacy and intersectionality; 3. Impersonal services: Intimidating and overwhelming; and, 4. Education in the community: Access and anecdotes. CONCLUSIONS:This study has highlighted the need to develop local solutions for local problems. In this geographical area, solutions need to address generally lower health literacy, how the community would prefer to receive diabetes education and the issue of diabetes fatalism. RELEVANCE TO CLINICAL PRACTICE:Findings from this study have highlighted a need to re-examine how diabetes education is delivered in communities that are already experiencing multiple disadvantages. There are research and practice connotations for how fatalism is positioned for people at high risk of developing diabetes.
Debono, D, Robertson, H & Travaglia, J 2019, 'Organisational communication as trespass: a patient safety perspective', Journal of Health Organization and Management, vol. 33, no. 7-8, pp. 835-848.View/Download from: Publisher's site
© 2019, Emerald Publishing Limited. Purpose: Significant, sustained improvement in patient safety has proved an intractable goal. Attempts to address persistent problems have largely focused on technical solutions to issues conceptualised as clinical, cultural or system based. While communication is at the core of many remediation strategies, the focus has remained largely on communication between clinicians or between clinicians and patients, and on creating centralised guidelines as communicative mechanisms to transmit approved practice. Yet, current attempts at improvement have had limited impact. The purpose of this paper is to highlight vital new ways of conceptualising and exploring the relations and actions that are meant to constitute safety within organisations. Design/methodology/approach: Utilising theory from social sciences, the authors reconceptualise trespass and transgression, traditionally positioned as infringements, as acts of resistance: mechanisms for intrusion which intentionally or unintentionally disrupt the territorial claims of professions and organisations to enhance patient safety. Findings: Drawing on the literature, research and professional experience, two forms of trespass are discussed: the intrusion of largely invisible and understudied ancillary staff into the world of clinicians; and the use of workarounds by clinicians themselves. In both cases, transgressors intend to increase rather than decrease patient safety and may, upon further examination, prove to do so. Originality/value: Trespasses and transgressions considered in this light offer the opportunity to make visible people, relationships and actions which have previously remained hidden in our understanding of, and therefore proposed solutions to, patient safety.
Amegbor, PM, Kuuire, VZ, Robertson, H & Kuffuor, OA 2018, 'Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana', Archives of Gerontology and Geriatrics, vol. 77, pp. 81-88.View/Download from: Publisher's site
© 2018 Elsevier B.V. The number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status.
Robertson, H & Nicholas, N 2018, 'Rising multimorbidity in our ageing world', Health Management Journal, vol. 18, no. 4, pp. 279-283.
The global population is ageing. This is not only a general demographic pattern but one with a variety of unique trajectories by country and region, and system-specific implications. A successful transition to the status of an aged society has implications for conventional medical approaches and health systems operations, which themselves have often emerged over decades in response to past problems and prevailing assumptions. These include the notion that people become ill from and tend to die due to one specific condition—as illustrated by health and insurance statistical systems globally (Kingston et al. 2018).
Robertson, H, Debono, D, Nicholas, N, Hinchcliff, R & Travaglia, J 2018, 'Health informatics as a spatial science: reflecting on technological and systemic change', HIM-Interchange Online, vol. 3, no. 8, pp. 26-29.
The field of health informatics has generally been seen
as developing separately from the spatial sciences.
Geography, cartography, surveying and a variety of
applied disciplines make enormous use of spatial
technologies, concepts and methods in their work.
These technologies are increasingly pervasive and
central to our emerging 'big data' environment in
which locational data quality and accuracy are central.
Health informatics is also a field now going beyond
the traditional hospital environment, especially as
factors such as population ageing and rising chronic
disease require outreach programs of various kinds and
growing sophistication. In this scenario, we suggest
that health information technology (HIT) and the spatial
sciences are converging at a rapid rate such that health
informatics will become increasingly spatial in character
In this short piece, we explore some of the factors
leading to this convergence and suggest that it is
not quite as novel as it might at first seem. Medical
geography and medical informatics, for example,
have a deeper history than is commonly known by
many health professionals. Cartographic methods
have long been utilised in some areas of public health,
international health and epidemiology. Climate change
and the demographic transition are also leading to
much more engagement between these two fields
of practice and healthcare. Climate change because
the flow-on effects of rising temperatures, and water
levels, are hugely significant for human health, and the
demographic transition because health status is closely
correlated with both affluence and ageing. Obviously,
in our increasingly complex world, information
management is central to our capacity to cope with and
address new problems arising from these complexities.
Health information management as a skill and
knowledge base can only grow in importance as the
systemic problems we face (and contribute to) become
more tightly interwoven.
Robertson, H 2017, 'Space, time and demographic change: A geographical approach to integrating health and social care', Journal of Integrated Care, vol. 25, no. 1, pp. 39-48.View/Download from: Publisher's site
© Emerald Publishing Limited. Purpose - The purpose of this paper is to explore the potential value of applying spatial science and technology to the issue of care integration across what are the often fragmented domains of health and social care provision. The issue of focus for this purpose is population ageing because it challenges existing information and practice silos. Better integration, the author proposes, needs to adopt a geographic approach to deal with the challenges that population ageing present to health and social care as they currently function in many countries. Design/methodology/approach - The approach utilised here explores the role that could be played by enhancing spatial perspectives in care integration. Spatial and temporal strategies need to be coordinated to produce systems of integrated care that are needed to meet the needs of growing numbers of older people. Findings - The author's premise is that, with some rare exceptions, geographies of care are needed to address important shifts in demography such as population ageing and their epidemiological consequences. The rising intersection between the ageing and disability concepts illustrates how the fluid nature of health and social care client groups will challenge existing systems and their presuppositions. Health and medical geography offer a theoretical and practical response to some of these emerging problems. Research limitations/implications - This is a brief conceptual piece in favour of integrating geographic concepts and methods in the context of changing demography and the social, economic and service implications of such changes. It is limited in scope and a more detailed explanation would be required for a proof of concept. Practical implications - Practically we know that all human services vary across space as do both healthcare and related social services and supports. Issues of quality and safety are numerous in these policy domains generally, with aged care evidencing ...
Robertson, H & Nicholas, N 2017, 'Digital landscapes of health and disability', GEO: connexion, vol. 16, no. 4, pp. 38-41.
Robertson, H, Nicholas, N, Dhagat, A & Travaglia, J 2017, 'A Spatial Dashboard for Alzheimer's Disease in New South Wales.', Studies in Health Technology and Informatics, vol. 239, pp. 126-132.View/Download from: Publisher's site
This paper illustrates a proof of concept scenario for the application of comprehensive data visualisation methods in the rapidly changing aged care sector. The scenario we explored is population ageing and the dementias with an emphasis on the spatial effects of change over time at the Statistical Area 2 (SA2) level for the state of New South Wales. We did this using a combination of methods, culminating in the use of the Tableau software environment to explore the intersections of demography, epidemiology and their formal cost of care implications. In addition, we briefly illustrate how key infrastructure data can be included in the same data management context by showing how service providers can be integrated and mapped in conjunction with other analyses. This is an innovative and practical approach to some of the complex issues already faced in the health and aged care sectors which can only become more pronounced as population ageing progresses.
Travaglia, J, Robertson, H, Nicholas, N & DHAGAT, A 2017, 'A Spatial Dashboard for Alzheimer's Disease in New South Wales.', Studies in Health Technology and Informatics, vol. 239, pp. 126-132.View/Download from: Publisher's site
Robertson, H, Nicholas, N, Travaglia, J, Hayen, A & Georgiou, A 2017, 'A Virtual Earth Model of the Dementias in China.', Studies in Health Technology and Informatics, vol. 245, pp. 569-572.View/Download from: Publisher's site
This developmental project was undertaken to explore how applying spatial science analysis and visualisation methods might inform societies undergoing significant structural and demographic change. China is rapidly transitioning to an aged society. It already exceeds all other countries in its population aged 65 years and over. Dementia is closely correlated with ageing and intersects with a variety of physical and cognitive disabilities. Information dashboards are a growing part of health and social policy data environments. These visual data applications increasingly include mapping capabilities. In this paper, we explore the utility of a geographic modelling approach to exploring the complex nature of population ageing and the dementias in China.
Robertson, H & Nicholas, N 2016, 'Older and wiser', GEO: connexion, vol. 15, no. 3, pp. 34-36.
Spatial dashboard systems can help combine older patients living far away and young doctors. Dashboards can also integrate geographic visualizations, as well as the usual bar charts and line graphs with which most people are already familiar. This means users can quickly move from the already familiar to the completely new, in terms of data access and visualizations. It also provides a platform for building spatial skills and methods as a growing audience becomes much more familiar with spatial science, technology and visual data access. A variety of basic spatial functions need to be integrated into standard health information systems to begin the trend to greater spatial literacy in the health sector. Basic spatial functions such as heat mapping, travel area or travel route analyses will become integral to both acute and non-acute healthcare systems management. Emerging technologies such a mobile monitoring devices will produce increasing volumes of real time health status data.
Robertson, H & Nicholas, N 2015, 'A healthy opportunity', GEO: connexion, vol. 14, no. 3, pp. 31-33.
The health and medical sector has a very mixed history of understanding and applying spatial concepts methods and technology to its problems. The heavy focus on clinical practices and administrative data has limited the range of opportunities for and understanding of the value of spatial knowledge in this sector, despite a variety of innovative projects including the Dartmouth Health Atlas and the Spanish Cancer Mapping project that illustrate the value of spatially enabled data to healthcare. One area of opportunity is to capitalize on periods of change and disruption in these complex and bureaucratic industries.
Radford, K, Mack, HA, Robertson, H, Draper, B, Chalkley, S, Daylight, G, Cumming, R, Bennett, H, Pulver, LJ & Broe, GA 2014, 'The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians', INTERNATIONAL PSYCHOGERIATRICS, vol. 26, no. 6, pp. 1033-1043.View/Download from: Publisher's site
Robertson, H & Nicholas, N 2014, 'Older and wiser', GEO: connexion, vol. 13, no. 6, pp. 36-38.
The article suggests ways in which advances in technology combined with geospatial techniques can help society to help its older members. Recent developments in spatial science have yet to be integrated into healthcare. Spatial technologies will soon be applicable not just to the analysis of health system problems, disease outbreaks and uneven treatment patterns but also to the real-time monitoring of infections in acute care hospitals or potential drug interactions in community dwelling older people. The huge growth in e-health, m-health and t-health technologies have the capacity to monitor the changing condition of frail older people and people with serious disabilities living in their own homes in the context of whole societies that are growing older. Another more developmental area to consider is if advances in spatial technology might assist older people in compensating for aspects of their physical and cognitive decline.
Robertson, H, Nicholas, N, Georgiou, A, Johnson, J & Travaglia, J 2014, 'Globalising health informatics: the role of GIScience.', Studies in health technology and informatics, vol. 205, pp. 1168-1172.
Health systems globally are undergoing significant changes. New systems are emerging in developing countries where there were previously limited healthcare options, existing systems in emerging and developed economies are under significant resource pressures and population dynamics are creating significant pressures for change. As health systems expand and intensify, information quality and timeliness will be central to their sustainability and continuity. Information collection and transfer across diverse systems and international borders already presents a significant challenge for health system operations and logistics. Geographic information science (giscience) has the potential to support and enhance health informatics in the coming decades as health information transfers become increasingly important. In this article we propose a spatially enabled approach to support and increasingly globalised health informatics environment. In a world where populations are ageing and urbanising and health systems are linked to economic and social policy shifts, knowing where patients, diseases, health care workers and facilities are located becomes central to those systems operational capacities. In this globalising environment, health informatics needs to be spatially enabled informatics.
Robertson, H, Nicholas, N, Rosenfeld, T, Georgiou, A, Johnson, J & Travaglia, J 2014, 'A virtual aged care system: when health informatics and spatial science intersect.', Studies in health technology and informatics, vol. 204, pp. 137-142.
Healthcare systems are increasingly adapting to address the issues associated with population ageing. The shift to chronic diseases and a rise in neuroepidemiological conditions, associated with rising life expectancies, means that continued change and accommodation will be required of our health and social support systems. Current social policy environments developed out of early approaches to state-supported health and welfare service provision, most now a century or more old. A feature of these systems has often been a formal separation between them, into silos, that does not and cannot effectively address the issues raised by a growing population of older people. This is especially true in the context of community-based care where the majority of older people currently live and where governments hope to keep more elderly people living into the future. This objective will require a far more sophisticated and responsive approach to the health information environment than is currently the case. One strategy for improving this scenario is the development of augmented and virtual environments that collect and analyse real-time data on which health professionals and support staff can act in a timely manner. In this paper we explore some aspects of a virtualised aged care system and provide some examples of how this would enhance our current strategies for aged care.
Robertson, H & Nicholas, N 2013, 'A healthy understanding', GEO: connexion, vol. 12, no. 10, pp. 30-33.
Hamish Robertson and Nick Nicholas examine how the healthcare sector is finding it difficult to adopt geospatial technologies due to the lack of even basic knowledge about their principles and potential. Health system comparison data is now integral to the World Health Organization, national health providers, health insurers and all the way down to individual hospitals and clinics. In an industry where costs only ever seem to rise, the need for continued and improved monitoring of costs and outcomes will only grow. And important societal trends, such as population ageing, will also require these developments and improvements. Disability characteristics, proxied here by need for assistance, are unevenly distributed in space and health care facilities need to understand who and where these people are. Uneven distribution entails uneven patterns of service demand including acute admissions through emergency departments, outpatient treatment demand and referrals as well as the need for outreach services and unmet needs in the community.
Debono, DS, Travaglia, J & Robertson, H 2018, 'Organisational communication as trespass: A patient safety perspective.', 11th International Organisational Behaviour in Healthcare Conference, Montreal, Canada.
Robertson, H, Carter, D & Travaglia, J 1970, 'A Sociological Examination of the Inquiry Mechanism in Healthcare: Where the Norm Becomes the Exception', Royal Commissions and Commissions of Inquiry Roundtable, University of Technology Sydney.
Robertson, H, Nicholas, N, Rosenfeld, T & Travaglia, JF 2014, 'Materiality, health informatics and the limits of knowledge production', IFIP Advances in Information and Communication Technology, 5th Working Conference on Information Systems and Organizations (ISO), pp. 132-148.
© IFIP International Federation for Information Processing 2014 Contemporary societies increasingly rely on complex and sophisticated information systems for a wide variety of tasks and, ultimately, knowledge about the world in which we live. Those systems are central to the kinds of problems our systems and sub-systems face such as health and medical diagnosis, treatment and care. While health information systems represent a continuously expanding field of knowledge production, we suggest that they carry forward significant limitations, particularly in their claims to represent human beings as living creatures and in their capacity to critically reflect on the social, cultural and political origins of many forms of data 'representation'. In this paper we take these ideas and explore them in relation to the way we see healthcare information systems currently functioning. We offer some examples from our own experience in healthcare settings to illustrate how unexamined ideas about individuals, groups and social categories of people continue to influence health information systems and practices as well as their resulting knowledge production. We suggest some ideas for better understanding how and why this still happens and look to a future where the reflexivity of healthcare administration, the healthcare professions and the information sciences might better engage with these issues. There is no denying the role of health informatics in contemporary healthcare systems but their capacity to represent people in those datascapes has a long way to go if the categories they use to describe and anal yse human beings are to produce meaningful knowledge about the social world and not simply to replicate past ideologies of those same categories.
Robertson, H, Nicholas, N, Georgiou, A, Johnson, J & Travaglia, J 2013, 'A spatial informatics for aged care.', Health Informatics: Digital Health Service Delivery - The Future is Now!, Health Informatics Conference (HIC), IOS Press, Adelaide, Australia, pp. 102-107.View/Download from: Publisher's site
Population ageing is the demographic process that characterises the first half of the twenty-first century. Australia's population is already ageing and the states and territories are ageing at different rates. Our understanding of the dementias remains limited and diagnosis in primary care settings is poor. Locating where older people with dementia are and how they are coping is an emerging need in health information management. In this paper we discuss how a spatially informed health information management system could support population ageing and the disconnected systems that address ageing. We illustrate this with examples from our work to show how spatial informatics can advance our understanding of and response to the implications of population ageing.