A prominent Victorian tertiary specialist hospital, one of Evora’s long-standing partners, faced a substantial and high-stakes challenge. A legal firm acting on behalf of women involved in a class action against manufacturers of defective pelvic mesh implants had lodged a Freedom of Information (FOI) request. These implants had caused profound and life-altering complications for thousands of women, and hospitals nationwide were required to provide comprehensive patient data related to the procedures in which these products were used. The objective was to identify additional women who had not yet been included in the class action and to offer them an opportunity to pursue legal recourse.
Evora was entrusted with the responsibility of navigating this complex data retrieval process, a task fraught with both technical and historical challenges. The FOI required the hospital to produce detailed patient and procedural records dating back several decades, long before data collection methods had achieved contemporary standards of consistency and accuracy. Many of these surgeries dated back as far as 1998, a period during which the hospital relied on the iSoft iPM Patient Administration System (PAS) to register patients and maintain waiting list records. Although the iSoft platform had been acquired by multiple vendors over the years, Evora was able to meticulously extract, transform, and refine the archival data into a format suitable for modern analysis.
Solving for Inconsistencies in Historical Data
The first major challenge lay in isolating the relevant surgical procedures. The FOI demanded precision in identifying patients who had undergone procedures involving the use of the defective implants. However, with both the Victorian Admitted Episodes Dataset (VAED) and the Elective Surgery Information System (ESIS) in their formative stages at the time of these procedures, the available data was fragmented and inconsistent. Evora’s team employed advanced data-matching techniques to align key diagnostic codes—such as ICD codes N81 (Female Genital Prolapse) and N39.3 (Stress Incontinence)—with corresponding procedure codes from ESIS (e.g., Code 230 for Cystocoele and Rectocoele) and surgical codes such as ICD 70.94 and 79.95 (Insertion of mesh or prosthesis for pelvic floor defect repair).
With these parameters in place, a cohort of potentially affected patients was identified. However, identifying the specific product implanted in each procedure presented another layer of complexity. The hospital’s theatre management system, ORMIS, had been retired and was not initially integrated with more modern systems. Evora accessed and restructured this data, which contained vital metadata on prostheses used during the surgeries. Yet, further difficulties arose: information on the exact implant model and manufacturer was frequently recorded in free text, shorthand, or even as acronyms.
From Data Fragmentation to Precision: Advanced Data Matching Techniques
To address this, Evora developed sophisticated search algorithms capable of identifying variations and phonetically similar product names, meticulously cleansing the dataset to ensure that all entries were cross-referenced and reconciled with other available data points. The Australian Government’s Prosthesis List, which catalogues medical devices and their associated costs, had not been implemented into ORMIS at the time of the procedures. Thus, Evora integrated data from the General Ledger via the Victorian Cost Data Collection (VCDC) to ensure that all prostheses were appropriately matched with financial records, validating the integrity of the dataset and ultimately delivering a highly accurate patient list.
Delivering Critical Outcomes for the Hospital and Patients
Through a combination of technical rigour, domain expertise, and innovative data solutions, Evora enabled the hospital to meet its FOI obligations within the demanding legal and regulatory timeframes. More crucially, Evora's efforts uncovered the identities of over 100 women who had received the faulty implants, allowing them to be contacted by legal representatives and invited to join the class action. This case contributed significantly to a historic $300 million settlement, offering crucial financial support for the women affected by the defective medical devices and facilitating their access to necessary medical care and recovery resources.
Evora: Driving Impact Through Expertise and Innovation
This case study exemplifies Evora’s ability to extract value from even the most fragmented and challenging healthcare datasets. Our unwavering commitment to precision and our deep understanding of healthcare data environments enabled the hospital to fulfil a highly sensitive request, all while empowering affected patients to pursue justice. At Evora, we transform data challenges into meaningful, actionable insights—delivering long-term impact for healthcare providers and the communities they serve.
