Implementing computerised Aboriginal and Torres Strait Islander health checks in primary care for clinical care and research: a process evaluation

Geoffrey Kp Spurling,Deborah A Askew,Philip J Schluter,Noel E Hayman

doi:10.1186/1472-6947-13-108

Geoffrey Kp Spurling, Deborah A Askew + Show 2 more

Open Access

https://doi.org/10.1186/1472-6947-13-108

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Abstract

BackgroundPaper-based Aboriginal and Torres Strait Islander health checks have promoted a preventive approach to primary care and provided data to support research at the Inala Indigenous Health Service, south-west Brisbane, Australia. Concerns about the limitations of paper-based health checks prompted us to change to a computerised system to realise potential benefits for clinical services and research capability. We describe the rationale, implementation and anticipated benefits of computerised Aboriginal and Torres Strait Islander health checks in one primary health care setting.MethodsIn May 2010, the Inala Indigenous Health Service commenced a project to computerise Aboriginal and Torres Strait Islander child, adult, diabetic, and antenatal health checks. The computerised health checks were launched in September 2010 and then evaluated for staff satisfaction, research consent rate and uptake. Ethical approval for health check data to be used for research purposes was granted in December 2010.ResultsThree months after the September 2010 launch date, all but two health checks (378 out of 380, 99.5%) had been completed using the computerised system. Staff gave the system a median mark of 8 out of 10 (range 5-9), where 10 represented the highest level of overall satisfaction. By September 2011, 1099 child and adult health checks, 138 annual diabetic checks and 52 of the newly introduced antenatal checks had been completed. These numbers of computerised health checks are greater than for the previous year (2010) of paper-based health checks with a risk difference of 0.07 (95% confidence interval 0.05, 0.10). Additionally, two research projects based on computerised health check data were underway.ConclusionsThe Inala Indigenous Health Service has demonstrated that moving from paper-based Aboriginal and Torres Strait Islander health checks to a system using computerised health checks is feasible and can facilitate research. We expect computerised health checks will improve clinical care and continue to enable research projects using validated data, reflecting the local Aboriginal and Torres Strait Islander community’s priorities.

Highlights

Paper-based Aboriginal and Torres Strait Islander health checks have promoted a preventive approach to primary care and provided data to support research at the Inala Indigenous Health Service, south-west Brisbane, Australia
In a 2007 audit of adult Aboriginal and Torres Strait Islander paper-based health check (HC) at the Indigenous Health Service (IIHS), 42% of participants came from the 4077 postcode area, with remaining participants distributed among 50 other postcodes across Queensland and Northern New South Wales [10]
IIHS primary health care practice software led to some computerised HCs not being completed as nursing staff no longer physically handed the paper HC to medical staff for completion

Summary

Introduction

Paper-based Aboriginal and Torres Strait Islander health checks have promoted a preventive approach to primary care and provided data to support research at the Inala Indigenous Health Service, south-west Brisbane, Australia. In Australia, improved clinical systems and research opportunities in urban Aboriginal and Torres Strait Islander primary health care are likely to be required to help meet the Australian Government’s ambitious target to close the gap in life expectancy between Indigenous and nonIndigenous Australians within a generation [1]. In the effort to close the life expectancy gap, an important clinical tool for primary care is the Australian Government funded annual well-person’s health check (HC) for Aboriginal and Torres Strait Islander peoples of all ages. These checks were intended to increase preventive health opportunities, detect chronic disease risk factors and reduce inequities in access to primary care for Aboriginal and Torres Strait Islander peoples [4]. While ethnicity was not an exclusion criteria for the most recent systematic review of HCs, all the included studies were conducted in North America or Europe and no information about the impact of health checks on Indigenous populations was presented [6]

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