Identification, data and technology
Information about Aboriginal and Torres Strait Islander patients and potential patients begins with identification. The national best practice guidelines for collecting Indigenous status in health data sets includes guidelines for asking the question, recording responses, and putting the guidelines into practice. Medicare also has a Voluntary Indigenous Identifier scheme, and there are special arrangements for people without documents who can have an approved referee, such as a community elder or minister of religion. A lack of documents may be the result of a birth failing to be registered, multiple birth dates and use of different names.
National Key Performance Indicators (nKPIs) for Aboriginal and Torres Strait Islander primary health care data is reported annually. nKPIs provide information about primary health care organisations that receive Commonwealth Department of Health funding and information on chronic disease burden, use of Team Care Arrangements, and detailed information on chronic disease management indicators. These KPIs also point to a service gap via a table comparing nKPI data with statistics for the non-Indigenous population in Australia or with the Australian total (including Indigenous people) when appropriate comparison data are available. Such data, along with detailed statistical information about jurisdiction and remoteness variation figures can be valuable for specialist service planning, integration with primary care, and staffing/administration support planning.
Electronic records are key to efficient recording of patient health information, and efficient and timely access to it. Electronic health records are particularly useful for patients who are mobile and/or have multiple health care providers. They can improve collaboration between health practitioners and between health services, reducing unnecessary duplication of tests (and reduce the inconvenience due to preventable appointments), reduce errors from handwriting, and provide for patient control and engagement with their health. Specific strategies and co-design processes are needed at the My Health Record implementation phase in order to gain the trust and active participation of Aboriginal and Torres Strait Islander people as well as medical specialists. Patients may have concerns about breaches of privacy and confidentiality which could have negative consequences for them and their family.
Telehealth is instrumental in reducing costs of specialist and patient travel, especially in rural and remote areas. It enables the provision of specialist consultations to patients in locations where a specialist is not physically available. Telehealth can be used to respond to inequitable service distribution and reduce travel costs paid for specialist travel, as well as ease the burden on patients, and often their carers, in travelling often long distances to access care. Effective telehealth for Aboriginal and Torres Strait Islander people and communities is an enabler of specialist care but also requires careful planning and education, including the capacity of primary health care practitioners to facilitate telehealth and support patients 'at the other end'. Telehealth is a useful means of supporting multidisciplinary care and professional development between staff.