Abstract
Background: The burden of chronic conditions is growing in Australia with people in remote areas experiencing high rates of disease, especially kidney disease. Health care in remote areas of the Northern Territory (NT) is complicated by a mobile population, high staff turnover, poor communication between health services and complex comorbid health conditions requiring multidisciplinary care.
Aim: This paper aims to describe the collaborative process between research, government and non-government health services to develop an integrated clinical decision support system to improve patient care.
Methods: Building on established partnerships in the government and Aboriginal Community-Controlled Health Service (ACCHS) sectors, we developed a novel digital clinical decision support system for people at risk of developing kidney disease (due to hypertension, diabetes, cardiovascular disease) or with kidney disease. A cross-organisational and multidisciplinary Steering Committee has overseen the design, development and implementation stages. Further, the system’s design and functionality were strongly informed by experts (Clinical Reference Group and Technical Working Group), health service providers, and end-user feedback through a formative evaluation.
Results: We established data sharing agreements with 11 ACCHS to link patient level data with 56 government primary health services and six hospitals. Electronic Health Record (EHR) data, based on agreed criteria, is automatically and securely transferred from 15 existing EHR platforms. Through clinician-determined algorithms, the system assists clinicians to diagnose, monitor and provide guideline-based care for individuals, as well as service-level risk stratification and alerts for clinically significant events.
Conclusion: Disconnected health services and separate EHRs result in information gaps and a health and safety risk, particularly for patients who access multiple health services. However, barriers to clinical data sharing between health services still exist. In this first phase, we report how robust partnerships and effective governance processes can overcome these barriers to support clinical decision making and contribute to holistic care.
| Original language | English |
|---|---|
| Article number | 69 |
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | BMC Medical Informatics and Decision Making |
| Volume | 24 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 2024 |
Bibliographical note
Funding Information:This manuscript has been published on behalf of the Territory Kidney Care Steering Committee. Membership at time of writing included: Jenny Jobst Miwatj Health Aboriginal Corporation NT; Nathan Garrawurra Miwatj Aboriginal Corporation NT; Susan Clarke Katherine West Health Board NT; Nathan Rosas Wurli Wurlinjang Health Service NT; Rebecca Bond Sunrise Health Service NT; Rama Nair NT Cardiac Pty Ltd; Bernie Cummins NT Primary Health Network; Liz Moore Aboriginal Medical Services Alliance Northern Territory; John Boffa and Sam Heard Central Australian Aboriginal Congress NT; Satpinder Daroch NT Department of Corporate and Digital Development; Andrew Bell, Sean Taylor, Karen Stringer, Paul Burgess, Priyantha Wijesurendra, Asanga Abeyaratne, Pratish George, Louise Maple-Brown and Nadarajah Kangaharan NT Health; Alan Cass and Gillian Gorham Charles Darwin University NT.
Publisher Copyright:
© The Author(s) 2024.
