Most, if not all community controlled Aboriginal health services in the NT now use electronic clinical information systems with or without a parallel paper file system.
The main advantage of these clinical IT systems is that they are able to assist clinical staff ind eveloping effective recall systems for clinical followup, chronic disease management and preventive care purposes. Computers are increasingly being used to print prescriptions, print pathology and radiology request, and to store patients clinical record. They are also useful in generating reports of the health service utilisation, the client population, etc by a range of parameters (eg age and sex, location). They should be able to assist services to provide the accountability reports required by funding bodies, and alos assist in providing feedback to the community about their health issues.
As well, of course, computers are powerful tools for finances, human resources, and other administrative and management purposes. They also provide access to the internet which is rich in information both clinical and general.
However, using computers for clinical information requires robust processes that ensure the integrity of the information, and its security. Access to confidential information should be limited to authorised staff, and even then should only be accessed when there is a legitimate professional reason to do so.
We have included a basic policy for computers in health services in the policies and procedures section.
This is a critical issue. If the service is going to use Medicare Australia online for billing, they will require special security certificates to be installed to ensure data security. As well there are a range of security issues that will need to be in place if you use a network or the internet. Anti-viral software is essential as is a firewall. operating systems can also present some security problems and updates are regularly produced to increase security. These can be automaticallydownloaded and installed provided there is a connection to the internet, and the automatic update option selected.
The RACGP have set up a General Practice Computing Group (GPCG) which is the peak national body for GP informatics in Australian general practice. They have developed guidelines and checklist to assit in ensuring robust security for computing in general practice.
Backups are also essential. Most clinical software packages come with built in back up systems. However it is essential that adequate protocols operate in the health service to ensure that these are done regulalry and that copies are held off site as an added precaution. BAckups should alos be done for other uses of computers - general data, financial data, email, etc.
It is well documented that Aboriginal people in the NT are very mobile and often spend significant amounts of time in 2, 3 or 4 communtiies and access health services in these communites form time to time. Whilst much work has been done to standardise treatment protocols and available pharmaceuticals as much as possible, there is still a need.
AMSANT is involved with the Commonwealth Government on a project called HealthConnect which has the intent of providing clinical data securely accross the internet.