Beyond clinical decision support - improving the quality and completeness of patient information using an integrated health information system in the Northern Territory of Australia

Author(s)
Balasubramanya, Bhavya
Gorham, Gillian
Kamler, Paul
Talukder, Mohammad Radwanur
Coffey, Patrick
Chen, Winnie
Pascoe, Sophie
Abeyaratne, Asanga
Cass, Alan
Publication Date
2022-03-01
Abstract
Background: In the Northern Territory, integrated healthcare is challenged by a highly mobile population, siloed health services and lack of a unique identifier. Territory Kidney Care (TKC) is a digital clinical decision support tool that was developed to close this information gap. As patients often have multiple unconnected health records, data linkage is central to the functionality of TKC. Aims: To validate the automatic linkage protocol in TKC, identify false negatives and co-design feedback mechanisms to improve the quality and completeness of patient information. Methods: We examined audit reports to identify potential false negatives where patient records remain unlinked due to mismatch in name, date of birth (DoB), or health record number (HRN). This was checked by searching for corroborating information in source systems (corrected HRN or DoB) and establishing a feedback mechanism with health services. Results: Of the 72159 TKC patients, 38096 (52.8%) had records from multiple systems consisting of 14,703 (20.4%), 18,104 (25.1%) and 5,289 (7.3%) from 2, 3 and ≥4 health systems respectively. 750 (2.0%) patients had multiple unlinked records requiring investigation. We co-designed an efficient and secure process to communicate demographic advice between services with 429 patients subsequently linked, 6 records adjudged never to be linked,144 patient records updated with a universal identifier and 174 awaiting additional information. Conclusion: The TKC data linkage protocol improves the quality and completeness of patient information by enabling almost all available data to be linked, which generates a more comprehensive picture of the patient journey to inform clinical decision making.
Affiliation
Menzies School of Health Research
Menzies School of Health Research, Charles Darwin University
NT Health
NT Department of Health
Citation
Balasubramanya, B., Gorham, G., Kamler, P., Talukder, M. R., Coffey, P., Chen, W., Pascoe, S., Abeyaratne, A., & Cass, A. (2022). Beyond clinical decision support -- improving the quality and completeness of patient information using an integrated health information system in the Northern Territory of Australia...Renal Society of Australasia Annual Conference, June 16-18, 2022, Darwin, Northern Territory. Renal Society of Australasia Journal, 18, 44.
Link
MESH subject
Decision Support Systems, Clinical
Quality Improvement
Health Information Systems
Health Care Delivery, Integrated -- Australia
Title
Beyond clinical decision support - improving the quality and completeness of patient information using an integrated health information system in the Northern Territory of Australia
Type of document
Conference abstract
Entity Type
Publication

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