Journal articles on the topic 'Medical records Australia'
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Michael, Robin. "Paperless Medical Records." Australian Medical Record Journal 19, no. 4 (December 1989): 149–54. http://dx.doi.org/10.1177/183335838901900404.
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Flinders Medical Centre (FMC) in South Australia has a storage problem. The space available for filing existing medical records is full, while the demand for additional storage continues its linear growth. The hospital plans to use this “crisis” as an opportunity to review the entire basis for the management of the medical record and pilot an optical disk system as a precursor to paperless medical records. There are many constraints to this objective, but many advantages if the scheme proves successful. Michael describes the events which precipitated this project and outlines the steps in FMC's planned progression to a paperless record. (AMRJ, 1989, 19(4), 149–154).
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Harrigan, Peter. "Ownership of medical records in Australia." Lancet 345, no. 8962 (June 1995): 1429. http://dx.doi.org/10.1016/s0140-6736(95)92612-7.
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Bomba, David, Kurt Svardsudd, and Per Kristiansson. "A comparison of patient attitudes towards the use of computerised medical records and unique identifiers in Australia and Sweden." Australian Journal of Primary Health 10, no. 2 (2004): 36. http://dx.doi.org/10.1071/py04024.
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This article compares the attitudes of Australian and Swedish patients towards the use of computerised medical records and unique identifiers in medical practices in Australia and Sweden. A Swedish translation of an Australian survey was conducted and results were compared. Surveys were distributed to patients at a medical practice in Sweden in 2003 and compared to the results of an Australian study by Bomba and Land (2003). Results: Based on the survey samples (Australia N=271 and Sweden N=55), 91% of Swedish respondents and 78% of Australian respondents gave a positive appraisal of the use of computers in health care. Of the Swedish respondents, 93% agreed that the computer-based patient record is an essential technology for health care in the future, while 86% of the Australian respondents agreed. Overwhelmingly, 95% of Swedish respondents and 91% of Australian respondents stated that the use of computers did not interfere with the doctor-patient consultation. Both groups preferred biometric identification as the method for uniquely identifying patients but differed in their preferred method to store medical information - a combination of central database and smart card for Australian respondents and central database for Swedish respondents. This analysis indicates that patient attitudes towards the use of computerised medical records and unique identifiers in Australia and Sweden are positive; however, there are concerns over information privacy and security. These concerns need to be taken into account in any future development of a national computer health network.
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Allen-Graham, Judith, Lauren Mitchell, Natalie Heriot, Roksana Armani, David Langton, Michele Levinson, Alan Young, Julian A. Smith, Tom Kotsimbos, and John W. Wilson. "Electronic health records and online medical records: an asset or a liability under current conditions?" Australian Health Review 42, no. 1 (2018): 59. http://dx.doi.org/10.1071/ah16095.
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Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital’s current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This causes inefficiencies in the recall of patient information and can potentially lead to incidences of adverse drug events. What does this paper add? This paper supports the concept of a shared medical record system using 200 audited patient records across five Victorian metropolitan hospitals, comparing the current information systems in place for healthcare practitioners to retrieve data. This research identifies the degree of concordance between these sources of information and in doing so, areas for improvement. What are the implications for practitioners? Implications of this research are the improvements in the quality, storage and accessibility of medical data in Australian healthcare systems. This is a relevant issue in the current Australian environment where no guidelines exist across the board in medical history documentation or in the distribution of discharge summaries to other healthcare providers (general practitioners, etc).
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Mair, Judith L. M. "Patient Access to Medical Records." Health Information Management 26, no. 3 (September 1996): 148–50. http://dx.doi.org/10.1177/183335839602600317.
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The issue of, and access to, medical records has been a contentious matter for some years in Australia. The recent High Court decision of Breen v Williams has clarified the law nationwide. The High Court confirmed that the ownership of medical records is vested in the creator of the records. The High Court further held that a patient has no right at law to access his or her medical records in the absence of any statute granting such a right, or other legal process.
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McAuley, Elise, Chandana Unnithan, and Sofie Karamzalis. "Implementing Scanned Medical Record Systems in Australia." International Journal of E-Adoption 4, no. 4 (October 2012): 29–54. http://dx.doi.org/10.4018/jea.2012100103.
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In recent years, influenced by the pervasive power of technology, standards and mandates, Australian hospitals have begun exploring digital forms of keeping this record. The main rationale is the ease of accessing different data sources at the same time by varied staff members. The initial step in this transition was implementation of scanned medical record systems, which converts the paper based records to digitised form, which required process flow redesign and changes to existing modes of work. For maximising the benefits of scanning implementation and to better prepare for the changes, Austin Hospital in the State of Victoria commissioned this research focused on elective admissions area. This structured case study redesigned existing processes that constituted the flow of external patient forms and recommended a set of best practices at the same time highlighting the significance of user participation in maximising the potential benefits anticipated. In the absence of published academic studies focused on Victorian hospitals, this study has become a conduit for other departments in the hospital as well as other hospitals in the incursion.
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Croll, P., B. Li, C. P. Wong, S. Gogia, A. Faud, Y. S. Kwak, S. Chu, et al. "Survey on Medical Records and EHR in Asia-Pacific Region." Methods of Information in Medicine 50, no. 04 (2011): 386–91. http://dx.doi.org/10.3414/me11-02-0002.
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SummaryObjectives: To clarify health record background information in the Asia-Pacific region, for planning and evaluation of medical information systems.Methods: The survey was carried out in the summer of 2009. Of the 14 APAMI (Asia-Pacific Association for Medical Informatics) delegates 12 responded which were Australia, China, Hong Kong, India, Indonesia, Japan, Korea, New Zealand, the Philippines, Singapore, Thailand, and Taiwan.Results: English is used for records and education in Australia, Hong Kong, India, New Zealand, the Philippines, Singapore and Taiwan. Most of the countries/regions are British Commonwealth. Nine out of 12 delegates responded that the second purpose of medical records was for the billing of medical services. Seven out of nine responders to this question answered that the second purpose of EHR (Electronic Health Records) was healthcare cost cutting. In Singapore, a versatile resident ID is used which can be applied to a variety of uses. Seven other regions have resident IDs which are used for a varying range of purposes. Regarding healthcare ID, resident ID is simply used as healthcare ID in Hong Kong, Singapore and Thailand. In most cases, disclosure of medical data with patient’s name identified is allowed only for the purpose of disease control within a legal framework and for disclosure to the patient and referred doctors. Secondary use of medical information with the patient’s identification anonymized is usually allowed in particular cases for specific purposes.Conclusion: This survey on the health record background information has yielded the above mentioned results. This information contributes to the planning and evaluation of medical information systems in the Asia-Pacific region.
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Carine, Fiona, and Anita Walker. "Establishing Electronic Patient Record Standards Using Paper-Based Record Functions and Standards." Health Information Management 27, no. 2 (June 1997): 78–82. http://dx.doi.org/10.1177/183335839702700207.
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The South Australian Health Commission has embarked on a long term project to establish an Electronic Patient Record (EPR) for South Australia. The process requires extensive evaluation at the conclusion of each phase of development using a range of existing and purpose-developed evaluation tools. This paper describes a purpose-developed evaluation tool that uses the functional aspects of, and existing standards for, paper-based medical records in hospitals as its basis. The resulting EPR Standards are a tool which can be used to establish a benchmark against which to evaluate the efficiency and effectiveness of an electronic patient record.
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Swerissen, Hal. "Editorial: Strengthening clinical governance in primary health and community care." Australian Journal of Primary Health 11, no. 1 (2005): 2. http://dx.doi.org/10.1071/py05001.
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Large numbers of people die each year in hospitals as a result of preventable errors. High profile cases like the Royal Bristol Infirmary in the UK or the King Edward Memorial Hospital in Western Australia highlight the problem in the popular media, putting pressure on governments, providers and the professions to improve safety and quality in hospitals. In Australia, the Quality in Australian Health Care study reviewed the medical records of 14,179 admissions to 28 hospitals and found that an adverse event occurred in 16.6% of cases, with 51% considered to have been preventable (Wilson et al., 1995).
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Wilkins, Julia. "The Royal Flying Doctor Service Flies to New Heights: The Journey of Health Information Management." Health Information Management Journal 38, no. 3 (October 2009): 51–55. http://dx.doi.org/10.1177/183335830903800308.
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The Royal Flying Doctor Service (RFDS) of Australia was founded in 1928 by the Reverend John Flynn to deliver health services to the people of the Australian Outback. In this unique environment the RFDS Queensland Section provides both Primary Health Care and Aeromedical services to rural and remote communities throughout Queensland. It provides health services from a hub and spoke model and its clinicians work very closely with other health service providers, such as Queensland Heath, within the communities it visits. Currently, the RFDS' health records are both paper and electronic and clinicians duplicate much of patient information and data between RFDS and non-RFDS health records. Introduction of an off-the-shelf electronic medical record (EMR) would not meet the RFDS' clinical and organisational needs because of complexity, the multidisciplinary nature of the teams and the lack of communication technology in the communities the RFDS visits. This article defines the vision for a health information system designed to meet the requirements of the RFDS, and describes its implementation throughout RFDS Queensland using the PRINCE2 project management methodology.
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Hirani, Kajal, Donald N. Payne, Raewyn Mutch, and Sarah Cherian. "Medical needs of adolescent refugees resettling in Western Australia." Archives of Disease in Childhood 104, no. 9 (July 3, 2018): 880–83. http://dx.doi.org/10.1136/archdischild-2018-315105.
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ObjectiveTo investigate the medical needs and socioeconomic determinants of health among adolescent refugees resettling in Western Australia.DesignComprehensive medical and socioeconomic health data of resettling adolescent refugees aged 12 years and above attending a Refugee Health Service over a 1-year period were analysed.ResultsMedical records of 122 adolescents, median (range) age of 14 (12–17) years, were reviewed. Socioeconomic vulnerabilities included dependence on government financial support (50%), housing issues (27%) and child protection service involvement (11%). Medical concerns included non-communicable disorders (85%), infectious diseases (81%), nutrition/growth (71%) and physical symptoms of non-organic origin (43%). One quarter (27%) of female adolescents had sexual/reproductive health issues. A median (range) of 5 (2–12) health concerns were identified for each adolescent with 49% requiring referral to subspecialty services.ConclusionResettling adolescent refugees are socioeconomically vulnerable with a range of medical issues that frequently require additional subspecialty health referrals.
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Tyner, Sophie E., Louise Hennessy, Lisa J. Coombs, and Jan Fizzell. "Analysis of Presentations to On-site Medical Units During World Youth Day 2008." Prehospital and Disaster Medicine 27, no. 6 (October 2, 2012): 595–600. http://dx.doi.org/10.1017/s1049023x12001240.
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AbstractWorld Youth Day 2008 was held in Sydney, Australia in July 2008. New South Wales (NSW) Health, the government health provider in Australia's most populous state, worked with partner agencies to provide medical services via on-site medical units at key event venues.A post-event review of medical records from the on-site medical units indicated 465 patient presentations, comprised largely of infectious respiratory symptoms and general health concerns of a primary care nature. Providing on-site health services is considered an important risk-mitigation action for many mass gatherings, especially those that generate a substantial temporary population of participants and take place over a number of days.TynerSE,HennessyL,CoombsLJ,FizzellJ.Analysis of presentations to on-site medical units during World Youth Day 2008.Prehosp Disaster Med.2012;27(6):1-6.
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McManus, Bill. "Patient access to medical records in Australia in the light of Breen v Williams." Monash Bioethics Review 14, no. 2 (April 1995): 38–43. http://dx.doi.org/10.1007/bf03351193.
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White, Saraya, and Warren Kealy-Bateman. "Primary evidence of seton therapy at Tarban Creek, New South Wales, 1839." Australasian Psychiatry 25, no. 3 (September 27, 2016): 293–96. http://dx.doi.org/10.1177/1039856216671666.
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Objective: We aimed to find and explore the earliest available New South Wales asylum medical records to identify any management or therapeutic data that might be of interest to the psychiatric field. Conclusions: The earliest known existing records of New South Wales asylum data are from Tarban Creek Asylum. After almost two centuries the preserved records allow insight into treatment used in early colonial Australia, including the scarcely remembered seton therapy. This finding highlights the importance of preserving historical records. It also demonstrates the necessity and/or evolving wish within the colony to care for patients with perceived mental health difficulties based on a shared medical culture inherited from techniques used in Britain.
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Morley, G. L., J. H. Matthews, I. Verpetinske, and G. A. Thom. "A Comparative Study Examining the Management of Bowen’s Disease in the United Kingdom and Australia." Dermatology Research and Practice 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/421460.
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Background and Aim. The optimum management of Bowen’s Disease (BD) is undefined. A review of current practice is required to allow the development of best practice guidelines.Methods. All BD cases, diagnosed in one UK centre and one Australian centre over a year (1 July 2012–30 June 2013), were analysed retrospectively. Patients with BD were identified from histopathology reports and their medical records were analysed to collect demographic data, site of lesion, and treatment used.Results. The treatment of 155 lesions from the UK centre and 151 lesions from the Australian centre was analysed. At both centres BD was most frequently observed on the face: UK had 70 (45%) lesions and Australia had 83 (55%) lesions (P=0.08). The greatest number of lesions was managed by the plastic surgery department in the UK centre, 72 (46%), and the dermatology department in the Australian centre, 121 (80%). The most common therapy was surgical excision at both centres.Conclusions. In both UK and Australia, BD arises on sun-exposed sites and was most commonly treated with surgical excision despite a lack of robust evidence-based guidelines.
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Deering, Patricia, Arthur Tatnall, and Stephen Burgess. "Adoption of ICT in Rural Medical General Practices in Australia." International Journal of Actor-Network Theory and Technological Innovation 2, no. 1 (January 2010): 54–69. http://dx.doi.org/10.4018/jantti.2010071603.
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ICT has been used in medical General Practice throughout Australia now for some years, but although most General Practices make use of ICT for administrative purposes such as billing, prescribing and medical records, many individual General Practitioners themselves do not make full use of these ICT systems for clinical purposes. The decisions taken in the adoption of ICT in general practice are very complex, and involve many actors, both human and non-human. This means that actor-network theory offers a most suitable framework for its analysis. This article investigates how GPs in a rural Division of General Practice not far from Melbourne considered the adoption and use of ICT. The study reported in the article shows that, rather than characteristics of the technology itself, it is often seemingly unimportant human issues that determine if and how ICT is used in General Practice.
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Almutairi, K., J. Nossent, D. Preen, H. Keen, K. Roger, and C. Inderjeeth. "AB0103 THE ACCURACY OF ADMINISTRATIVE HEALTH DATA FOR IDENTIFYING PATIENTS WITH RHEUMATOID ARTHRITIS: A VALIDATION STUDY USING MEDICAL RECORDS IN WESTERN AUSTRALIA." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1079.3–1080. http://dx.doi.org/10.1136/annrheumdis-2021-eular.335.
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Background:The use of large administrative health datasets is increasingly important in Rheumatology for disease trends and outcome research (1). We established the West Australian Rheumatic Disease Epidemiological Registry containing longitudinal health data for over 10000 patients with Rheumatoid Arthritis (RA) in Western Australia (WA). Accuracy of coding for RA is essential to validity of the datasets.Objectives:Investigate the diagnostic accuracy of International Classification of Diseases (ICD) based discharge codes for RA at WA’s largest tertiary hospital.Methods:Medical records for RA patients randomly selected from the hospital discharge database with ICD 10 codes (M05.00–M06.99) from 2008–2020 were retrospectively reviewed. Rheumatologist reported diagnosis and ACR/EULAR classification were used as gold standards to determine positive predictive value (PPV) with 95% Confidence Interval (CI) for RA primary diagnostic codes.Results:Medical chart review was completed for 87 patients (mean age 64.7 years, 67% female). Total of 80 (92%) patients had specialist confirmed RA diagnoses, while seven patients (8%) had alternate clinical diagnoses providing a PPV of 93.5% (95%CI: 89.9 to 95.86). Overall, 69 out 87 patients (79.3%) fulfilled ACR/EULAR classification criteria based on RA primary diagnostic codes with a PPV of 80.5% (95%CI: 76.81 to 83.7). A combination of a diagnostic RA code with biologic infusion codes in two or more codes increased the PPV to 97.9%.Conclusion:Hospital discharge diagnostic codes in WA identify RA patients with a high degree of accuracy. Combining a primary diagnostic code for RA with biological infusion codes can further increase the PPV.References:[1]Hanly et al. The use of administrative health care databases to identify patients with rheumatoid arthritis. Open Access Rheumatol 2015; 7: 69–75.Table 1.Accuracy measures of different algorithms for random sample of rheumatoid arthritis (RA) patients with one or more RA codes.Rheumatologist-reported diagnosisACR/EULAR classification criteriaAdministrative dataSNSPPPVNPVSNSPPPVNPVOne or more RA primary codes90%28.5%93.5%7.6%89.8%16.6%80.5%30%One or more RA biological infusion codes25%71.4%90.9%7.7%20.3%55.5%63.6%15.3%Two or more RA codes including biological codes60%85.7%97.9%15.8%56.5%44.4%79.6%21%RA=Rheumatoid Arthritis, SN=Sensitivity, SP=Specificity, PPV= Positive predictive value, NPV= Negative predictive value.Acknowledgements:Khalid Almutairi was supported by an Australian Government research training Program PhD Scholarship at the University of Western Australia.Disclosure of Interests:Khalid Almutairi: None declared, Johannes Nossent Speakers bureau: Janssen, David Preen: None declared, Helen Keen Speakers bureau: Pfizer Australia, Abbvie Australia, Katrina Roger: None declared, Charles Inderjeeth Speakers bureau: Eli Lilly
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Mazza, Danielle, Christopher Pearce, Lyle Robert Turner, Maria De Leon-Santiago, Adam McLeod, Jason Ferriggi, and Marianne Shearer. "The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research." Journal of Innovation in Health Informatics 23, no. 2 (July 4, 2016): 523. http://dx.doi.org/10.14236/jhi.v23i2.181.
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The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia. MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients. The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices. While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia
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Salmi, Liz, Selina Brudnicki, Maho Isono, Sara Riggare, Cecilia Rodriquez, Louise K. Schaper, Jan Walker, and Tom Delbanco. "Six countries, six individuals: resourceful patients navigating medical records in Australia, Canada, Chile, Japan, Sweden and the USA." BMJ Open 10, no. 9 (September 2020): e037016. http://dx.doi.org/10.1136/bmjopen-2020-037016.
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In the absence of international standards, widely differing attitudes and laws, medical and social cultures strongly influence whether and how patients may access their medical records in various settings of care. Reviewing records, including the notes clinicians write, can help shape how people participate in their own care. Aided at times by new technologies, individual patients and care partners are repurposing existing tools and designing innovative, often ‘low-tech’ ways to collect, sort and interpret their own health information. To illustrate diverse approaches that individuals may take, six individuals from six nations offer anecdotes demonstrating how they are learning to collect, assess and benefit from their personal health information.
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Fanning, Laura, Lilian Vo, Jenni Ilomäki, J. Simon Bell, Rohan A. Elliott, and Pēteris Dārziņš. "Validity of electronic hospital discharge prescription records as a source of medication data for pharmacoepidemiological research." Therapeutic Advances in Drug Safety 9, no. 8 (May 18, 2018): 425–38. http://dx.doi.org/10.1177/2042098618776598.
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Background: The advent of hospital electronic medical records (EMRs) with electronic prescribing provides considerable opportunity for pharmacoepidemiological research. However, validity of EMR prescribing data for research purposes is not well established. Validity concerns the percentage of cases in which medications and characteristics (name, type, formulation, dose) are true when verified with an independent data source. This study evaluated the validity of EMR discharge prescription data within the Eastern Health hospital network in Melbourne, Australia. Methods: A random sample of patients were selected who had a diagnosis of atrial fibrillation (AF) and were prescribed at least five medications. Prescription records from 2012 to 2015 were compared with pharmacy dispensing and hospital medical records (reference standards). Medication name, dose, directions and route of administration were compared. Discrepancies between data sources were categorized as omissions, additions, discrepancies in dose, medication form or route of administration or discrepancies in reordering. Sensitivities and 95% confidence intervals (CIs) for intended medication exposure were estimated for therapeutic classes. Results: A total of 5724 prescription orders for 479 patients for whom reference standards were available were included. There were 163 discrepancies (2.8%) between prescription records and reference standards. Additions were the most common data discrepancy ( n = 65; ~1.1% of total prescriptions evaluated), followed by discrepancies in reordering ( n = 34; 0.59%). Sensitivities for intended patient exposure to a medication for each therapeutic class at the first level of the Anatomical Therapeutic Chemical (ATC) classification system were between 97% and 100%. The genitourinary system and sex hormone level of the ATC system demonstrated the lowest sensitivity, (97.3%; 95% CI 92.0%–100%) and the cardiovascular system level demonstrated the highest sensitivity (99.9%; 95% CI 99.7%–100%). Conclusion: EMR discharge prescription records for patients with AF are a valid information source for conducting pharmacoepidemiological research within Eastern Health in Melbourne, Australia. Further studies in different regions, countries and patient cohorts are required to establish validity of hospital EMR prescription records for pharmacoepidemiological research.
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Luther, Matt, Fergus Gardiner, Shane Lenson, David Caldicott, Ryan Harris, Ryan Sabet, Mark Malloy, and Jo Perkins. "An Effective Risk Minimization Strategy Applied to an Outdoor Music Festival: A Multi-Agency Approach." Prehospital and Disaster Medicine 33, no. 2 (March 21, 2018): 220–24. http://dx.doi.org/10.1017/s1049023x18000195.
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Specific Event Identifiersa. Event type: Outdoor music festival.b. Event onset date: December 3, 2016.c. Location of event: Regatta Point, Commonwealth Park.d. Geographical coordinates: Canberra, Australian Capital Territory (ACT), Australia (-35.289002, 149.131957, 600m).e. Dates and times of observation in latitude, longitude, and elevation: December 3, 2016, 11:00-23:00.f. Response type: Event medical support.AbstractIntroductionYoung adult patrons are vulnerable to risk-taking behavior, including drug taking, at outdoor music festivals. Therefore, the aim of this field report is to discuss the on-site medical response during a music festival, and subsequently highlight observed strategies aimed at minimizing substance abuse harm.MethodThe observed outdoor music festival was held in Canberra (Australian Capital Territory [ACT], Australia) during the early summer of 2016, with an attendance of 23,008 patrons. First aid and on-site medical treatment data were gained from the relevant treatment area and service.ResultsThe integrated first aid service provided support to 292 patients. Final analysis consisted of 286 patients’ records, with 119 (41.6%) males and 167 (58.4%) females. Results from this report indicated that drug intoxication was an observed event issue, with 15 (5.1%) treated on site and 13 emergency department (ED) presentations, primarily related to trauma or medical conditions requiring further diagnostics.ConclusionThis report details an important public health need, which could be met by providing a coordinated approach, including a robust on-site medical service, accepting intrinsic risk-taking behavior. This may include on-site drug-checking, providing reliable information on drug content with associated education.LutherM, GardinerF, LensonS, CaldicottD, HarrisR, SabetR, MalloyM, PerkinsJ. An effective risk minimization strategy applied to an outdoor music festival: a multi-agency approach. Prehosp Disaster Med. 2018;33(2):220–224.
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Hume, Craig, Margee Hume, and Paul Johnston. "Creating Awareness and Practice." International Journal of Reliable and Quality E-Healthcare 5, no. 4 (October 2016): 1–14. http://dx.doi.org/10.4018/ijrqeh.2016100101.
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This paper focuses on the important area of aged care services as a national priority with this a priority for many countries worldwide. The paper uses the aged care sector as an exploratory artifact. The Australian aged care system is widely considered as innovative and provides the benchmark for many countries developing reforms and strategies for aged care. Many countries including Australia are faced with increasingly ageing populations, with this demographic burden creating the need for policy reform and the introduction of new programs to improve the quality of life of senior citizens. This research adopts a qualitative and exploratory approach advancing on previous research. The paper discusses the benefit of knowledge management and innovative approaches to patient medical records, funding reporting and basic accreditation records with particular emphasis on the long-term improvements in knowledge sharing for healthcare delivery. This paper proposes the ARCC@T framework for Knowledge Management in Aged Care.
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Sturgiss, Elizabeth, Nilakshi Gunatillaka, Lauren Ball, Tina Lam, Suzanne Nielsen, Renee O'Donnell, Chris Barton, et al. "Embedding brief interventions for alcohol in general practice: a study protocol for the REACH Project feasibility trial." BJGP Open 5, no. 4 (April 28, 2021): BJGPO.2021.0037. http://dx.doi.org/10.3399/bjgpo.2021.0037.
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BackgroundAlcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person’s alcohol use with advice to reduce health risks. Despite their effectiveness, ABIs are not routinely performed by clinicians. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices.AimTo explore the facilitators and barriers to increasing the uptake of ABIs in primary care, including acceptability, reach, adoption, fidelity, and sustainability.Design & settingA mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT).MethodThe implementation strategies and resources will be trialled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention.ConclusionThe study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.
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Bernardo, Carla De Oliveira, David Alejandro González‐Chica, Monique Chilver, and Nigel Stocks. "Influenza‐like illness in Australia: A comparison of general practice surveillance system with electronic medical records." Influenza and Other Respiratory Viruses 14, no. 6 (June 24, 2020): 605–9. http://dx.doi.org/10.1111/irv.12774.
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Kalnins, Nicole Jacqueline, Catriona Croton, Mark Haworth, Justine Gibson, Sarah Leonie Purcell, and Allison Jean Stewart. "A VetCompass Australia Study of Antimicrobial Use in Dog-to-Dog Bite Wounds (1998–2018)." Antibiotics 11, no. 1 (January 2, 2022): 55. http://dx.doi.org/10.3390/antibiotics11010055.
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Although dog-to-dog bite wounds (DBW) are a common presentation to veterinary clinics, antimicrobial prescribing habits of Australian clinics have not been reported. This study determined the frequency and results of DBW cultures; antimicrobial selection; and importance class of antimicrobials prescribed relative to wound severity, geographic location, or year. A systematic sample of 72,507 patient records was retrieved from the VetCompass Australia database. Records for 1713 dog bite events involving 1655 dogs were reviewed for presenting signs, results of culture and susceptibility testing (C&S), antimicrobial treatment, geographical location, and outcome. A crossed random effects multivariable logistic regression model was used to determine if antimicrobial importance was associated with wound severity, year, and location, and to assess the differences in antimicrobial prescription between geographical locations, clinics, and veterinarians. Antimicrobials were prescribed in 86.1% of DBW. Amoxicillin-clavulanic acid was prescribed in 70% (1202/1713) with underdosing in 15.8% (191/1202). High-importance antimicrobial use was associated with wound severity (p < 0.001), year category (p = 0.007), and surgery (p = 0.03). C&S testing was recorded as having been performed in only one case. Differences in individual veterinarian prescribing habits were stronger than the clinic culture, suggesting that education utilizing clinic-wide antimicrobial guidelines may aid in improving antimicrobial stewardship.
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Mulligan, Ea, and Annette Braunack-Mayer. "Why protect confidentiality in health records? A review of research evidence." Australian Health Review 28, no. 1 (2004): 48. http://dx.doi.org/10.1071/ah040048.
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We present the main arguments for protecting the confidentiality of health services, along with those for limiting confidentiality. These arguments are then substantiated by reference to research evidence. There is evidence that access to health care is restricted if confidentiality is not promised to some groups of patients. Fear of disclosure does diminish patients? candour, and this can compromise the quality of care. While patients are concerned about confidentiality and some are harmed by ?leaks? from health services, most people in Australia still trust health providers to keep their secrets, and patients rarely become aware of a breach of confidence. It has been claimed that strict protection of confidentiality may obstruct the pursuit of medical research and the use of electronic medical records. There is, as yet, no evidence that gaining full benefit from the use of electronic medical records entails reduced protection for confidentiality. The losses to epidemiological research if patient consent were always required are hotly debated. Confidentiality should be protected because it protects patients from harm, supports access to health care and produces better health outcomes.
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Boyle, Malcolm J., M. ClinEpi, Erin C. Smith, and Frank L. Archer. "Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia." Prehospital and Disaster Medicine 23, no. 1 (February 2008): 20–28. http://dx.doi.org/10.1017/s1049023x00005501.
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AbstractIntroduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.
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Pearce, Christopher, Adam McLeod, Jon Patrick, Jason Ferrigi, Michael Michael Bainbridge, Natalie Rinehart, and Anna Fragkoudi. "Coding and classifying GP data: the POLAR project." BMJ Health & Care Informatics 26, no. 1 (November 2019): e100009. http://dx.doi.org/10.1136/bmjhci-2019-100009.
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BackgroundData, particularly ‘big’ data are increasingly being used for research in health. Using data from electronic medical records optimally requires coded data, but not all systems produce coded data.ObjectiveTo design a suitable, accurate method for converting large volumes of narrative diagnoses from Australian general practice records to codify them into SNOMED-CT-AU. Such codification will make them clinically useful for aggregation for population health and research purposes.MethodThe developed method consisted of using natural language processing to automatically code the texts, followed by a manual process to correct codes and subsequent natural language processing re-computation. These steps were repeated for four iterations until 95% of the records were coded. The coded data were then aggregated into classes considered to be useful for population health analytics.ResultsCoding the data effectively covered 95% of the corpus. Problems with the use of SNOMED CT-AU were identified and protocols for creating consistent coding were created. These protocols can be used to guide further development of SNOMED CT-AU (SCT). The coded values will be immensely useful for the development of population health analytics for Australia, and the lessons learnt applicable elsewhere.
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Witkowski, Chris, Lara Kimmel, Elton Edwards, and Filip Cosic. "Comparison of the quality of documentation between electronic and paper medical records in orthopaedic trauma patients." Australian Health Review 46, no. 2 (November 9, 2021): 204–9. http://dx.doi.org/10.1071/ah21112.
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Objective The medical record is critical for documentation and communication between healthcare professionals. This study compared the completeness of orthopaedic documentation between the electronic medical record (EMR) and paper medical record (PMR). Methods A review was undertaken of 400 medical records (200 EMR, 200 PMR) of patients with operatively managed traumatic lower limb injury. The operative report, discharge summary and first and second out-patient reviews were evaluated using criteria designed by a senior orthopaedic surgeon and senior physiotherapist. The criteria included information deemed critical to the post-operative care of the patient in the first 6 weeks post-surgery. Results In all cases, an operative report was completed by a senior surgeon. Notable findings included inferior documentation of patient weight-bearing status on the operative report in the EMR than PMR group (P = 0.018). There was a significant improvement in the completion of discharge summaries in the EMR compared with PMR cohort (100% vs 82.5% respectively; P < 0.001). In the PMR group, 70.0% of discharge summaries were completed and adequately documented, compared with 91.5% of those in the EMR group (P < 0.001). At out-patient review, there was an improvement in documentation of weight-bearing instructions in the EMR compared with PMR group (81.1% vs 76.2% respectively; P = 0.032). Conclusion The EMR is associated with an improvement in the standard of orthopaedic medical record documentation, but deficiencies remain in key components of the medical record. What is known about the topic? Medical records are an essential tool in modern medical practice and have significant implications for patient care and management, communication and medicolegal issues. Despite the importance of comprehensive documentation, numerous examples of poor documentation continue to be demonstrated. Recently, significant changes to the medical record in Australia have been implemented with the conversion of some hospitals to an EMR and the implementation of the My Health Record. What does this paper add? Standards of patient care should be monitored continuously and deficiencies identified in order to implement measures for improvement and to close the quality loop. This study has highlighted that although there has been improvement in medical record keeping with the implementation of an EMR, the standard of orthopaedic medical record keeping continues to be below what is expected, and several key areas of documentation require improvement. What are the implications for practitioners? The implications of these findings for practitioners are to highlight current deficiencies in documentation and promote change in current practice to improve the quality of medical record documentation among medical staff. Although the EMR has improved documentation, there remain areas for further improvement, and hospital administrators will find these observations useful in implementing ongoing change.
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Wang, K., K. K. W. Yau, and A. H. Lee. "Factors Influencing Hospitalisation of Infants for Recurrent Gastroenteritis in Western Australia." Methods of Information in Medicine 42, no. 03 (2003): 251–54. http://dx.doi.org/10.1055/s-0038-1634357.
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Summary Objective: To determine factors affecting length of hospitalisation of infants for recurrent gastroenteritis using linked data records from the Western Australia heath information system. Methods: A seven-year retrospective cohort study was undertaken on all infants born in Western Australia in 1995 who were admitted for gastroenteritis during their first year of life (n = 519). Linked hospitalisation records were retrieved to derive the outcome measure and other demographic variables for the cohort. Unlike previous studies that focused mainly on a single episode of gastroenteritis, the durations of successive hospitalisations were analysed using a proportional hazards model with correlated frailty to determine the prognostic factors influencing recurrent gastroenteritis. Results: Older children experienced a shorter stay with an increased discharge rate of 1.9% for each month increase in admission age. An additional comorbidity recorded in the hospital discharge summary slowed the adjusted discharge rate by 46.5%. Aboriginal infants were readmitted to hospital more frequently, and had an adjusted hazard ratio of 0.253, implying a much higher risk of prolonged hospitalisation compared to non-Aborigines. Conclusions: The use of linked hospitalisation records has the advantage of providing access to hospital-based population information in the context of medical informatics. The analysis of linked data has enabled the assessment of prognostic factors influencing length of hospitalisations for recurrent gastroenteritis with high statistical power.
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Ellis, Louise A., Louise K. Wiles, Ruth Selig, Kate Churruca, Raghu Lingam, Janet C. Long, Charlotte J. Molloy, et al. "Assessing the quality of care for paediatric depression and anxiety in Australia: A population-based sample survey." Australian & New Zealand Journal of Psychiatry 53, no. 10 (August 8, 2019): 1013–25. http://dx.doi.org/10.1177/0004867419866512.
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Objective: We examine the prevalence of quality care (as measured by adherence to recommendations in clinical practice guidelines) for Australian paediatric patients (⩽15 years) with depression and/or anxiety, using data from the CareTrack Kids study; a population-based study of the quality of healthcare practice in inpatient and ambulatory healthcare settings. Methods: A multistage stratified sample identified records of 6689 children. Of these, 156 records were identified for depression and 356 for anxiety. These were assessed for adherence to 15 depression and 13 anxiety indicators, respectively, using a review of medical records. Results: Adherence to assessment and management guidelines was low for both conditions: assessment bundle (depression = 33%, 95% confidence interval = [20, 48]; anxiety = 54%, 95% confidence interval = [43, 64] and depression management bundle = 35%, 95% confidence interval = [15, 60]). Across both conditions, the highest adherence was recorded for indicators that addressed prescription of medications (e.g. venlafaxine, 100%; benzodiazepines, 100%; selective serotonin reuptake inhibitor, 94% and antidepressants, 91%), while compliance was the lowest for ensuring children with depression had an emergency safety plan (44%), informing parents of the risks and benefits of prescribed anxiety medication (51%) and assessment for other causes (59% for depression; 68% for anxiety). Conclusion: These findings suggest that strategies are needed to improve guideline adherence for mental health disorders in children and adolescents, particularly among general practitioners. Learning from these indicators could inform clinical prompts in electronic medical records, as well as links to additional information, to assist in decision-making and streamline work practices.
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Long, Janet C., Helena M. Williams, Shefali Jani, Gaston Arnolda, Hsuen P. Ting, Charlotte J. Molloy, Peter D. Hibbert, Kate Churruca, Louise A. Ellis, and Jeffrey Braithwaite. "Assessing the appropriateness of the management of upper respiratory tract infection in Australian children: a population-based sample survey." BMJ Open 9, no. 5 (May 2019): e026915. http://dx.doi.org/10.1136/bmjopen-2018-026915.
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ObjectiveTo assess the proportion of Australian children aged 0–15 years that received care in line with clinical practice guidelines (CPGs) for upper respiratory tract infections (URTIs).DesignRetrospective medical record review using a multistage sampling strategy.SettingGeneral practices, hospital emergency departments and hospital inpatient service providers in three Australian states.ParticipantsChildren aged up to 15 years who received care for URTI in 2012 and 2013.Primary and secondary outcome measuresThe primary assessment was estimated adherence with 14 indicators of appropriate care as documented in medical records. Indicators were extracted from national and international CPGs and ratified by experts. Secondary assessment was adherence to two bundles of indicators (diagnostic symptoms and medical history taking), where all indicators must be adherent for the bundle to be scored as adherent.ResultsThere were 1653 children with one or more assessments of URTI care to CPG adherence. Over half of the children were under 3 years of age, with roughly equal numbers of males and females. Three indicators had fewer than 25 visits so were not reported. Overall adherence ranged from 0.5% for ‘documented advice around antibiotics’ to 88.3% for ‘documentation of medical history’. Adherence with Bundle A (documentation of all three definitive symptoms) was 43.1% (95% CI 32.8% to 54.0%) and Bundle B (documentation of all four indicators of medical history) was 30.2% (95% CI 20.9% to 40.9%).ConclusionsURTIs in children are common, usually self-limiting, conditions that are allocated considerable resources. The results suggest that there may be a need for more thorough holistic assessment of the patient and improved documentation. Since inappropriate prescription of antibiotics for URTIs is still a known problem in Australia, there is a need for consistent, clear communication around antibiotics’ lack of impact on symptoms and a high association with undesirable side effects.
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Kitsos, Alex, Gregory M. Peterson, Matthew D. Jose, Masuma Akter Khanam, Ronald L. Castelino, and Jan C. Radford. "Variation in Documenting Diagnosable Chronic Kidney Disease in General Medical Practice: Implications for Quality Improvement and Research." Journal of Primary Care & Community Health 10 (January 2019): 215013271983329. http://dx.doi.org/10.1177/2150132719833298.
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Background: National health surveys indicate that chronic kidney disease (CKD) is an increasingly prevalent condition in Australia, placing a significant burden on the health budget and on the affected individuals themselves. Yet, there are relatively limited data on the prevalence of CKD within Australian general practice patients. In part, this could be due to variation in the terminology used by general practitioners (GPs) to identify and document a diagnosis of CKD. This project sought to investigate the variation in terms used when recording a diagnosis of CKD in general practice. Methods: A search of routinely collected de-identified Australian general practice patient data (NPS MedicineWise MedicineInsight from January 1, 2013, to June 1, 2016; collected from 329 general practices) was conducted to determine the terms used. Manual searches were conducted on coded and on “free-text” or narrative information in the medical history, reason for encounter, and reason for prescription data fields. Results: From this data set, 61 102 patients were potentially diagnosable with CKD on the basis of pathology results, but only 14 172 (23.2%) of these had a term representing CKD in their electronic record. Younger patients with pathology evidence of CKD were more likely to have documented CKD compared with older patients. There were a total of 2090 unique recorded documentation terms used by the GPs for CKD. The most commonly used terms tended to be those included as “pick-list” options within the various general practice software packages’ standard “classifications,” accounting for 84% of use. Conclusions: A diagnosis of CKD was often not documented and, when recorded, it was in a variety of ways. While recording CKD with various terms and in free-text fields may allow GPs to flexibly document disease qualifiers and enter patient specific information, it might inadvertently decrease the quality of data collected from general practice records for clinical audit or research purposes.
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Tinton, Inga, Lara Spence, and David H. Henry. "Highlights of BRCA genetic testing in prostate cancer from a real-world patient cohort in Australia." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e13574-e13574. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e13574.
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e13574 Background: There is an increase in interest and awareness in BRCA 1/2 testing recently. However, despite high awareness of these tests due to their frequent use among patients with certain cancer types such as ovarian cancer or breast cancer, BRCA testing is still only emerging in the prostate cancer (PC) treatment landscape. This study aims to understand what is driving the interest and use of BRCA testing in PC as well as the main barriers to testing in Australia. Methods: Between September 2019 and November 2019, n = 51 physicians of different specialties (n = 26 medical oncologists, n = 11 urologists, n = 14 pathologists) in Australia provided their quantitative and qualitative insights on BRCA testing. Medical oncologists and urologists (n = 37) also submitted patient tissue record forms of PC patients (n = 102) who received at least one biomarker test. The findings are derived from perceptual questionnaires, patient tissue record forms, and qualitative interviews. Results: The data suggests high (100%) awareness of BRCA testing in PC among medical oncologists and urologists, however that’s not the case among pathologists (36%). BRCA testing was seen in almost half of the patient records collected, primarily as blood tests (40%) as opposed to tissue (28%) or any other tests. Larger number (40%) of blood tests are carried out post-diagnosis with almost half (46%) of them initiated due to family history. Prior treatment history and patient request are more common patient selection criteria when deciding whether to test any PC patient for BRCA. The main barrier (64%) to BRCA testing is lack of funding/reimbursement for the test in PC at the moment. Only clinical trial PC patients typically have access to funded BRCA tests or those patients who are supported by the genetic counsellor program. Conclusions: Driven by significant uptake in ovarian and breast cancer and high awareness among oncologists and urologists, BRCA testing for prostate cancer is being increasingly used in the clinical setting in Australia. However, significant barriers remain; addressing these barriers should result in further uptake.
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Uddin, Ruby N. N., Nathan Ryder, Anna M. McNulty, Lynne Wray, and Basil Donovan. "Trichomonas vaginalis infection among women in a low prevalence setting." Sexual Health 8, no. 1 (2011): 65. http://dx.doi.org/10.1071/sh09147.
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Objectives: Trichomonas vaginalis has become rare in Australian cities but remains endemic in some remote regions. We describe the prevalence and associations of infection among women attending an urban Australian sexual health clinic. Methods: A retrospective case control study was conducted with women diagnosed with T. vaginalis at Sydney Sexual Health Centre between January 1992 and December 2006. Proforma medical records for all women were reviewed to extract demographic, behavioural and diagnostic variables using a predefined data collection instrument. Results: Over the 15-year period, 123 cases of T. vaginalis were diagnosed, with a prevalence of 0.40%. Factors independently associated with infection were older age, vaginitis symptoms (adjusted odds ratio (AOR) 6.47; 95% confidence interval (CI), 3.29–12.7), sex with a partner from outside Australia (AOR 2.33; 95% CI, 1.18–4.62), a concurrent (AOR 3.65; 95% CI, 1.23–10.8) or past (AOR 2.67; 95% CI, 1.28–5.57) sexually transmissible infection, injecting drugs (AOR 7.27; 95% CI, 1.43–36.8), and never having had a Papanicolaou smear (AOR 7.22; 95% CI, 2.81–18.9). Conclusions: T. vaginalis infection was rare in women attending our urban clinic. Rarity, combined with an association with sex outside Australia, points to imported infections accounting for a large proportion of T. vaginalis infections in an urban population. The association with never having had cervical cancer screening, along with injecting drug use, likely reflects an increased prevalence in those with reduced access to health services or poor health seeking behaviours.
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Detering, Karen M., Kimberly Buck, Marcus Sellars, Helana Kelly, Craig Sinclair, Ben White, and Linda Nolte. "Prospective multicentre cross-sectional audit among older Australians accessing health and residential aged care services: protocol for a national advance care directive prevalence study." BMJ Open 9, no. 10 (October 2019): e031691. http://dx.doi.org/10.1136/bmjopen-2019-031691.
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IntroductionAdvance care planning (ACP), an ongoing communication and planning process, aims to clarify a person’s values and preferences, so these guide decision-making if the person becomes unable to make his or her own decisions. Ideally, ACP results in completion of advance care directives (ACD), documents completed by competent people outlining their values, treatment preferences and/or appointment of a substitute decision-maker (SDM). ACDs are most effective at the point of care, where they can be used to inform treatment decisions. Australian governments fund initiatives and have developed policy to increase ACD completion rates. However, little is known about the prevalence of ACDs at the point of care in Australian health services, making ACP evaluation efforts difficult. This study aims to determine the prevalence of ACDs in records of older people in Australian hospitals, aged care facilities and general practices.Methods and analysisThis is a national multicentre cross-sectional prevalence study in selected aged care facilities, hospitals and general practices. Following a 2017 feasibility study, a new protocol incorporating key learnings was developed. Sites will be recruited via expression of interest process. Health records of people aged ≥65 years, admitted to or attending services on study day(s) will be audited by trained staff from sites. Site-level data will be collected during the expression of interest. The primary outcome is the presence of at least one ACD in the health record. Secondary outcomes include prevalence of other documented outcomes of ACP (by health practitioner(s)/family/SDM), assessment of ACD quality and content and concordance between the person’s documented preferences and any medical treatment orders. Individuals and sites characteristics where ACDs are present will be explored.Ethics and disseminationProtocol approval by Austin Health Human Research Ethics Committee, Melbourne, Australia (reference: HREC/18/Austin/109). Results will be disseminated via peer-reviewed journals and conferences. Participating sites and jurisdictions will receive individualised reports of findings.
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Adamson, Greg, and Rick Noble. "Interview." International Journal of Web Portals 2, no. 4 (October 2010): 45–51. http://dx.doi.org/10.4018/jwp.2010100105.
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Not-for-profit organisations are significant users of IT services, including Portals, for the use of public outreach and service delivery. While lacking the resources of the commercial sector, many not-for-profit organisations’ needs may be similarly complex if they are relying on a portal for service delivery to a vulnerable client sector, or for the protection of medical records. In this paper, the authors examine the experience of service delivery to two medium-sized not-for-profits in Melbourne, Australia.
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Churruca, Kate, Brian Draper, and Rebecca Mitchell. "Varying impact of co-morbid conditions on self-harm resulting in mortality in Australia." Health Information Management Journal 47, no. 1 (December 29, 2016): 28–37. http://dx.doi.org/10.1177/1833358316686799.
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Background: Research has associated some chronic conditions with self-harm and suicide. Quantifying such a relationship in mortality data relies on accurate death records and adequate techniques for identifying these conditions. Objective: This study aimed to quantify the impact of identification methods for co-morbid conditions on suicides in individuals aged 30 years and older in Australia and examined differences by gender. Method: A retrospective examination of mortality records in the National Coronial Information System (NCIS) was conducted. Two different methods for identifying co-morbidities were compared: International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) coded data, which are provided to the NCIS by the Australian Bureau of Statistics, and free-text searches of Medical Cause of Death fields. Descriptive statistics and χ2 tests were used to compare the methods for identifying co-morbidities and look at differences by gender. Results: Results showed inconsistencies between ICD-10 coded and coronial reports in the identification of suicide and chronic conditions, particularly by type (physical or mental). There were also significant differences in the proportion of co-morbid conditions by gender. Conclusion: While ICD-10 coded mortality data more comprehensively identified co-morbidities, discrepancies in the identification of suicide and co-morbid conditions in both systems require further investigation to determine their nature (linkage errors, human subjectivity) and address them. Furthermore, due to the prescriptive coding procedures, the extent to which medico-legal databases may be used to explore potential and previously unrecognised associations between chronic conditions and self-harm deaths remains limited.
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Hilton, Deborah Joy. "A literature review on COVID-19 [coronavirus] research specific to Australia including manuscripts on policy and media releases." Journal of Evidence-Based Healthcare 4 (March 8, 2022): e3846. http://dx.doi.org/10.17267/2675-021xevidence.2022.e3846.
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INTRODUCTION / OBJECTIVES: Comprehending the avalanche of statistical research on COVID-19 [coronavirus] is laborious. Predictions, forecasts, and diagnostic algorithms are important for planning, allocation, and meeting the needs of the increasing population disease burden. Statisticians must be aware of spreadsheets, databases, and calculation methodology to produce valid estimates. Policymakers, government officials, and planners interpret results and read reports without knowing calculation intricacies. Health care workers must be aware of scientific websites whilst they are under increasing stress due to aging populations and improved technology. It is important that context-specific information is sought, read, and understood. METHODS: A literature review was undertaken to find context-specific statistical research information on COVID-19. The author performed a Pubmed search, a search utilising the coronavirus MeSH terms (Medical Subject Headings), adding the additional MeSH terms of Australia AND policy, and then another search with media as a text word. RESULTS: The Pubmed search, utilising the MeSH (Medical Subject Headings) on coronavirus, adding the MeSH terms [Australia AND Policy] resulted in 52 records being retrieved. The Australian Government Department of Health website dedicated link listing coronavirus (COVID-19) news reports, statements, and media releases included 347 departmental media retrievals. CONCLUSION: The COVID-19 pandemic has posed itself as the most critical health issue of the 21st century. It is important to understand the quality evidence-based information within the context, specific to the reason for seeking information so that well-informed decisions are made that relate to preventative actions, early detection, and treatment options.
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Goldsbury, David E., Eleonora Feletto, Marianne F. Weber, Philip Haywood, Alison Pearce, Jie-Bin Lew, Joachim Worthington, et al. "Health system costs and days in hospital for colorectal cancer patients in New South Wales, Australia." PLOS ONE 16, no. 11 (November 29, 2021): e0260088. http://dx.doi.org/10.1371/journal.pone.0260088.
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Introduction Colorectal cancer (CRC) care costs the Australian healthcare system more than any other cancer. We estimated costs and days in hospital for CRC cases, stratified by site (colon/rectal cancer) and disease stage, to inform detailed analyses of CRC-related healthcare. Methods Incident CRC patients were identified using the Australian 45 and Up Study cohort linked with cancer registry records. We analysed linked hospital admission records, emergency department records, and reimbursement records for government-subsidised medical services and prescription medicines. Cases’ health system costs (2020 Australian dollars) and hospital days were compared with those for cancer-free controls (matched by age, sex, geography, smoking) to estimate excess resources by phase of care, analysed by sociodemographic, health, and disease characteristics. Results 1200 colon and 546 rectal cancer cases were diagnosed 2006–2013, and followed up to June 2016. Eighty-nine percent of cases had surgery, chemotherapy or radiotherapy, and excess costs were predominantly for hospitalisations. Initial phase (12 months post-diagnosis) mean excess health system costs were $50,434 for colon and $60,877 for rectal cancer cases, with means of 16 and 18.5 excess hospital days, respectively. The annual continuing mean excess costs were $6,779 (colon) and $8,336 (rectal), with a mean of 2 excess hospital days each. Resources utilised (costs and days) in these phases increased with more advanced disease, comorbidities, and younger age. Mean excess costs in the year before death were $74,952 (colon) and $67,733 (rectal), with means of 34 and 30 excess hospital days, respectively–resources utilised were similar across all characteristics, apart from lower costs for cases aged ≥75 at diagnosis. Conclusions Health system costs and hospital utilisation for CRC care are greater for people with more advanced disease. These findings provide a benchmark, and will help inform future cost-effectiveness analyses of potential approaches to CRC screening and treatment.
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Takano, Takako, Michio Akagi, Haruyoshi Takaki, Ryo Inuzuka, Yoshitsugu Nogimori, Hiroshi Ono, Masahide Kaneko, and Norifumi Hagiwara. "Sex differences in congenital heart disease in Down syndrome: study data from medical records and questionnaires in a region of Japan." BMJ Paediatrics Open 3, no. 1 (June 2019): e000414. http://dx.doi.org/10.1136/bmjpo-2018-000414.
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Reports indicate lower Down syndrome (DS) survival among females than among males in Australia, contrasting with female longevity in the general population. Using data on 1310 people with DS (626 females and 684 males) in Japan from five hospitals’ medical records and questionnaires completed by parents of people with DS, we investigated sex differences in congenital heart disease (CHD), which may be related to mortality. The CHD rate was significantly higher for females (354, 57%) than for males (338, 49%; p=0.010). Significantly more females (199, 32%) than males (175, 26%) underwent surgery for CHD (p=0.018).
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McBryde, Emma S., Judy Brett, Philip L. Russo, Leon J. Worth, Ann L. Bull, and Michael J. Richards. "Validation of Statewide Surveillance System Data on Central Line–Associated Bloodstream Infection in Intensive Care Units in Australia." Infection Control & Hospital Epidemiology 30, no. 11 (November 2009): 1045–49. http://dx.doi.org/10.1086/606168.
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Objective.To measure the interobserver agreement, sensitivity, specificity, positive predictive value, and negative predictive value of data submitted to a statewide surveillance system for identifying central line-associated bloodstream infection (BSI).Design.Retrospective review of hospital medical records comparing reported data with gold standard according to definitions of central line–associated BSI.Setting.Six Victorian public hospitals with more than 100 beds.Methods.Reporting of surveillance outcomes was undertaken by infection control practitioners at the hospital sites. Retrospective evaluation of the surveillance process was carried out by independent infection control practitioners from the Victorian Hospital Acquired Infection Surveillance System (VICNISS). A sample of records of patients reported to have a central line-associated BSI were assessed to determine whether they met the definition of central line–associated BSI. A sample of records of patients with bacteremia in the intensive care unit during the assessment period who were not reported as having central line–associated BSI were also assessed to see whether they met the definition of central line-associated BSI.Results.Records of 108 patients were reviewed; the agreement between surveillance reports and the VICNISS assessment was 67.6% (κ = 0.31). Of the 46 reported central line–associated BSIs, 27 were confirmed to be central line–associated BSIs, for a positive predictive value of 59% (95% confidence interval [CI], 43%–73%). Of the 62 cases of bacteremia reviewed that were not reported as central line–associated BSIs, 45 were not associated with a central line, for a negative predictive value of 73% (95% CI, 60%–83%). Estimated sensitivity was 35%, and specificity was 87%. The positive likelihood ratio was 3.0, and the negative likelihood ratio was 0.72.Discussion.The agreement between the reporting of central line–associated BSI and the gold standard application of definitions was unacceptably low. False-negative results were problematic; more than half of central line–associated BSIs may be missed in Victorian public hospitals.
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Simpson, Steve, and Richard Turner. "Four decades of anal cancer in Tasmania, Australia: what do the case data tell us?" Sexual Health 9, no. 3 (2012): 213. http://dx.doi.org/10.1071/sh11002.
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Background Anal cancer is a rare cancer analogous to cervical cancer, largely caused by exposure to oncogenic human papillomavirus. We have sought to study this disease in the epidemiologically distinct population of Tasmania. Methods: Medical records at all tertiary and secondary referral centres in Tasmania were audited for records with corresponding International Classification of Diseases (ICD)-10 codes. Statistical significances of trends were evaluated using Fisher’s exact test, logistic regression or linear regression. Results: Of ~1350 screening records, 170 cases of anal cancer were found with patient presentation during 1973–2010, corresponding to 132 patients. This cohort was mostly female (66.7%), with squamous cell histology (81.8%) and anal canal primaries (72.0%). Most cases were detected at Stage II or below and the majority remained disease-free after treatment. Relatively few cases had documentation of typical risk factors for anal cancer, such as HIV seropositivity, a history of cancer or smoking. After 2000, there was a trend towards a lower stage at presentation, correlating with an increased 5-year survival. After 2000, no anal margin tumours presented beyond Stage II; nearly half were detected in situ and none were fatal. For anal canal tumours, there was virtually no change in the mean stage at detection or in survival. Conclusion: This is the first case series of anal cancer in Tasmania. We find that in many ways, including symptoms and pathology at presentation, epidemiology is typical. However, our cohort is distinct in its paucity of known risk groups, including HIV-positive people, those with a history of cancer and smokers.
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Edmiston, Natalie, Erin Passmore, David J. Smith, and Kathy Petoumenos. "Multimorbidity among people with HIV in regional New South Wales, Australia." Sexual Health 12, no. 5 (2015): 425. http://dx.doi.org/10.1071/sh14070.
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Background Multimorbidity is the co-occurrence of more than one chronic health condition in addition to HIV. Higher multimorbidity increases mortality, complexity of care and healthcare costs while decreasing quality of life. The prevalence of and factors associated with multimorbidity among HIV positive patients attending a regional sexual health service are described. Methods: A record review of all HIV positive patients attending the service between 1 July 2011 and 30 June 2012 was conducted. Two medical officers reviewed records for chronic health conditions and to rate multimorbidity using the Cumulative Illness Rating Scale (CIRS). Univariate and multivariate linear regression analyses were used to determine factors associated with a higher CIRS score. Results: One hundred and eighty-nine individuals were included in the study; the mean age was 51.8 years and 92.6% were men. One-quarter (25.4%) had ever been diagnosed with AIDS. Multimorbidity was extremely common, with 54.5% of individuals having two or more chronic health conditions in addition to HIV; the most common being a mental health diagnosis, followed by vascular disease. In multivariate analysis, older age, having ever been diagnosed with AIDS and being on an antiretroviral regimen other than two nucleosides and a non-nucleoside reverse transcriptase inhibitor or protease inhibitor were associated with a higher CIRS score. Conclusion: To the best of our knowledge, this is the first study looking at associations with multimorbidity in the Australian setting. Care models for HIV positive patients should include assessing and managing multimorbidity, particularly in older people and those that have ever been diagnosed with AIDS.
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Taylor, Andrew, and Hanish Bagga. "Measures of Rheumatoid Arthritis Disease Activity in Australian Clinical Practice." ISRN Rheumatology 2011 (May 4, 2011): 1–7. http://dx.doi.org/10.5402/2011/437281.
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Objectives. To investigate which rheumatoid arthritis (RA) disease activity measures are being collected in patients receiving glucocorticoids, non-biologic or biologic disease-modifying antirheumatic drugs (DMARDs) in Australian rheumatology practice. Methods. A retrospective audit of medical records was conducted from eight rheumatology practices around Australia. Each rheumatologist recruited 30 consecutive eligible patients into the review, 10 of whom must have been receiving a biological agent for rheumatoid arthritis. Disease activity measures and radiographic assessments were collected from each patient's last consultation. For biologic patients, disease activity measures were also collected from when the patient was first initiated on the biological agent. Results. At last consultation, the disease measures that were recorded most often were ESR (89.2%), haemoglobin (87.5%), and CRP (84.2%). DAS28 was infrequently recorded (16.3%). The rate of recording disease activity measures for patients receiving biologic DMARDs decreased over time (mean 27 months). Conclusion. This review has shown inconsistency of RA activity measures being recorded in Australian rheumatology clinical practice. An accurate assessment of the disease process is necessary to effectively target rheumatoid arthritis patients to treat in order to achieve optimal outcomes.
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Thomas, Laura A., Eleanor Milligan, Holly Tibble, Lay S. Too, David M. Studdert, Matthew J. Spittal, and Marie M. Bismark. "Health, performance and conduct concerns among older doctors: A retrospective cohort study of notifications received by medical regulators in Australia." Journal of Patient Safety and Risk Management 23, no. 2 (March 21, 2018): 54–62. http://dx.doi.org/10.1177/2516043518763181.
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Objectives To determine whether ‘older doctors’ (aged over 65) are at higher risk of notifications to the medical regulator than ‘younger doctors’ (aged 36–60 years) regarding their health, performance and/or conduct. Design Retrospective cohort study. Setting National dataset of 12,878 notifications lodged with medical regulators in Australia between 1 January 2011 and 31 December 2014. Participants All registered doctors in Australia aged 36–60 and >65 years during the study period. Main outcome measures Incidence rates of notifications and incidence rate ratios of notifications (older versus younger doctors). Results Older doctors had higher notification rates (90.9 compared with 66.6 per 1000 practitioner years, p < 0.001). Sex-adjusted incidence rate ratios showed that older doctors had a higher risk of notifications relating to physical illness or cognitive decline (incidence rate ratio = 15.54), inadequate record keeping (incidence rate ratio = 1.98), unlawful use or supply of medications (incidence rate ratio = 2.26), substandard certificates/reports (incidence rate ratio = 2.02), inappropriate prescribing (incidence rate ratio = 1.99), disruptive behaviours (incidence rate ratio = 1.37) and substandard treatment (incidence rate ratio = 1.24). Older doctors had lower notification rates relating to mental illness and substance misuse (incidence rate ratio = 0.58) and for performance issues relating to problems with procedures (incidence rate ratio = 0.61). Conclusions Older doctors were at higher risk for notifications relating to physical or cognitive impairment, records and reports, prescribing or supply of medicines, disruptive behaviour and treatment. They were at lower risk for notifications about mental illness or substance misuse. Incorporating knowledge of these patterns into regulatory practices, workplace adjustments and continuing education/assessment could enhance patient care.
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Hamilton, Lauren, and Shirley Wyver. "Parental Use and Views of the Child Personal Health Record." Australian Educational and Developmental Psychologist 29, no. 1 (July 2012): 66–77. http://dx.doi.org/10.1017/edp.2012.2.
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In New South Wales, Australia, the Child Personal Health Record (CPHR, aka ‘The Blue Book’, which includes notes on health and development) is proclaimed as an important document with widespread use throughout the state. Despite the significance of the record, there are few published evaluations of the efficacy of the CPHR. Parental use and views of the CPHR were examined using a two-phase, mixed-method design. One hundred and twenty mothers completed an online questionnaire, which included questions on demographics, use and views of the CPHR and child care experience. Six of these mothers participated in a follow-up interview. Perceived value of the CPHR was at its highest when the child was younger and if the child was first-born. The CPHR is used by medical professionals, yet broadening its use may increase efficiency of information transfer and promote parent understanding of developmental records, especially on growth indicators such as head circumference, which are not well understood. Implications for CPHRs as an empowering tool for families are considered.
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Musich, Shirley, Dan Hook, Stephanie Baaner, and Dee W. Edington. "The Association of Two Productivity Measures with Health Risks and Medical Conditions in an Australian Employee Population." American Journal of Health Promotion 20, no. 5 (May 2006): 353–63. http://dx.doi.org/10.4278/0890-1171-20.5.353.
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Purpose. To investigate the impact of health on job performance using two measures of productivity loss: (1) a self-reported measure of health-related presenteeism and (2) an objective measure of absenteeism. Design. A cross-sectional survey using a Health Risk Appraisal (HRA) to evaluate self-reported presenteeism and the prevalence of 12 health risks and eight medical conditions. Setting and Subjects. Employees (n = 224) of a private insurance provider in Australia. Measures. A Health Risk Appraisal (HRA) questionnaire was used to evaluate self-reported presenteeism on different aspects of job demands and to assess the prevalence of 12 health risks and eight medical conditions. Illness absent hours were obtained from company administrative records. Results. Increased presenteeism was significantly associated with high stress, life dissatisfaction, and back pain, while increased illness absenteeism was significantly associated with overweight, poor perception of health, and diabetes. Excess presenteeism associated with excess health risks (productivity loss among those with medium- or high-risk status compared to those with low-risk status) was independently calculated at 19.0% for presenteeism and 12.8% for illness absenteeism. Conclusions. This study demonstrates an association between health metrics and self-reported work impairment (presenteeism) and measured absenteeism. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss.
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Morrow, Melanie, Hollie Sekulich, Abigail Trewin, and Peter Archer. "Immunization Readiness of a Deploying Emergency Medical Team." Prehospital and Disaster Medicine 34, s1 (May 2019): s137—s138. http://dx.doi.org/10.1017/s1049023x19003030.
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Introduction:It is a requirement for a World Health Organization verified Emergency Medical Team (EMT) that all members be immunized against common diseases in the deploying region. Most jurisdictions use private suppliers such as travel doctors for immunization services. When a deployment is announced, members are nominated by their jurisdiction under the condition they are fully immunized. It is up to the individual to monitor their immunization status.Aim:To determine how many members nominated for deployment were fully immunized.Methods:Nominated members sent their completed vaccination record to a central location for assessment of their immunization status. The following data were recorded: vaccination status, last-minute booster doses required, and the number of emails sent by the assessor in processing the records. The number of phone calls made and received were not recorded.Results:To complete the skills matrix for a field hospital containing an emergency department and operating theater (an EMT type 2), 61 members were nominated. At the time of assessment, 32 (52%) were fully immunized, requiring no further booster doses (vaccinations or serology tests). Three members were removed from the deployment as they were not fully immunized. Last-minute booster doses were required by 27 (44%) members, with a total of 74 booster doses administered (range 0-5). 19 of the booster doses administered were immunizations required to work in any health facility in Australia. The most common vaccines requiring booster doses were rabies (n=21) and typhoid (n=15). 58 emails were sent over a period of 5 days to 24 members to clarify vaccination status.Discussion:This deployment highlighted a gap in members’ perception of their immunization status, leading to delays in deployment readiness for the team. A new electronic system where vaccine status tracking occurs in real time should address this issue.
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Hendrie, Delia, Sonja E. Hall, Gina Arena, and Matthew Legge. "Health system costs of falls of older adults in Western Australia." Australian Health Review 28, no. 3 (2004): 363. http://dx.doi.org/10.1071/ah040363.
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The aim of this study was to determine the health system costs associated with falls in older adults who had attended an emergency department (ED) in Western Australia. The data relating to the ED presentations and hospital admissions were obtained from population-based hospital administrative records for 2001?2002. The type of other health services (eg, outpatient, medical, community, ancillary and residential care), the quantity, and their cost were estimated from the literature. In adults aged 65 years and above, there were 18 706 ED presentations and 6222 hospital admissions for fall-related injuries. The estimated cost of falls to the health system was $86.4 million, with more than half of this attributable to hospital inpatient treatment. Assuming the current rate of falls remains constant for each age group and gender, the projected health system costs of falls in older adults will increase to $181 million in 2021 (expressed in 2001?02 Australian dollars). The economic burden to the health services imposed by falls in older adults is substantial, and a long-term strategic approach to falls prevention needs to be adopted. Policy in this area should be targeted at both reducing the current rate of falls through preventing injury in people from high-risk groups and reducing the future rate of falls through reducing population risk.