Accuracy of national key performance indicator reporting from two Aboriginal medical services: potential to underestimate the performance of primary health care

Hill, Isaac, Johnson, David, Scrimgeour, David, and McDermott, Robyn (2018) Accuracy of national key performance indicator reporting from two Aboriginal medical services: potential to underestimate the performance of primary health care. Australian Health Review, 42 (4). pp. 453-460.

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Abstract

Objective: The aim of the present study was to assess the accuracy of extracting national key performance indicator (nKPI) data for the Online Community Health Reporting Environment for Health Services (OCHREStreams) program using the Pen Computer Systems (Leichhardt, NSW, Australia) Clinical Audit Tool (CAT) from Communicare (Telstra Health Communicare Systems, Perth, WA, Australia), a commonly used patient information management system (PIMS) in Aboriginal primary care.

Methods: Two Aboriginal Community-Controlled Health Services (ACCHSs) were recruited to the present study. A sample of regular clients aged ≥55 years from each ACCHS was selected and a subset of 13 nKPIs was examined. A manual case note audit of the nKPI subset within Communicare was undertaken by a clinician at each participating ACCHS and acted as a ‘gold standard’ comparator for three query methods: (1) internal Communicare nKPI reports; (2) PenCS CAT nKPI manual filtering (a third-party data-extraction tool); and (3) nKPI data submitted to the Improvement Foundation qiConnect portal.

Results: No errors were found in nKPI data extraction from Communicare using the CAT and subsequent submission to the qiConnect portal. However, the Communicare internal nKPI report included deceased clients and past patients, and we can be very confident that deceased clients and past patients are also included in the qiConnect portal data. This resulted in inflation of client denominators and an underestimation of health service performance, particularly for nKPIs recording activity in the past 6 months. Several minor errors were also detected in Communicare internal nKPI reports.

Conclusions: CAT accurately extracts a subset of nKPI data from Communicare. However, given the widespread use of Communicare in ACCHSs, the inclusion of deceased clients and past patients in the OCHREStreams nKPI data program is likely to have resulted in systematic under-reporting of health service performance nationally.

Item ID: 56988
Item Type: Article (Research - C1)
ISSN: 1449-8944
Copyright Information: Copyright © AHHA 2018. Open Access CC BY-NC-ND
Funders: Centre for Research Excellence for Prevention of Chronic Conditions in Rural and Remote High Risk Populations
Date Deposited: 12 Feb 2019 21:38
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111711 Health Information Systems (incl Surveillance) @ 50%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 50%
92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 50%
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