"Help us modernise our 17 year old community focussed electronic health record."
- Communicare CEO
A completely redesigned health record that makes documentation and preventative care much easier.
There's an unacceptable gap between the health of Aboriginal and non-Aboriginal Australians.
Aboriginal and Torres Straight Islander Australians:
- Die 10 to 17 years earlier than other Australians
- Experience much higher rates of preventable illness such as heart disease, kidney disease and diabetes
- Have babies who die at more than twice the rate of other Australian babies
Close the Gap is a campaign for Indigenous Health Equality. The campaign's goal is to close the health and life expectancy gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians within a generation. Reaching the goal requires the input from the entire community, health organisations and government.
Software plays a critical role too. Communicare is an electronic health record that has been used by health organisations in remote communities for an amazing 17 years. In 2006 Communicare's data highlighted the incredibly high rates of alcohol related visits to ED in a remote community. The government and community then introduced a ban on selling take-away alcohol which reduced those rates by 48%.
Communicare hired us to design a future vision for their software. To experience the difference in healthcare first hand we visited the Kimberley and interviewed health organisations from remote communities across Australia. We shadowed nurses in towns with only 2 or 3 buildings and visited larger hospitals across the region. It was a chaotic, real and eye opening experience. A crucial input into the redesign of Communicare.
What we learned about healthcare in Aboriginal communities...
Health organisations need to reach out to patients
Many Aboriginal people only seek medical help when there's a serious problem which, is usually too late. Health clinics need to reach out to patients instead of the other way around. A clinic will create a list of people who are at risk, Aboriginal liaisons jump in the car and drive around town until they find everyone and convince them to visit the clinic for a check up. Communicare can detect high risk patients and alert care providers so they can reach out to patients early. This is crucial to help prevent the onset of chronic diseases.
Health literacy is much lower
Health education is extremely important. For example, there's a huge problem with Foetal Alcohol Spectrum Disorders or FASD. There are prominent campaigns throughout the towns communicating the dangers of drinking alcohol during pregnancy.
Communicare has the data to recommend content based on community or individual trends, allowing the nurse to teach patients about health topics during a checkup.
Travel is part of healthcare
Getting patients to the clinic can be more work than the procedure itself. The clinics often organise and pay for travel as most people don't own cars. They'll even send a helicopter to get patients if necessary. One hospital transfers patients around using the linen van. Care providers need more than just a health record, so Communicare helps people make travel arrangements for their patients.
Contacting patients can be difficult
Some people might spend 6 months in one town then move 100 kms to spend time with other family members in a different community. A family might share one mobile phone between them. You can't always just say "pop back in a few weeks and we'll see how you're recovering." Clinics never know when they'll get the chance to see a patient again so they need to make the most of each visit. During the visit, Communicare alerts the nurse of all the things they should check on with the patient and their family.
Doctors are often part time
Doctors often fly in from Sydney or Melbourne for a two week stay in a remote town. They don't get time to build relationships with patients and they definitely don't get time to learn how to use each piece of software a hospital has. Communicare is being designed so that people pick it up and know how to use it with minimal training.
Software like Communicare can make a big difference for both the individual and the community but it needs to be approached differently to health records designed for major cities. Our research highlighted the many complexities of healthcare in Aboriginal communities. It helped us understand what these amazing health professionals need from their software to build healthier communities.