None listed
Conditions
Brief summary
Based on our prior research we have found that a large number of people are missing out on best practice care and this is leading to many avoidable deaths, especially from heart attack and stroke. HealthTracker is an electronic system that provides tailored management advice to staff and patients to reduce the risks of heart attack and stroke. There is a large body of international evidence that has shown electronic decision support systems lead to better quality care. Despite this, development of these systems in Australia has been limited and HealthTracker is the first of its kind to be used in primary health care services. In the study, we will conduct: 1. Health service audits at the beginning and again at the end of 12 months. Anonymous data is collected on how well cardiovascular risk factors are measured and whether people at high risk of heart attack or stroke are being prescribed the recommended medicines. Comparisions will be made between the group who received the HealthTracker software and the group that did not. 2. Interviews with selected health staff and patients are being conducted to understand the usefulness and acceptability of HealthTracker. 3. Video or audio recording of some healthcare consultations between staff and patients will be conducted to better understand how HealthTracker is actually used in practice.
Interventions
Using a cluster randomised controlled trial design, 60 sites (30 intervention and 30 control) from 40 general practices and 20 Aboriginal Community Controlled Health Services will be recruited. The intervention arm will receive the electronic decision support system for a period of 12 months. Features of HealthTracker include:
(1) Point of care decision support providing screening and management recommendations based on national guidelines; (2) A risk communication interface for discussing CVD m
Using a cluster randomised controlled trial design, 60 sites (30 intervention and 30 control) from 40 general practices and 20 Aboriginal Community Controlled Health Services will be recruited. The intervention arm will receive the electronic decision support system for a period of 12 months. Features of HealthTracker include: (1) Point of care decision support providing screening and management recommendations based on national guidelines; (2) A risk communication interface for discussing CVD management options with patients; (3) Access to a clinical audit tool that will provide immediate feedback on performance against a range of CVD-related indicators; (4) participation in a quality improvement component in which de-identified, peer-ranked monthly reports will be provided along with support to develop strategies to improve performance. Health staff will use some or all of these features at their discretion.
Sponsors
The George Institute for Global Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
35 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Health service inclusion criteria: 1. Use of Medical Director or Best Practice for Electronic Health Record management. 2. Exclusive use of these systems to record risk factor information, pathology test results and prescribe medications. Services using 'hybrid' paper and electronic system for these features will not be eligible. 3. Agreement that all GPs and other designated staff are willin g to use the HealthTracker-CVD system. Patient inclusion criteria: 1. Aboriginal and Torres Strait Islander people 35+ years and all others 45+ years AND 2. Attendance at least 3 times in the previous 24 month period AND at least once in the previous 6 month period
Exclusion criteria
Patients will be excluded from the study if they do not have an attendence of at least 3 times in the previous 24 month period AND at least once in the previous 6 month period. Age exclusion - Aboriginal and Torres Strait Islander patients age less than 35+ years and non Aboriginal / Torres Strait island age less than 45+ years will not be recruited.
Outcome results
None listed