Background:

PAMS returned from being operated by an Administrator to Community Control in June 2009 with the appointment of a salaried CEO in March 2010.  The new CEO and Board of Directors determined that quality industrial strength support systems needed to be acquired as a foundation for improving the provision of comprehensive primary health care to the 1,800 or so Aboriginal and non-Aboriginal residents of the East Pilbara.  Currently, four remote clinics are operated although, to increase access, PAMS plans to provide clinic services to 2 additional remote communities and to Newman in 2011, expanding the regular client base from over 800 to hopefully reach almost 100% of the 1,800 Aboriginal people of the region.

Requirements:

The PAMS Strategic Plan requires “the re-design the Information and Communications Technology infrastructure to significantly improve technology support for clients, permanent staff and locums and to introduce Personally Controlled Electronic Health Records (PCEHR) to facilitate communications with other providers in the primary, secondary and tertiary health sectors”.

One of the drivers for the re-design is PAMS’ success at attracting CoAG Funding for Patient Journey, Chronic Disease, Mothers and Babies, and Health Promotion programs.  All these initiatives require timely effective and accurate communications between practitioners, providers, clients and the communities and all of which would be adversely affected by the lack of telecommunications infrastructure and rapid progress towards the uptake of eHealth benefits such as Shared Electronic Health Records.

A number of costed proposals had been prepared for various grant and other funding applications.  These prior PAMS’ investments were consolidated into an action plan entitled Health e-Records and the url www.healthe-records.com.au was acquired.

Issues to be addressed also included staff retention, without internet access for staff in their accommodations in remote areas it is difficult to recruit and retain staff.  There are not only their considerations of retaining contacts with family and colleagues but also being able to access the increasing number of professional development resources available on the internet.

Tasks:

1.  acquire, deploy, install, commission and monitor reliable and usable internet connections for each of the remote clinics.

2. acquire install, commission and monitor servers that could deliver the Communicare Patient Information and Recall System, within which PAMS’ clients’ data resides over the new telecomms infrastructure in a reliable and usable manner, despite the lack of a web-based interface to Communicare and its client-server approach to application delivery.

3. introduce Shared Electronic Health Records using a web-based patient information system, MMEx, in collaboration with the University of Western Australia.

4 design and implement a monitoring and evaluation system for each of the above three processes with UWA.

5. provide a governance framework to allow inclusion of Aboriginal Health Planning Forums and observers from adjacent geographic areas and specialist providers in the Tri-State Region (WA, NT and SA) and potentially Capricornia (including Queensland) along with national standards bodies (e.g. RACGP, NeHTA and Standards Australia) and others to contribute to the PAMS’ processes while retaining the essential ingredients of Comprehensive Primary Health Care, best-practices and Aboriginal Community Control.

Summary of Progress:

Task 1:  Accomplished by teaming with URSYS, a Sydney based company, that has developed a strong track-record of designing and supplying and monitoring satellite-based communications systems within the Aboriginal Community Controlled Sector in the Northern Territory and broad Central Desert Region as well as with the exploration, mining and pipeline industries.  The contrasts in access to resources between the end points of the spectrum of URSYS clients spans that of the Australian Economy. For details, click here.

Task 2:  Accomplished by teaming with Immensedata, a Katherine, NT based company, with a strong record with Aboriginal Community Controlled Health Services including Katherine West, Sunrise and Miwatj for remote monitoring of the performance of the PIRS. For details, click here.

Task 3: In progress through a shared development project with UWA Centre for Software Practice and application for funding through the Commonwealth PCEHR E-Health Site Grant program.  The PCEHR application is to help fund a statewide roll out in collaboration with UWA,  AHCWA, WA GPNetwork, WA Department of Health including WA Country Health Services and RFDS.

Task 4: To be started with UWA to provide detailed monitoring and evaluation of local, regional and statewide implementations of PCEHR related initiatives. Awaiting decision on DOHA Wave 2 eHealth Sites funding decision (March 2011)

Task 5: In progress – consultations with the PAMS’ members in the communities of Jigalong, Parnngurr, Punmu and Kunawarritji through the General Meeting of 16th November 2010, discussions with the Chairpersons and CEOs of AHCWA, AMSANT, AHCWA and QAIHC and on-going in the deliberations of the Aboriginal Health Fora for WA, NT and SA.