NACCHO Aboriginal eye health : Small victories add up to gap closure for Aboriginal health

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With a team at the University of Melbourne, we have researched and consulted  widely over the past five years to come up with a plan to “Close the Gap” in  Indigenous eye health.  ‘The Roadmap to Close the Gap for Vision’ presents an  opportunity for another ‘small victory’ by eliminating preventable vision loss  for Indigenous people over the next five years

Professor Hugh Taylor (pictured centre above)

Early this year, then Prime Minister Julia Gillard spoke to Parliament about  some of the positive trends that are emerging in the long-term goal of the  Government to “Close the Gap” for Australian Indigenous disadvantage.

From The AGE

She described Closing the Gap as ‘an accumulation of small victories’ which  can provide ‘the basic public services…delivered at the standard that every  Australian expects’.

The general theme is that some things are improving, albeit slowly, and  others need to get a wriggle on.

With a team at the University of Melbourne, we have researched and consulted  widely over the past five years to come up with a plan to “Close the Gap” in  Indigenous eye health.  ‘The Roadmap to Close the Gap for Vision’ presents an  opportunity for another ‘small victory’ by eliminating preventable vision loss  for Indigenous people over the next five years.

This is the first time  Indigenous eye health has been comprehensively researched to identify the  problems, needs and solutions.

Previous reports on Indigenous eye care have been  limited to reviews and the findings have been implemented incompletely at best.  ‘The Roadmap to Close the Gap for Vision’ has drawn on successful examples and  practices from around the country and extensive community and stakeholder  consultation. Best of all, it is feasible and doable, but each component is  essential for success.

The key to the Roadmap is the comprehensive approach that will improve the  provision and utilisation of eye services by the application of additional  resources to increase the availability of eye care and provide good  co-ordination and case management of patients.

Indigenous Australians experience six times the rate of blindness compared  with the rest of Australia. Vision loss causes 11 per cent of the Gap in health  – it is equal third with trauma, following heart disease and diabetes but ahead  of stroke and alcoholism. The provision of good quality eye care is fundamental  to improving the health of Indigenous Australians and unlike many other  conditions, most vision loss can be eliminated overnight.

The Roadmap provides policy recommendations to eliminate unnecessary vision  loss through 42 interlocking strategies. The recommendations build on previous  reports from the Indigenous Eye Health Unit at the University of Melbourne and  an extensive consultation process with the community-controlled sector, eye  health professionals, governments and other stakeholders.

The Roadmap addresses primary eye care, refractive services, cataract,  diabetic eye disease and trachoma. It includes cost estimates for the  Commonwealth, state and territory governments. It builds on community  consultation and control, the regional delivery of services and the National  Health Reforms. It stresses the assessment of population-based needs, strong  co-ordination, monitoring of performance and national accountability.

A recent Victorian initiative is one example of the difference a co-ordinated  approach that involves all the key partners and addresses one of the concerns  raised as a barrier can make. The Victorian Eyecare Service was augmented in  2010 by the Victorian Government with funds to allow Aboriginal Victorians  access to a specifically designed pair of spectacles for $10. The scheme is  available from optometrists working in Aboriginal Health Services and through a  network of private optometrists in rural Victoria.

There is no requirement for a  health care card or pensioner status to be eligible for access to the scheme.  The introduction of this scheme in 2010 has been followed by a more than twofold  increase in demand. Cost is identified as the most common reason Indigenous  people do not go to a health professional when needed. However, rather than  cost, we found that cost-certainty was the more important issue.  Cost-uncertainty for spectacles was commonly reported to the research team as  the reason for not visiting the optometrist and not having eyes tested. The  Victorian scheme demonstrates that when good quality spectacles are provided at  a low and certain cost, the service is rapidly accepted and taken up.

All Australians reasonably expect to see clearly and comfortably and to have  healthy eyes. We all fear vision loss and blindness given its considerable  potential impact on the quality of our lives. The Roadmap to Close the Gap for  Vision provides opportunity to accumulate yet another small victory to reduce  Indigenous disadvantage. We have the evidence, the strategy and the capacity to  close the gap for vision – the time is right to take this next “small step”.

The Indigenous Eye  Health Unit would like to acknowledge support from the following donors; The  Harold Mitchell Foundation, The Ian Potter Foundation, Mr Greg Poche AO, the  University of Melbourne, Dr David Middleton, Mr Peter Anastasiou, Mr Rob Bowen,  Dr Vera Bowen, Mr Noel Andresen, Dr Mark & Alla Medownick, Gandel  Philanthropy, CBM Australia, The Cybec Foundation, The Aspen Foundation and “K”  Line Logistics. Funding for work on the Implementation of the Roadmap to Close  the Gap for Vision has been provided by the Department of Health for 2013 –  2014.

Read more about Hugh Taylor at: www.medicine150.mdhs.unimelb.edu.au/taylor

Read more: http://www.theage.com.au/national/education/voice/small-victories-add-up-to-gap-closure-for-indigenous-health-20131203-2ynvb.html#ixzz2n84tSyNG

NACCHO ehealth opportunity alert:an initiative to register people to the Personally Controlled Electronic Health Record (PCEHR)

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NACCHO Affiliates are being informed of this initiative, so they can choose to take up the opportunity to work with the Department and the dedicated workforce to offer Assisted Registration to their member health service patients.

The Department of Health and Aging is currently conducting an initiative to register people to the Personally Controlled Electronic Health Record (PCEHR) using a dedicated Assisted Registration workforce (Aspen Medical) supplied through McKinsey and Company (National Change and Adoption Partners).

They will concentrate on conducting Assisted Registration activities, until 30 June 2013, in a variety of healthcare settings across the country.

To ensure that this initiative meets the needs of our Sector, Winnunga Nimmityjah Aboriginal Health Service in Canberra has piloted with Aspen Medical a very successful campaign which has to date registered over 260 Winnunga clients and staff for an eHealth record.

As such, NACCHO Affiliates are being informed of this initiative, so they can choose to take up the opportunity to work with the Department and the dedicated workforce to offer Assisted Registration to their member health service patients.

This will be of significance to health services with larger centralised populations with access to a waiting room area, aged care facility or groups of patients where Aspen staff are able to inform and register patients individually.
The Assisted Registration process offers patients a quick, personalised and well-informed way of applying to register for a national eHealth record.

Previous to this process, consumers seeking to apply to participate in the PCEHR, would either do so on the internet, by post, by phone call or at a Medicare office.

The Assisted Registration process allows patients of a health service to fill in a one page application form, and have their identity verified either using a 100 point documentary ID check, or by being a known customer of the health care service. Patients have the opportunity to ask the trained Aspen staff members about the PCEHR and what it would mean for them.

The experience at Winnunga is that patients are quick to see the benefits of having an eHealth record, and are keen to opt in to the system.

The dedicated Aspen workforce tailor their approach to each setting. All  staff deployed will have undergone cultural competency training, and will work with the Affiliates and the service to understand the local context and needs of their patients. The staff would be happy to sign a client confidentiality agreement. Male and female staff members can be deployed if requested. In fact, where there are vacancies, Aspen are open to employing people recommended by the health service to be Assisted Registration staff.

Using Aspen Medical authorised staff members to assist your patients to register does not alter your connectivity with your patients. PCEHR compliant practice software will flag who has an eHealth record (provided the patient has chosen to allow access to clinicians in your service).

Please note that Aspen Medical is not in a position legally to provide a list of patients who have registered through them to a service, however they are more than willing to provide you with data on registration numbers.

Greg Henschke (Acting NACCHO eHealth Project Manager) will be contacting NACCHO Affiliates, with the aim of identifying services that would be interested in participating in this PCEHR consumer registration program.

This resource is currently available until 30th June 2013 and deployment will be managed nationally through DoHA.

It is important to note that the dedicated workforce are not unlimited and we will need to move quickly to identify where we could best use them for our sector.

As more consumers and healthcare practitioners become registered and use the eHealth record system, benefits of the system will be realised through efficiency in healthcare services and increased access to health information.

To this end, I would strongly encourage you to consider working with the Department and the dedicated workforce to offer Assisted Registration to our sector.

For more information on the PCEHR and Assisted Registration,

contact Greg Henschke (Acting NACCHO eHealth Project Manager,

greg.henschke@amsant.org.au

08 89446651 / 0400448159)

or go to the website http://www.ehealth.gov.au .