title: Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.
abstract: BACKGROUND
  Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed.
  
  
  OBJECTIVE
  To identify health professionals' perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples.
  
  
  METHODS
  Semi-structured interviews were conducted with health professionals involved in CR within mainstream and Aboriginal Community Controlled Health Services in Western Australia (WA). Thirty-eight health professionals from 17 services (ten rural, seven metropolitan) listed in the WA Directory of CR services and seven Aboriginal Medical Services in WA were interviewed.
  
  
  RESULTS
  Respondents reported barriers encountered in health information management and the impact of access to CR services for Aboriginal people. Crucial issues identified by participants were: poor communication across the health care sector and between providers, inconsistent and insufficient data collection processes (particularly relating to Aboriginal ethnicity identification), and challenges resulting from multiple clinical information systems and incompatible technologies.
  
  
  CONCLUSIONS
  This study has demonstrated that inadequate information systems and communication strategies, particularly those representing the interface between primary and secondary care, contribute to the low participation rates of Aboriginal Australians in CR. Although these challenges are shared by non-Aboriginal Australians, the needs are greater for Aboriginal Australians and innovative solutions are required.
authors.affiliation: Centre for Cardiovascular and Chronic Care, Curtin Health Innovation Research Institute, Curtin University of Technology, 39 Regent Street, Chippendale, NSW 2008, Australia. m.digiacomo@curtin.edu.au
authors.forename: Michelle
authors.initials: M
authors.lastname: Digiacomo
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Kate P
authors.initials: KP
authors.lastname: Taylor
authors.forename: Julie S
authors.initials: JS
authors.lastname: Smith
authors.forename: Lyn
authors.initials: L
authors.lastname: Dimer
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ali
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Wood
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Leahy
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Thompson
mesh_terms: D001315:Australia; D000072038:Cardiac Rehabilitation; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration; D054521:Cultural Competency; D019981:Health Care Sector / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods; D007256:Information Systems / Q000458:organization & administration*; D007400:Interprofessional Relations; D012017:Referral and Consultation / Q000458:organization & administration; D000095283:Australian Aboriginal and Torres Strait Islander Peoples