Could health information systems enhance the quality of Aboriginal health promotion? A retrospective audit of Aboriginal health programs in the Northern Territory of Australia
Authors: Percival Nikki Ann , Boucher Priscilla , Conte Kathleen , Robertson Kate , Cook Julie 
Published: September 2020

Abstract
Background In Australia, health services are seeking innovative ways to utilize data stored in health information systems to report on, and improve, health care quality and health system performance for Aboriginal Australians. However, there is little research about the use of health information systems in the context of Aboriginal health promotion. In 2008, the Northern Territory’s (NT) publicly funded healthcare system introduced the Quality Improvement Program Planning System (QIPPS) as the centralized online system for recording information about health promotion programs. The purpose of this study was to explore the feasibility of a health information system to capture and share data that could improve quality and reporting of Aboriginal health promotion. Using QIPPS as an example, we identify the potential benefits and limitations of health information systems for enhancing Aboriginal health promotion. Methods We conducted a retrospective audit of information recorded and stored in QIPPS about a sample of chronic disease prevention activities delivered between 2013 and 2016 in NT Aboriginal communities. A validated, paper-based audit tool was used to extract information stored in the QIPPS online system. We conducted an in-depth analysis on the audit data to report on Aboriginal health promotion quality. Simple frequency counts were calculated for dichotomous and categorical items of the audit tool. Text was also extracted and thematically analyzed to describe community participation processes and strategies used in Aboriginal health promotion. Results A total of 39 chronic disease prevention activities were included in the analysis. Of the three phases of the health promotion planning cycle, 34/39 activities recorded information pertaining to the planning phase, such as statements of project goals, ‘needs assessment’ findings, and processes for consulting Aboriginal people in the community. Information about actions during implementation and evaluation phases, was limited. Evaluation findings were reported in approximately one third of projects and were mostly limited to a recording of numbers of people participating in activities. In almost half of the projects analyzed, community participation strategies were not recorded or in insufficient detail.Conclusion This is the first Australian study to shed light on the feasibility of utilizing data stored in a purposefully designed health information system for reporting on Aboriginal health promotion quality. QIPPS provided an organized data source on a vast array of health promotion information for secondary analysis. However, data availability and quality were limiting factors for reporting health promotion quality. Based on our learnings of QIPPS, strategies for improving the quality and accuracy of data entry together with the use of quality improvement approaches are needed to reap the potential benefits of future health promotion information systems.