Atlas 2017 - General recommendations

Driving appropriateness of care

5a. The MBS Review Taskforce Committees to identify a range of educational and regulatory mechanisms to improve appropriate test ordering and interpretation. These might include clinical decision support, restrictions on ordering, individualised audit and feedback, and guidance on referrals to secondary care. Funders, test providers and clinicians to ensure these are used in practice and their effectiveness monitored.

5b. The Australian Government and state and territory health departments to promote routine measurement and recording of obesity markers, such as body mass index (BMI) and waist circumference for all adults and children who attend primary care or an outpatient clinic, or who are admitted to a health service, to facilitate strategies to manage obesity being included as options in healthcare decision-making.

5c. The Commission to work with relevant colleges, epidemiological experts and government agencies to develop methods for estimating population needs (expected rates and ranges) of specified interventions based on clinical consensus on best practice and the body of available academic literature.

5d. The Council of Presidents of Medical Colleges to progress its work on obesity by identifying actions that can be taken by professional colleges and societies to improve the prevention and management of obesity. 5e. Professional colleges and societies to work in partnership with relevant organisations within the Aboriginal and Torres Strait Islander health sector to provide cultural safety competency training to their members as part of continuing professional development.

5f. The Commission to publish a set of core common questions for patient reported outcome measures (PROMS) for use in Australia.

5g. The Commission to work with the states and territories, the private healthcare sector and HealthPACT to identify best-practice models for the introduction of new technology in the Australian clinical setting and develop guidance, as required, to support appropriate uptake of new medical technology.

Supporting investigation of variation

5h. The Commission to develop, in collaboration with professional colleges, state and territory health departments and health service representatives (public and private), a guide for clinicians, health service managers and governing bodies of health services to investigate variation in health care and improve appropriateness of care.

5i. The Commission to work with professional colleges and specialist societies to develop resources for clinical leaders, heads of departments and managers on use of data to investigate variation and improve appropriateness of care, consistent with action 1.28 in the National Safety and Quality Health Service Standards (second edition). The resources should be suitable for adoption in training and continuing professional development curriculums for colleges.

5j. Health services to routinely monitor variation in clinical practice and patient outcomes, provide feedback to clinicians on their practice, and take action to improve care, consistent with action 1.28 in the National Safety and Quality Health Service Standards (second edition).

Improving data use

5k. The Commission to hold a roundtable meeting of policymakers, researchers, and clinicians experienced in using routine data sources to investigate variation, to identify ways in which those data sources could be better used for analysing appropriateness of care.

5l. The Australian Institute of Health and Welfare (AIHW) to develop the capacity for national linked data for examining variations in clinical practice, appropriateness of care and patient outcomes.

5m. The Commission to work with the AIHW, state and territory health departments, and researchers to use linked data for examining variations in clinical practice, and to support states and territories to drive appropriateness of care and patient outcomes. Cardiovascular disease to be an initial priority for this work.

5n. The Health Workforce Division of the Australian Government Department of Health to work with the Australian Health Practitioner Regulation Agency (AHPRA) to expand data collection on clinician location of practice so the extent of practice in outer regional and remote areas is quantified. Professional colleges, and states and territories, to use the expanded data on workforce statistics to inform the number and location of training positions.

5o. The Commission to work with the AIHW, state and territory health departments, and researchers to investigate methodologies for monitoring changes in unwarranted variation over time, and the impacts of actions to reduce variation.