Evaluation of the Medical Specialist Outreach Assistance Program and the Visiting Optometrists Scheme

9.5 Data collection and management

Page last updated: 28 February 2012

Stakeholder views

Data is collected at two main points: when a service proposal is initially assessed/approved and when an optometrist submits a six monthly invoice/report. Program data is held in spreadsheets managed by the DoHA central office.

The current practice is for VOS optometrists to submit a tax invoice and report every six months. The report specifies the number of circuits undertaken in the period and for each location visited the number of visits, number of patients who identify as Aboriginal or Torres Strait Islander, the total number of patients and the ‘type of service’ provided. In a separate non-structured textual response, optometrists are required to “outline if you have identified an cases of eye disease at you outreach location”.

In the survey of optometrists, data reporting was identified as reasonable by 57% of respondents and as onerous by 29% of respondents (see Table 89 above).

Optometrists were also asked whether they would be willing to collect additional data. Ninety-seven per cent indicated that they either already collected data or would be willing to collect data on the number of patients seen with eye conditions other than refractive error, and the number of patients referred to an ophthalmologist. Some indicated that they would be willing to collect additional data, provided additional remuneration was provided. Others made suggestions on the nature of data to be collected and the need for standardisation. One respondent suggested that there was a need for centralised but de-identified data collection.
Table 92 VOS optometrists willingness to collect additional data
  Participating optometrists who would be willing to collect data on:
  Number of patients with eye conditions other than refractive error (e.g. diabetic retinopathy, glaucoma, cataract) Number of patients examined who are referred to an ophthalmologist
1.1 Yes - Already do so 31% 17%
1.2 Yes 66% 80%
2. No 3% 3%


Source: HPA survey of VOS service providers, 2011. See also Table 3.14 in Volume 3.


Table 93 Data collection: qualitative responses from VOS optometrists
  Responses mentioning these issues
Willingness to collect addition data: Would do so provided additional renumeration is provided for extra paperwork and time required, or additional administrative support. 3
Willingness to collect addition data: Can be time consuming and rubbery. Should be specified as "newly diagnosed", "cataract requiring referral", "required report to primary health provider". 1
Other: Collect data on a centralised (deidentified) database 1
Other: Use a standardised reporting template 2


Source: HPA survey of VOS service providers, 2011. See also Tables 3.15 and Table 3.16 in Volume 3.

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In consultations, the Australian Optometry Association indicated that the current reporting requirements were not excessive and that reforms some years ago had significantly reduced the burden of reporting. Overall, data processes and management of VOS were not as much of a concern for stakeholders as were the processes and management of MSOAP data.

Data are submitted, generally in a paper form, to the relevant the state/Northern Territory office of DoHA. An officer in the state/Northern Territory office checks the data submitted and the associated invoices then forwards these onto Canberra for further checking. Issues identified at central office are referred back to the state/Northern Territory office, who will contact the optometrist. Once accepted, the data will be entered into a national database, and payment will be arranged. State/Northern Territory officers consulted indicated they did not they have an integrated view of services in the jurisdictions and did not see analyses of the relevant VOS data.

There were comments from several optometrists outside VOS regarding the little public information available on VOS and visiting services, including: who the service providers are, when they visit certain communities and how to refer to the service provider. This information is only available if the service provider communicates this information individually. Similarly, the Australian Optometry Association commented that information on visiting ophthalmologists supported under MSOAP is not routinely available for optometrists (unless the individual service provider ensures this information is available). This creates significant issues in coordinating services, including referral of patients for follow-up.

Evaluation findings

The current approaches to managing data are not optimal and could be significantly improved. Suggestions are:
    • The structure and content of the national data base: The national database should be updated to include all relevant details from the service application/approval, submitted reports, payments made to optometrists, and relevant attachments (e.g. copies of signed funding agreements).
    • The manual process for submitting service proposals and data reports: (See discussion above)
    • The structure and content of activity reports: The current reports could be restructured and enhanced to capture better information about services delivered, numbers of patients identified with eye health conditions and referral to ophthalmologists. We suggest the report be restructured to reflect each visit undertaken, with the data items along the following lines:
        • date of visit
        • location
        • provider number
        • number of Aboriginal or Torres Strait Islander patients seen
        • number of non-Indigenous patients seen
        • total patients seen
        • Number of newly diagnosed cases of eye conditions identified other than refractive error (e.g. diabetic retinopathy, glaucoma, cataract)
        • number of patients referred to ophthalmologist.
      • Definitions and specification of the final two items should be developed in consultation with the Optometry Association of Australia.
    • Little feedback reports to relevant parties involved in planning and management of VOS: It is suggested that a set of standard reports derived from the national database be available to DoHA officers (including state/Northern Territory officers) and the various advisory groups. It is also suggested that a short annual program statistics report be developed which summarises key statistics from the program (visits, patients etc.) for both states/territories and by remoteness areas.
    • The lack of sharing of information on visiting services with the public and other interested parties: (See discussion above).

Recommendations

50. A national VOS program database is required which has the following features:
    a. Details of the original service proposal approved and the history of approved changes to a service proposal are recorded.
    b. Data submitted online by VOS optometrists are automatically populated into the system
    c. Details of visits, numbers of patients seen, payments and service provider comments on visits are recorded.
    d. DoHA state/NT officers should be able to run reports.
51. Following consultation through the Optometry Association of Australia, the structure and content of activity reports by optometrists be restructured as proposed and include additional data on Number of newly diagnoses cases of eye conditions identified other than refractive error (e.g. diabetic retinopathy, glaucoma, cataract) and the number of patients referred to ophthalmologist.
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