The process of collecting data at the local level for transfer to the national trachoma surveillance system is complex and can be streamlined, but the arrangements for achieving improvements depend on local circumstances within the jurisdictions. As previously discussed, it is not recommended to move to a system through which data are collected nationally at a person-level (either with identified or de-identified) at this point in time. However, systems established locally for the collection of screening and other data should facilitate the efficient management of the data and the accurate calculation of summary statistics. For example, greater use could be made of local clinical information systems in the data collection process, with data extracts from these local systems used to create summary data in a format consistent with the national data collection. We believe the responsibility for improving existing arrangements is best managed by jurisdictional coordinators.

R15: It is recommended that jurisdictional trachoma coordinators continue to explore opportunities to improve data collection systems and mechanisms for extracting data from local clinical systems for trachoma surveillance reporting.

Mechanisms for collecting data on screening for trichiasis need to be improved, particularly in the Northern Territory and South Australia. If arrangements are to be established for screening along with the provision of vaccinations and/or a healthy adult check, then mechanisms need to be developed to capture information on the results of screening. Data collection may be best done by ensuring the relevant information is recorded in the clinical information systems for local primary health care services and arranging for summary data extracts to be obtained from these systems.

A major weakness in current arrangements is the capture of information on surgery for trichiasis. We suggest this issue be addressed through two mechanisms. First local trachoma coordinators should attempt to make arrangements to be able to collect relevant data directly from ophthalmologists providing this surgery for Aboriginal people in the relevant regions. Secondly, at a national level, a specific MBS code could be developed for trichiasis surgery (currently trichiasis surgery is included under a broader MBS code related to ophthalmic surgery). Combined with the MBS Indigenous identifier, it may be possible to use MBS data to gain a clearer appreciation of the level of access to surgery. This approach could be supplemented by analysis of the national hospital morbidity data, through which data on trichiasis surgery provided on an admitted patient basis can be identified.

R16: It is recommended that jurisdictional trachoma coordinators seek to establish arrangements with ophthalmologists designed to capture relevant information on Aboriginal persons provided with trichiasis surgery.

R17: It is recommended that the Department of Health and Ageing consider the development of a specific MBS code for trichiasis surgery.

Currently the flow of information from the jurisdictional level to the national level occurs once a year with the provision of the Access database. The flow of information could be facilitated through the establishment of a web-based system for data entry (which the NTSRU can access directly). Aside from allowing instant access of the data by the NTSRU, the system needs to provide for the immediate availability of reports that can be generated by local coordinators. The availability of such reports will not only increase the quality of the surveillance and treatment data but also allow greater use of the information at local level to better direct trachoma control activities.

R18: It is recommended that OATSIH consider allocating resources to assist with the development of a web based system for capturing surveillance and treatment data and allowing access to standard reports. top of page