The Australian Government has funded the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS) pathology programme since 1999 to support the provision of culturally appropriate and clinically effective diabetes management in Aboriginal and Torres Strait Islander communities. The programme supports better management of diabetes by enabling participating Aboriginal Medical Services (AMS) and Aboriginal Community Controlled Health Services (ACCHS) to provide accurate diabetes-related pathology testing on site through ‘point of care testing’.
This programme contributes to ‘closing the gap’ on Aboriginal and Torres Strait Islander disadvantage by helping to avoid the poor health outcomes that are associated with unmanaged diabetes in a population where diabetes is diagnosed at an estimated rate of more than three times that of the general population.
Many of the sites participating in the QAAMS programme are in rural and remote locations across Australia where there is poor or no access to rapid pathology testing for the management of diabetes in Aboriginal and Torres Strait Islander communities. The QAAMS programme overcomes this by providing ‘point of care’ pathology testing with a six minute test time to allow appropriate treatment and management of diabetes while the patient is still present.
The three pathology tests that are currently used in the QAAMS programme are;
- glycosylated haemoglobin (HbA1c) – quantitation in blood, performed for the diagnosis of diabetes;
- HbA1c – quantitation in blood, which shows how well glucose levels are being managed; and
- microalbumin or the albumin:creatinine ratio (ACR), which detects early stage renal disease, an adverse outcome of poorly managed diabetes.
These pathology tests are specific to the QAAMS programme and are only available for Medicare reimbursement if the health service is enrolled in the QAAMS programme and the medical practitioner has the Medicare Benefit Schedule speciality code 601 (Indigenous health).
The QAAMS programme provides training, technical support, a quality assurance programme and a consultation programme to support the point of care pathology testing at participating Aboriginal and Torres Strait Islander health care sites so as to improve the management of diabetes in Aboriginal and Torres Strait Islander communities. The operators of the 'point of care' device at participating ACCHS and AMS sites must undertake a competency training programme and meet the quality control and assurance programme targets. The QAAMS quality and training framework has enabled the participating services to achieve an equivalent quality of pathology testing to that achieved in conventional pathology laboratories.
The Australian Government provided $4.2 million over three years from 2013-14 to 2015-16 for the continuation of QAAMS. The number of sites enrolled in QAAMS has increased from 120 sites in 2008-09 to 194 sites as at 30 June 2015.
The QAAMS programme is administered on behalf of the department by the Flinders University International Centre for Point of Care Testing and RCPA Quality Assurance Programs Pty Ltd. More information is available at the QAAMS website QAAMS