Establishing a Linked Sexual Health Database for Indigenous Primary Care Services: Ethical and IT Development Perspectives

Dr Clare Bradley1,2, Ms Helen Dockrell3, Professor James Ward4

1South Australian Health and Medical Research Institute, Adelaide, Australia
2Flinders University, Bedford Park, Australia
3Notitia, Adelaide, Australia
4University of Queensland, St Lucia, Australia


Aboriginal Community-Controlled Health Services (ACCHSs) routinely collect sexually transmissible infection (STI) and blood-borne virus (BBV) clinical data as electronic medical records (EMRs). At a population level these data are an underutilised resource and can be used to help drive clinical and public health interventions. Accordingly, we have established an Aboriginal and Torres Strait Islander Sexual Health Surveillance network, known as ATLAS.


Key contacts at each site were consulted in order to minimise the impact of data extraction on site resources, maximise utility of analyses, and to ensure fair representation of site data.

Data are extracted and hashed using the University of Melbourne’s GeneRic Health Network Information Technology for the Enterprise (GRHANITE™) software. Data are stored in Microsoft Structured Query Language databases at the South Australian Health and Medical Research Institute and analysed and visualised using R.


The ATLAS network currently includes more than 30 ACCHSs across five clinical hubs in four jurisdictions and encompasses multiple EMRs. Twelve performance measures have been defined in consultation with site contacts and clinical staff to constitute Continuous Quality Improvement (CQI) metrics.

Relevant medical records are entered predominantly within free-text fields. Natural Language Processing is most resilient in processing and standardising these data and is used to translate the free-text data to a largely numeric record system.


The ATLAS team has established an integrated network of deidentified STI and BBV testing and management data. This network can be readily expanded and supports both research programs and CQI activities within participating sites.


Dr Clare Bradley is the Study Coordinator for the Centre for Research Excellence in Aboriginal Sexual Health and Blood Borne Viruses, currently located within the South Australian Health and Medical Research Institute’s Wardliparingga Aboriginal Health Equity theme. Clare’s current research interests are in the area of sexually transmitted infections and blood-borne viruses in Indigenous populations. Clare is also maintains involvement in research addressing aged care service planning, injury surveillance and outcomes, and administrative data linkage for use in epidemiologic studies.

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