Organising prevention

Abstract

[Extract] A major challenge for the primary health care (primary health care) sector is to implement preventive population health strategies in service delivery settings that are characterised by underresourcing and a high level of curative demand. The provision of comprehensive primary health care is made efficient by information management systems that prompt health workers to offer preventive interventions when patients present at the clinic ('opportunistic' care). 'Active recall' strategies can then be reserved for a smaller number of patients whose health care needs justify the effort involved. Organising opportunistic care and targeting active recall activities are prime tasks for patient information management systems in the primary health care setting. Health services should develop a critical appreciatlon of the various applications of information technology in primary care as well as the uses and demands for health data. A shift to a model of health service delivery emphasising opportunistic care has substantial implications for the character and function of an established primary health care service. Use of information management and information technology to support comprehensive primary health care requires careful planning.