The Queensland coroner has heard the medical records of an Aboriginal woman presenting between health services in the state's north-west in the months before her death showed varied indications of her patient plan and medication history whilst suffering with rheumatic heart disease.

The third sitting of an inquest into the Doomadgee rheumatic heart disease cluster, three young Indigenous women between who died between 2019-2020, Kaya (17), Ms Sandy (37) and Betty (18), began in Cairns on Monday.

It follows initial examinations in July and August.

The court heard Ms Sandy attended hospitals in Mt Isa, her home in Doomadgee and local primary health provider Gidgee Healing a number of times between November 2019 and early 2020 where access to her medical records presented barriers.

Ms Sandy required lifelong treatment for rheumatic heart diseases with anti-blood clotting medication.

Resulting consultations saw her prescribed various drugs, including oral penicillin and Clexane over the period.

Inquest witness, remote clinical health lecturer and Queensland Aboriginal medical service practitioner Samuel Stevens said the health system allowed for this type of reporting and difficulties ensuring follow ups on patient progress.

Mr Stevens said loose requirements on uploading documentation at each consult and on discharge from emergency departments was an issue, and suggested it was poor practice not to provide a health summary handover between providers.

Without a known individual doctor, records are unable to be sent electronically, instead relying on fax and mail of hard copies.

"If it wasn't addressed to you it would not turn up on your electronic record," Mr Stevens said.

Understaffed services in remote locations were identified as contributing factors, with doctors often overworked and required to be on-call at all times over a seven-day period.

In May 2020, medical records indicated no presence of Warfarin, a medication Ms Sandy had not taken since 2019, without reference to the Clexane prescribed in the months prior.

Mr Stevens said with an active case manager "it is possible" to have avoided the error.

With the information available to doctors at each stage, Mr Stevens felt appropriate practice was carried out.

Lowitja Aboriginal and Torres Strait Islander health research institute's Mark Wenitong said he expected phone calls to be made for better clarity on patient progress throughout Indigenous communities.

"It leaves you needing to audit these kinds of progress notes," Mr Wenitong said.

"Its easy to pick up the phone and call, especially in communities this size"

He said a morning meeting between clinicians to handover discharge and progress notes should be sufficient for patient care.

"(Letters are) not a very good medium when working with Aboriginal and Torres Strait Islander patients," he said.

Lack of cultural awareness and stigmatised language standards, or medical paternalism, were pointed to as impacting patient experience.

Standard healthcare terms like non-compliance and failure to attend were agreed by Mr Stevens as potentially leading to bias and squeeing quality of care, both with the patient and colleagues.

Mr Stevens said he was aware of cases where First Nations people might have concern over data-sovereignty and opt-out of medical health records for the fear the information being shared to external bodies, including the police.

The inquest continues.