In my experience the only people interested in improved analytics are the practice managers or principals. The other workers (GPs, nurses and support staff) are not involved in data extraction so cannot see the benefit of careful data input. We have a large number of GP registrars through the practice and they are mainly interested in surviving the patients and decision making. Data extraction for them can be useful if they get involved in a project that requires this during their term. Non-registrar employee GPs are not interested until they have been there a long time, and they come to use some data extraction for writing medico-legal reports etc.. Audits (such as NPS, Pap smear, etc.) can be drivers for careful data entry but GP registrars and employees are difficult to motivate to do these. I tend to agree with Michael Tooth that a lot of it comes down to professional pride. However, there is also a lack of education/ignorance involved in why some data is poorly entered or maintained. My suspicion is that whilst there are poor referrals written by computer, they would have been even worse from a paper-based system. At least a poorly maintained medication list is better than none at all! Poorly performing doctors will continue to perform poorly. At least their poor performance is legible in a computer based system! Rob Hosking
Jon Patrick wrote: >A number of people have spoken to me about how getting outputs from clinical >information systems would improve the willingness/enthusiasm for GPs to use >computers more. Our own work focuses on the description of an information >system primarily based on the required analytics and not so much on the >perceived inputs. >Who believes that motivation to use computers would be improved if the >analytics available were more comprehensive? > >jon patrick > Date: Tue, 11 Jul 2006 12:52:21 +1000 > From: Greg Twyford <[EMAIL PROTECTED]> > > Michael Tooth wrote: > > I wonder how much of this comes down to Professional pride. It > > surprises me the rubbish that people will send out; the excuse is often > > that there is "not enough time" or "I didn't know how to change it." > > > > If your carpenter couldn't sharpen his tools, or couldn't saw in a > > straight line, you would question his ability. Computerised EHR is the > > professional tool of the doctor. > > > > It all smacks of lazziness and poor professionalism to me. > > Michael, > > I think there is a wide spectrum operating here. It's also not entirely > helpful to target the individual GP as being the problem in total. > > Some older GPs have been challenged by having to use computers and are > still highly ambivalent. Some feel inadequate in their skills and do > double work, by which I mean they still keep paper notes as well, which > has obvious problems. Some are very skilled and diligent and see they > are more productive. Some make my skin crawl. > > But I think the professional organisations and things like the GP > accreditation process are also avoiding confronting lots of the hard > issues of where the profession is on this stuff. The college's third > edition standards will form the basis for future accreditation surveys. > But how many surveyors will have the IT qualifications necessary to do a > proper survey under these standards? As a person who spent 3 and a half > years getting a tertiary IT qualification on top of my professional > qualification I'd be unhappy if a weekend workshop was all that was seen > to be needed. > > No real evaluation of this mass change in GP work practices was built > into the whole thing, and seven years has gone by with only limited > evaluation. Similarly, the standards arena has moved on very slowly. > > Mr Abbott has belatedly referred to some Sydney Uni research pointing to > limited skills and referring to paperweights on desks, which was by and > large, an overstatement. ACT Division did research in 2002 that blew the > whistle on the poor standards of practice IM security, which has led to > some improvements. > > Against this the expectations re breadth of use and skills expected, as > well as the range of functionality pushed for adoption, continue to grow > apace, without much in the way to help GPs keep up, or much recognition > of the real costs, both financial and human that are required to reach a > high overall standard. Yep, a case for accreditation of GPs use, but > with suitably qualified surveyors, which would be another cost. > > Similarly, the ADGP's data extraction framework, which will determine if > Divisions can meet the targets of their new reporting framework, and > hence survive or not, looks like it will rely on unqualified staff at > Division level, who may be expected to be installing software on > practice PCs, despite the very significant risk-management issues > involved for Divisions and GPs. > > Watch this space, it will be interesting. > > Greg > -- > Greg Twyford > Information Management & Technology Program Officer > Canterbury Division of General Practice > E-mail: [EMAIL PROTECTED] > Ph.: 02 9787 9033 > Fax: 02 9787 9200 > > PRIVATE & CONFIDENTIAL > *********************************************************************** > The information contained in this e-mail and their attached files, > including replies and forwarded copies, are confidential and intended > solely for the addressee(s) and may be legally privileged or prohibited > from disclosure and unauthorised use. If you are not the intended > recipient, any form of reproduction, dissemination, copying, disclosure, > modification, distribution and/or publication or any action taken or > omitted to be taken in reliance upon this message or its attachments is > prohibited. > > All liability for viruses is excluded to the fullest extent permitted by > law. > *********************************************************************** > > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > >Jon >______________________________________________________________ > > > > >_______________________________________________ >Gpcg_talk mailing list >[email protected] >http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > > > > _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
