Andrew Patterson wrote:
> ?Identifying diabetic patient cohorts (+/-co-morbidities)?
Exploring how a practice identifies and manages these patients
ie. Diagnosis coding, disease registers, outcome indicators
I think it was at a more meta level - i.e. the Atlas says
"census stats tell us that your area has a diabetic
level of 5% yet the data we have extracted has
only 1% of your population identified as diabetic.. lets
look at how your practice goes about identifying and managing
patients to see if we can work out why we are missing
so many".. so not really identifying them in the sense of
"you missed Mary Smith", but "there are some out there
you missed".
Andrew,
I feel the reality is that most GP 'datasets' are incomplete, owing to
individual GPs in a practice using some features, and others not, etc.
This is something we had to do to help practices meet the PIP CDM
guidelines, and lots still don't. So I doubt the information fed back
would be based on the real situation of what the practice does, but on
incomplete data. Fixing that would require lots of funded division support.
Certainly the datasets I have seen extracted for the Atlas
are de-identified.
As I said, too, I feel that identifying data by GP and sending it to
Canberra won't be acceptable to many GPs. Adelaide Western hasn't taken
the data beyond themselves.
True - the Atlas provides information for a GP about
themselves so is not so threatening.. not sure how keen
they'd be to see it compared against other practices.
The HIC, aka Medicare Australia, have queered that particular pitch by
accusing practices of over-servicing, over-prescribing, etc., when the
practice has been in no position to refute the claims, because they
haven't known how to summarise/analyse their own data, or it is only
partly electronic and able to be summarised.
But maybe they should accept the reality of the
world - most of us get held up to performance standards
in our jobs.. why not GP's (now I know there are good
reasons why making performance metrics the be all and
end all is a bad idea in primary care, but I think there is
some middle ground here where some sensible metrics
might actually improve the way everyone does things..
just my humble opinion from the non-clinical side of
the fence!)
Identifying what can be usefully done through this proposed project will
be a major challenge. If you haven't seen Michael Kidd's recent
research, the URL is here:
http://www.mja.com.au/public/issues/185_02_170706/mci10476_fm.pdf
"General practitioners’ use of computers for prescribing and
electronic health records: results from a national survey"
D Keith McInnes, Deborah C Saltman and Michael R Kidd
MJA • Volume 185 Number 2 • 17 July 2006
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
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