I guess this means that Divisions will no longer need to have any
interest in information management and population health. You will need
a new job Greg. 


Regards
 
John Johnston BSc DipSci AIMM
Managing Director
0408 276 742
 

-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Greg Twyford
Sent: Monday, 9 July 2007 10:30 AM
To: GPCG_TALK at OzDocIT
Subject: [GPCG_TALK] BEACH thinks computers don't help GP quality

Colleagues,

This from recent PHCRIS conference:

  <http://www.phcris.org.au>


GP & PHC Research Conference Abstracts 2007

Effect of computerisation on quality of general practice care-a
comparison with quality indicators

Author(s)

Joan Henderson
<http://www.phcris.org.au/elib/browse.php?search=Joan+Henderson>, Graeme
Miller <http://www.phcris.org.au/elib/browse.php?search=+Graeme+Miller>,
Helena Britt
<http://www.phcris.org.au/elib/browse.php?search=+Helena+Britt>, Ying 
Pan <http://www.phcris.org.au/elib/browse.php?search=+Ying+Pan> 
Organisation

Family Medicine Research Centre, University of Sydney   
Objectives

There is an assumption expressed in literature that computer use for
clinical activity will improve quality of general practice care, but
with little evidence to support or refute this assumption. This study
compares GPs using a computer to prescribe, order tests, or keep patient

records, with GPs who do not, using a set of validated quality
indicators.     
Methods

BEACH (Bettering the Evaluation and Care of Health) is a continuous
national cross-sectional survey of general practice activity in
Australia. A sub-sample of 1257 BEACH participants between November 2003
and March 2005 were grouped according to their computer use for: test
ordering, prescribing, and/or medical records. Linear regression
analysis was used to compare the two groups on a set of 33 quality 
indicators.     
Principal Findings

The univariate analysis showed that computerised GPs managed more
problems; provided fewer medications; ordered more pathology tests;
performed more Pap smears; provided more immunisations; ordered more
HbA1c tests and provided more referrals to ophthalmologists and allied
health workers for diabetes patients; and provided less lifestyle
counselling. After adjustment, the only differences that could be
contributed solely to computer use were prescribed medication rates,
lifestyle counselling and referrals to ophthalmologists. Two other
differences emerged-computerised GPs provided more referrals for allied
health workers for all patients, and fewer prescribed anti-depressants
for patients with depression. Twenty-two measures failed to discriminate

before or after adjustment.     
Discussion

Deciding 'best quality' is subjective. While literature and guidelines
provide clear parameters for many measures, others are difficult to
judge. Only five differences were directly related to computer
use-computerised GPs performed better on four measures and worse on one.

Overall, there was little difference between the two groups.    
Implications

This study has found little evidence to support the claim that
computerisation of general practice in Australia has changed the quality

of care provided to patients.   
Presentation

Open document. <javascript: 
openDoc('/phplib/filedownload.php?file=/elib/lib/downloaded_files/confer
ence/presentations/3700_JoanHende.pdf');>  PDF 563.5 
Kb      

Copyright (c) 2007 Primary Health Care Research and Information Service.
Copyright & Disclaimer information
<http://www.phcris.org.au/website/copyright_wd.php>

   <http://www.phcris.org.au/images/logo/minilogo.gif>
www.phcris.org.au 
<http://www.phcris.org.au>

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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John Johnston
Pen Computer Systems Pty Ltd
Level 6, The Barrington
10-14 Smith Street 
Parramatta NSW 2150
Ph: (02) 9635 8955
Fax: (02) 9635 8966

5
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