presenting health care data and information

Review and evaluation of Australian information about primary health
care
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Back to the report Review and evaluation of Australian information
about primary health care

Summary
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Primary health care is the cornerstone of the Australian health-care
system, and general practice is its central component. It is vital,
therefore, that accurate, reliable and timely information is available
to assess the quality, effectiveness and outcomes of services provided
in general practice. Such information is essential for:

determining the need for services

highlighting inequities in access and outcomes

assessing the uptake of best-practice guidelines and
 evidence-based practices

evaluating the outcomes of interventions

providing practitioners with evidence for clinical decision making

informing policy and strategy development.

Although several Australian collections contain information relevant
to general practice, the extent and usefulness of these data for
meeting priority information needs is variable. In order to improve
the data environment, take advantage of advances in information
technology and build on the capabilities of existing data collection
systems, we need to take stock of what exists now, consider what is
needed for the future, and determine the most effective and efficient
ways of moving forward.

This report provides a review and evaluation of current data
collections and methods. The evaluation considers not only the quality
and breadth of the data items collected, but also looks more broadly
at the usefulness of the data with regard to meeting the information
needs of stakeholders. The report highlights gaps and limitations in
the currently available data, and suggests strategies for improving
the quality and usefulness of information about general practice in
Australia. In addition, it outlines methods currently being used to
collect general practice data electronically, and establishes options
for further investigation.

Main findings

Usefulness of existing collections

Data that are able to be used to build a comprehensive picture of
 the care provided in general practice are limited.

At the national level, ‘quality’ is currently only able to be
 assessed in specific circumstances and for particular health
 conditions (for example, tracking the annual cycle of care for
 diabetes).

To enable thorough investigation of general practice care, data
 should:

be able to be analysed at the individual patient level

link each management action (such as a prescription, clinical
 procedure, pathology or imaging request) to a diagnosis or
 symptom pattern

be able to be linked to allow tracking of presenting problems
 and management actions over time and to examine patient
 outcomes.

Options for future collection of general practice data

Several collections use electronic methods to collect data from or
 about general practice. These include CONDUIT (Collaborative
 Network and Data Using IT), GPRN (the General Practice Research
 Network), the Australian Primary Care Collaboratives, ASPREN (the
 Australian Sentinel Practices Research Network) and the GP Census.

The types of electronic methods in use by CONDUIT and GPRN appear
 to be useful starting points for exploring a national electronic
 data collection (though some important limitations need to be
 overcome).

The CONDUIT system has great potential in that it enables linkage
 and transfer of clinical records between different health
 providers and services.

The experiences and expertise of the groups involved in other
 collections, such as MEDIC-GP (Medical Enquiry Drug Information
 Centre—General Practice), BEACH (Bettering the Evaluation and Care
 of Health) and the Practice Health Atlas, can provide valuable
 insights to inform decisions about the way forward.

Collections other than those containing GP–patient encounter data
 also provide useful information, such as patient satisfaction,
 functioning and quality of life, and reasons for seeking, or not
 seeking, care.

Contextual information, such as workforce data and information
 about access to care, is necessary to aid interpretation of
 clinical data.

Enabling the transition to electronic collection

There is a need for a set of principles around the collection and
 use of general practice data, covering implementation, data access
 and use, governance, and resourcing.

Several important issues need to be tackled before electronic
 collection of general practice data could be implemented in
 Australia, including adoption of standards and resolution of legal
 and ethical issues (such as privacy and consent).

Internationally, countries that have been more successful in
 introducing electronic patient records have been those that have
 had standards, protocols and infrastructure in place at an early
 stage.

The low rate of uptake of electronic clinical record keeping in
 Australian general practices will limit the number of GPs able to
 participate in electronic data collection.

GP groups expressed a willingness to participate in data
 collection, but need to be convinced of the usefulness of the data
 in terms of informing policy decisions or improving health
 outcomes or practices.

Recommendations

A minimum data set specification for GP–patient encounters should
 be defined, in consultation with all stakeholders, which builds on
 work already undertaken in this area.

The options established as potential starting points for an
 electronic collection should be explored with all stakeholders to
 formulate an agreed approach for implementing collection of this
 minimum data set at the national level.

Where existing collections provide useful data, they should
 continue to be supported during the transition period and, where
 appropriate, afterwards.

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