An Information Strategy for General Practice

An information strategy for general practice HINZ 16/3/07 Harry Pert This presentation 1. Why a GP information strategy? 2. What might it look like? 3. Some implications 4. What next? 1

1. To improve patient care We have problems of: Sub optimal practice BPAC, NICE, Cochrane Dangerous practice Adverse events, particularly medicines Consequence: Loss of public (and funder) confidence Bristol, Alder Hey, National Women’s, Gisborne, Green Lane, Wanganui 2. Considerable, but disconnected activity Government: PHO Performance Management Programme Key Directions National collections & programmes CVD, Diabetes Get Checked, Cancer, Mental Health General Practice: Individual Practices/IPAs/PHOs BPAC, HISAC, PCIM Consequence: Confusion, duplication, fragmentation, waste. Poor outcomes for patients 2

3. Opportunities of PHCS not fully realised Most PHOs still sole provider (GP) organisations. Many DHBs remain hospital centred organisations, little understanding or engagement with primary care. Poor understanding of opportunity offered by comprehensive ITIM via GP. Health gains offered by networks providing OGP may be lost unless we defend those gains Recent criticism in BMJ. 4. UK study tour The UK has stronger Government support for general practice Government and PCT support for commissioning Focus on population health at general practice level Moving towards outcomes focus More sophisticated PMS & responsive IT companies 3

On the other hand…. New Zealand has some advantages Existing infrastructure: enrolment, NHI, HPI, IT Networks: Support: for IT, quality etc Cornerstone: Organisational domains. Can learn: our own experience, UK, Australia US GPLF: unity Opportunity now because of newer interest, HISAC, Key Directions. A proposed approach Long Term National Conditions Proactive Regional Structured Perspectives DHB/NGO Individual Population Network Practice Acute Clinical Governance Conditions Provider Reactive ‘Unstructured’ Individual 4

A proposed approach: patient centred Long Term National Conditions Proactive Regional Structured Perspectives DHB/NGO Individual Population Network Practice Acute Clinical Governance Conditions Provider Reactive ‘Unstructured’ Individual The practice as custodian of the EHR in partnership with patient. Some implications Population Health Clinical Governance Patient Centredness PMS 5

Population health: context We know that 80% visit in 12 months (RGPG 79.5%) 90% visit in 24 months (RGPG 92.3%) 50,000 visits to general practice each day 1,200 admitted to hosp (2,000 ED, 4,000 OPD) Midland Health: in 12 months, children under 5 97% visited GP 13% admitted, 13% seen in ED, 13% seen on OPD The PHCS has made these relationships more explicit through patient enrolment with PHO and General Practice Population health: context Information routinely collected: Name Age Address (address standards, geocode) Ethnicities (affiliations) Gender CSC, HUHC, Care Plus eligibility Clinical information Prevention, screening Conditions 6

Population health: opportunity A population is a group of individuals with shared characteristics, eg Children needing immunisation Women needing mammograms Patients with diabetes, cardiovascular disease But also the ability to measure Any disease Access, utilisation & outcome by deprivation Inequalities To improve the care of the individual and inform the sector A proposed approach Long Term National Conditions Proactive Regional Structured Perspectives DHB/NGO Individual Population Network Practice Acute Conditions Provider Reactive ‘Unstructured’ Individual 7

Clinical governance: context The NHS has defined clinical governance as follows: ‘Clinical governance is a system through which NHS organisations are accountable for continuously improving quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish’. Or, ‘managing the gap between current practice and best practice’ Clinical governance: opportunity Managing the gap between current practice and best practice. 1. Understand, measure current practice 2. Identify best practice 3. Manage the gap, Feedback, quality circles, peer review, electronic decision support This is best achieved using networks & support of Organised General Practice 8

A proposed approach Long Term National Conditions Proactive Regional Structured Perspectives DHB/NGO Individual Population Network Practice Acute Clinical Governance Conditions Provider Reactive ‘Unstructured’ Individual Support for best practice Decision support; Quality processes: (audit, feedback, education); Outcomes focus Patient centred: context Increasing role of the patient at the centre of health care (cf the provider and organisations) Variable quality of information available for knowledge and self management Poor access to electronic health records, compared with some other countries 9

Patient centred: opportunity For information to follow the patient through the health system Referrals, status, discharge, shared records, interconnectivity Direct access to EHR Appointments, results, (parts of) the health record Access to information about the provider, performance, outcomes Implications for our PMS PMS development has not kept pace with the changing requirements of general practice, nor support the potential of general practice and wider sector information needs. 6/10 2/10 Individual Population 3/10 Clinical Governance 10

What happens next? Work alongside HISAC and MoH Key Directions Draft document by April/May 07 sector comment, feedback, collation Full by report by August 07 11

An Information Strategy for General Practice

by Health Informatics New Zealand on Apr 03, 2010

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An Information Strategy for General Practice — Document Transcript