Developing a Quality Audit Report for General Practice Prescribing for Hypertension: Methodology

Developing a Quality Audit Report for General Practice Prescribing for Hypertension: Methodology Prof Jim Warren National Institute for Health Innovation, The University of Auckland With Rekha Gaikwad, Thusitha Mabotuwana, John Kennelly, Timothy Kenealy

‘ Business Intelligence’ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Minlaton ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tracing individual ‘therapeutic paths’ Nb. Chose these because they’re confounding… most individuals have simple and sensible patterns

‘ High specificity’ alerts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

So why doesn’t everybody make sense? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Healthwest Fono ,[object Object],[object Object],[object Object],[object Object],[object Object]

Criteria ,[object Object],[object Object],[object Object],[object Object]

Beyond the normal Query Builder ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Temporal Queries ,[object Object],[object Object]

‘ Ontology’ management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HealthWest Fono Findings: an Example Case ,[object Object],[object Object],[object Object],[object Object],Yes No Yes 1. A lapse in AHT of >30 days during the EP or the lapse extends into the EP 2. A period of >180 days with no BP measurements extending into the EP Practice Assessment The data from the PMS satisfactorily explains the therapy. The therapy is optimized, or the process of seeking optimized treatment is satisfactory The therapy is free of clinically significant contraindications and interactions. Criteria Assessment

Performance of Criteria Ability to detect positive cases Meaning of a negative result Criteria Assessment Suboptimal therapy (+) Optimal therapy (-) Sensitivity = 76% Specificity = 70% Positive Predictive Value = 65% Negative Predictive Value = 80% 13 4 Suboptimal therapy (+) 7 16 Optimal therapy (-) Practice Assessment

Results Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Building a temporal query support system ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Adherence ,[object Object],Your Prescribing Other docs’ Prescribing Dispensing Reliable Consumption It’s but one step, but it is along the road to more reliable chronic disease management outcomes

Thanks, questions? ,[object Object],??? The Minlaton work: Gadzhanova, S., Iankov, I., Warren, J., Stanek, J., Misan, G., Baig, Z. & Ponte, L., “Developing High-Specificity Anti-hypertensive Alerts by Therapeutic State Analysis of Electronic Prescribing Records,” Journal of the American Medical Informatics Association , Vol 14, No 1, Jan/Feb 2007, pp. 100-109

Developing a Quality Audit Report for General Practice Prescribing for Hypertension: Methodology

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Developing a Quality Audit Report for General Practice Prescribing for Hypertension: Methodology