“There’s so much data around. But what data is useful and why is it important to use data to improve patient care?”
In July, AIHW published Australia’s health data 2020: data insights that explore current health data and selected health issues in Australia. This publication recognises data as key to achieving long-term and sustainable improvements in the Australian healthcare system as a whole.
But why is having good quality health data important for GPs? What value does it bring to general practices? And what support is there currently for general practices to undertake data quality improvement practices?
We interviewed our data expert, Matthias, who has been with Pen CS since 2005. His role includes verifying whether our products meet the national guidelines, ensuring that we are up to date with medications, conditions which we report on, and more.
Read Part 1 of the interview with data expert, Matthias Merzenich, Pen CS Clinical Assurance Manager to learn more about:
- What exactly is mapping?
- Benefits of having quality data in general practices
- Quality data effects on practice and population health considerations
What have you been working on this year?
This year, we have commenced a major review of all our mapping, in terms of the conditions and other things including alignment to SNOMED, the coding system recommended by the Australian government.
The pandemic situation has thrown things a bit out of schedule. But you will see changes with the products over this year and more in the next year.
You mentioned mapping, what exactly is mapping?
Firstly, our tool works with multiple clinical systems across the primary care sector. We’re not just looking at what’s just entered in one system but we need to be able to consistently report across different clinical systems. For those of you who are familiar with multiple patient records or management systems used in primary care, you would know, there are different options for coding.
For example, an ideal world would have Type II Diabetes as just one term used for coding in the patient record when a diagnosis is made.
Instead, what we have is 6-10 different possibilities for clinicians to diagnose someone is diabetes Type II (Diabetes Type II, Type II diabetes, NIDDM, and more variations).
Additionally to all this, you have different options available between the different clinical systems.
In our products, we aim to pick up all of the terms. We make it easy in terms of reporting. The user just has to click one box to say “Yes, we’re covering all patients with Diabetes Type II”.
This is a simple example, but we can get a more complicated grouping such as coronary heart disease or stroke.
They cover multiple accounts of different conditions and to individually find all patients that are classed under this category of coronary heart disease would be very tedious and time-consuming.
We’re doing mapping for efficiency on the user side as well as for reporting on the bigger health picture.
What are the other benefits of having quality data for general practices?
Mapping relies on the coding of data. We do not pick up free-text data.
In the context of PIP QI, there are several improvement measures that report on patients with diabetes.
There is a proportion of patients with diabetes with a ‘current HbA1c result’, ‘who were immunized against influenza’, and ‘a blood pressure result’.
So, if your clinic doesn’t code patients correctly, they might not be counted which means your PIP QI reports won’t contain all patients with diabetes. You can argue the point of how good or bad that is, but it’s an inaccuracy.
Practice and Population Health Considerations
If you’re not coding patients correctly, we find that a lot of drug interactions or other risk factors that relate to a condition will not be picked up by the built-in intelligence of the clinical systems. The clinical system isn’t aware that the patient has a certain condition unless it’s been coded.
This also applies to My Health Record, where sharing of data occurs with other clinicians. If it’s not coded and it’s free text, there’s a problem because it’s not clear what conditions have been entered.
There’s are a lot of reasons to code. Not only for the sake of your own data at the practice but even more so, if you look at the bigger picture of sharing data with My Health Record and for national reporting for PIP QI or similar initiatives.
Why is quality data more important now than ever?
If you record the data right, in the right place, and if it’s reliably recorded, it also enables you to look at what’s actually going on.
You need a way to measure what you’ve implemented, e.g. a new management system for patients with heart disease. Do we see a stabilising of their blood pressure? Do we see any impact on their lipid values?
Whatever you’ve targeted you will need data to be able to evaluate it and that’s all part of the quality improvement cycle.
Not just implementing things but also evaluating the outcomes. You need data to identify the group of patients you want to target for your quality improvement efforts, but you also need data to see if it works. And if it worked, what are the quantified outcomes?
Support Funding for Quality Improvement in Practices
Clinicians are not really paid to look at data or to improve data or to go in and fix up their clinical data, so this is something that PIP QI has helped with by providing funding earmarked for quality improvement.
Through PIP QI, there is now available funding on a practice level which is a good thing. There might be other things to assist improving primary care data quality over time, since it is very early days.
I hope that people can see the value in having good and reliable data at the practice level with a look of the broader picture, not just at the individual patient in the consult but also all patients who visit the practice.
On the bigger picture, looking at the role data plays on the national health and primary care plays a vital role in that.
We welcome your ideas and questions. If you have any feedback or questions, please send them to firstname.lastname@example.org.