Upload
calix
View
26
Download
1
Embed Size (px)
DESCRIPTION
Quality data: The PRIMIS Comparative Analysis Service for Coronary Heart Disease. Dr Pete Horsfield PRIMIS Clinical Director Ms Shirley McLean PRIMIS Facilitator, South Hams & West Devon PCT. Outline of Session. Overview of Comparative Analysis Service (CAS) – Pete Horsfield - PowerPoint PPT Presentation
Citation preview
3rd April 2001Birmingham
PRIMISFirst National Conference
3rd April 2001Birmingham
PRIMISFirst National Conference
Quality data:
The PRIMIS Comparative Analysis Service for Coronary
Heart Disease
Dr Pete HorsfieldPRIMIS Clinical DirectorMs Shirley McLean
PRIMIS Facilitator, South Hams & West Devon PCT
3rd April 2001Birmingham
PRIMISFirst National Conference
Outline of Session
• Overview of Comparative Analysis Service (CAS) – Pete Horsfield
• Outline of CAS for CHD – Pete Horsfield
• User perspective of CAS for CHD – Shirley McLean
• Discussion
3rd April 2001Birmingham
PRIMISFirst National Conference
Overview of CAS (1)• PRIMIS
– Support and Training• Information Management• Data Quality
– Data Quality Analysis• Standard Query Set• All schemes (within scheme only)
– Comparative Analysis Service• Added-value service• Clinically focused• Voluntary• Selective (data quality filters)• Out-of-scheme, practice level
3rd April 2001Birmingham
PRIMISFirst National Conference
Overview of CAS (2)• Methods
– Selection of topics• Clinical Advisory Group• User Representative Group• PRIMIS Team
– Development of queries• National standards
– NSFs– Recognised guidelines
• Clinical Advisory Group• Iterative process
3rd April 2001Birmingham
PRIMISFirst National Conference
CAS for CHD
• First CAS query set– Pilot model for future work– Approaching end of first cycle of iteration– Run in 14 schemes ( 150 practices)
• Pragmatic approach– Loosely based on immediate priorities of NSF– Anticipate core information needs– Reflect what is achievable now– Platform on which to build
3rd April 2001Birmingham
PRIMISFirst National Conference
The PRIMIS Comparative Analysis Service for Coronary
Heart Disease
Dr Pete HorsfieldPRIMIS Clinical Director
3rd April 2001Birmingham
PRIMISFirst National Conference
PRIMISFirst National Conference
Information from General Practice
Coronary Heart Disease Shirley McLean
Clinical Information Co-ordinatorSouth Hams & West Devon PCT
3rd April 2001Birmingham
3rd April 2001Birmingham
PRIMISFirst National Conference
South Hams & West DevonClinical Data Project
Started Aug 200018 practices in total16 participating2 due to start in
July
av. 75% patient records on computer
100% by April 2002
Query sets used• DQ Data Quality• CHDB Basic LevelSystems in Use• Microtest x 8• EMIS x 4• Meditel System5 x 3• Vision x 3
3rd April 2001Birmingham
PRIMISFirst National Conference
September• Approval from Clinical Governance Leads
October / November• Read Code training
December• New version of MIQUEST received for use with CHD
NSF Queries• Test sites, one for each system• MIQUEST Interpreter failure• Deadline extended (thanks Lynne!)
3rd April 2001Birmingham
PRIMISFirst National Conference
January• PCT CHD NSF Launch Day held• Summary list of Read codes• Data sent to the Comparative Analysis Service
February• Feedback received; gross errors at one practice fixed
by supplier; data resubmitted
March• Feedback received & reported to Clinical Governance• Practices visits arranged
3rd April 2001Birmingham
PRIMISFirst National Conference
Beneficial Outcomes• Motivation to enter data on the computer• Coding lessons learnt• System failures identified & fixed• Corrupt data identified & fixed• Under-recording of Diagnoses, Smoking
Status, Alcohol, BMIs identified• New templates enabling improved data
collection• Validation of ‘Registers’ supported &
encouraged
3rd April 2001Birmingham
PRIMISFirst National Conference
Hints & Tips
• Select Test sites• Check the raw data• Allocate PRIMIS Unique
Identifiers in batches by supplier• Provide free training, preferably
on-site• Suppliers can help!
3rd April 2001Birmingham
PRIMISFirst National Conference
Known Problems with Results
• Un-coded drug data• Unreliable incidence data• A true picture of Clinical Practice is masked by
clinical system / data quality issues, e.g.Apparent under-recording:– Not all patient records on the computer /
codes not entered at all– Alternative Read codes used
• No guarantee that NSF information requirements will be fully met in the form required by HAs
3rd April 2001Birmingham
PRIMISFirst National Conference
Wish List• Rush output in NSF age ranges, <35, 35-74,
>74• To be included in queries:
G73% PVD
5853. Echocardiogram792.. / 773. Coronary Artery Operations771. Angioplasty8HTK. Referral to stop-smoking clinic
137L. Current non-smoker (where date ceased = ?)
• Rush files to include a record of the Read codes and terms used for each chart
3rd April 2001Birmingham
PRIMISFirst National Conference
Future Plans
• Provide feedback & agree action plans with practices
• Get written consent from each practice before identifying & publishing the results
• Report to the Executive• CHD Intermediate & Advanced queries• More Read Code training• Repeat query cycle & map trends
PRIMISFirst National Conference
Information from General Practice
Coronary Heart Disease Shirley McLean
Clinical Information Co-ordinatorSouth Hams & West Devon PCT
3rd April 2001Birmingham
3rd April 2001Birmingham
PRIMISFirst National Conference
3rd April 2001Birmingham
PRIMISFirst National Conference
Discussion Topics
• Strengths• Weaknesses• Training / support implications• Suggestions for improvement• Data Quality criteria• Clarification of rationale
3rd April 2001Birmingham
PRIMISFirst National Conference