Transcript Computerisation Survey of GP Practices within Lothian

Computerisation Survey of GP
Practices within Lothian
Dr Colette Fulton - Lothian Primary Care Research Network
Coordinator
Dr Brian McKinstry - Lothian Primary Care Research Network
Director
What I want to cover………..
• Rationale for the study: Overview of
the role of the Lothian Primary Care
Research Network
• Method adopted in the survey
• Results of the survey
• Discussion
The remit of the Network
• To manage high quality projects relevant to
primary care which are carried out in the
primary care setting
• To develop the culture of research in
primary care in the Lothians and Borders
• To develop protocols and to complete high
quality studies that will make a difference to
the provision of primary care
• To maintain and update a database of
professionals and practices interested/
involved in research
Current Membership
• 80 practices
• 370 individual primary care
practitioners
Research in the Trust
well
women
services
mental
health
maternal and child
health
community
services
Lothian Primary
service delivery
Care NHS Trust
occupational
health
Rehabilitation: e.g. after stroke; MS
Background to the present
study
• Network required to recruit practices to
studies – often studies state strict inclusion/
exclusion criteria in relation to study e.g.
patients with COPD on particular
medication; patients with varicose veins
who have not had surgery
• Letters asking for recruitment are sent to all
practices – poor uptake and poor
recruitment
• More focussed recruitment required to
those practices which code/ or hold
computerised information specifically
related to pathologies etc.
Aim of the present study
• to ascertain the level of
computerisation of particular
diagnostic information and test
results within each practice.
Method
• A questionnaire was sent to practice
managers in 80 practices which included
questions on the degree to which
summarised information on a variety of
important chronic and acute diseases, test
results and prescribing were recorded on
computer and also the use of scanning of
hospital letters and use of SCIMP codes.
Results
• Response rate – 66 practices returned
completed questionnaires (an 82.5%
response rate)
• information relating to diabetes, asthma,
ischaemic heart disease and hypertension
are most commonly computerised
• data on the presence of stroke/ TIA and
COPD are not commonly computerised.
• The majority of practices (41%)
reported they summarised over 90%
of other major diagnoses on
computer; 30% summarising over
50% and 21% summarising under
50% of major diagnoses.
Computerisation of Data by Practices According to Pathology
70
60
Number of Practices
50
Complete Recording
40
Incomplete Recording
No Recording
30
Missing Data
20
10
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• practices were universally
summarising repeat prescriptions on
computer and the majority
summarising acute prescribing.
• additional information such as routine
bloods, X ray/ ultrasound and MRI
results, and the scanning of hospital
letters were rarely summarised on
computer.
• 78% also utilised SCIMP codes or
equivalent.
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rs
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Ac
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Number of Practices
Additional Information Held on Database
70
60
50
40
Recorded
Not Recorded
30
Missing Data
20
10
0
Discussion
• From the information received, at least in
Lothian, the long-term objective of practices
becoming ‘paperless’ appears to be still a
long way off.
• For the Research Network, the recruitment
of practices to assist in large multi-centre
trials is hindered by the lack of
comprehensive information systems in the
primary care setting.
• This survey was, however, conducted
before the details of the new GP contract
were made known and this may be a driver
for increased computerisation.
Further research ideas to explore
• To undertake follow- up survey to
explore accuracy of information
obtained by survey e.g. COPD study
currently underway targeting only
those studies that responded that they
could code for COPD.
• Undertake follow – up study once new
contract in place.