General Practice Statistics in Australia: Pushing a Round Peg into a Square Hole
Abstract
:1. Introduction
2. Background
3. History of General Practice Statistics in Australia
4. Current Status of General Practice Clinical Activity Data
- (1)
- MedicineInsight (NPS MedicineWise);
- (2)
- Data for Decisions (University of Melbourne);
- (3)
- Primary Health Insights (led by WA Primary Health Alliance).
5. The Use of EHR Data for Research and Statistics
5.1. Variability in EHR Design
5.2. Data Completeness
5.3. The Medical Record as an ‘Aide Memoir’
5.4. Privacy and Information Protection
6. A Fresh Approach
- (1)
- Data from general practice can provide an excellent overview of the health of the population overall;
- (2)
- Using the GP as an ‘expert interviewer’ to curate data can facilitate data with higher levels of accuracy than patient self-report;
- (3)
- It is not necessary to collect data about all the patients, all the time. The BEACH study demonstrated that the production of structured data, about a sample of patients, can generate high-quality statistics from general practice for use in policy planning, education, and research;
- (4)
- The sample of patients must be representative of the patient population to ensure validity and reliability;
- (5)
- Data need to be longitudinal for the investigation of outcomes of care, including care provided by other health services (e.g., specialists, hospitals);
- (6)
- The capacity to review the patient’s experience with the health system overall, through linking general practice data to that from other health agencies, is encouraged.
- (1)
- A health summary template where the GP extracts a health summary from the EHR (similar to the patient summary currently contained in the EHR), followed by a ‘check and curate’ process, in which the GP reviews the accuracy and completeness of the data extracted. For example, is the patient’s problem list accurate? Are medications listed that the patient no longer takes, or are there over-the-counter medications taken regularly that should be added? There are also additional data elements not currently included in GP EHRs that could be captured in this process. For example, capture of data about social determinants of health (e.g., education level, household income) would contribute to a greater understanding of a patient’s health and related health outcomes;
- (2)
- An encounter summary template where the GP extracts and curates data about an individual GP–patient encounter. This data extraction would be based on data elements that were collected in BEACH using a problem-oriented structure. The GP would curate the data by completing areas within the template that are missing and add linkages between problems managed and their treatments.
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Gordon, J.; Britt, H.; Miller, G.C.; Henderson, J.; Scott, A.; Harrison, C. General Practice Statistics in Australia: Pushing a Round Peg into a Square Hole. Int. J. Environ. Res. Public Health 2022, 19, 1912. https://doi.org/10.3390/ijerph19041912
Gordon J, Britt H, Miller GC, Henderson J, Scott A, Harrison C. General Practice Statistics in Australia: Pushing a Round Peg into a Square Hole. International Journal of Environmental Research and Public Health. 2022; 19(4):1912. https://doi.org/10.3390/ijerph19041912
Chicago/Turabian StyleGordon, Julie, Helena Britt, Graeme C. Miller, Joan Henderson, Anthony Scott, and Christopher Harrison. 2022. "General Practice Statistics in Australia: Pushing a Round Peg into a Square Hole" International Journal of Environmental Research and Public Health 19, no. 4: 1912. https://doi.org/10.3390/ijerph19041912