Preparing practice data for the PCEHR

This article first appeared in the May 2012 edition of Pulse+IT Magazine.
High quality and accurate clinical notes are an integral part of a computerised general practice. However, the ongoing transition from paper-based and hybrid records to fully electronic records has resulted in some variability. The PCEHR may serve as a catalyst to improve electronic records, with this article highlighting two software products designed with this aim in mind.

To assist practices to analyse and improve the quality of their electronic patient records in preparation for uploading to the PCEHR, the National E-Health Transition Authority (NEHTA) engaged Pen Computer Systems, developers of the Clinical Audit Tool (CAT), and the Canning Division of General Practice, developers of the Canning Tool, to add a collection of reports to their existing data extraction tools.

Collectively known as the Clinical Data Self-Assessment (CDSA) module, the products are designed to extract a snapshot of selected data from a clinical system for analysis, presenting the user with reports built upon the RACGP’s GP eHealth Summary recommendations.

It is understood that as part of NEHTA’s funding arrangements with each developer, the CDSA functionality is to be made freely available to any practice that wishes to install the software. Details about the arrangements each vendor has made in this regard are outlined later in the article.

Data indicators

In consultation with NEHTA, Pen Computer Systems was engaged to develop specifications for both their own purposes and for the Canning Tool. As such, there is a large amount of commonality between the two products as far as their CDSA reports go, with each product particularly focused on active patients, being those that have presented at least three times in the last two years.

The list of data indicators that are analysed and reported on in the CDSA utilities are as follows:

Allergies and adverse reactions: The number of patients with an allergy status recorded is retrieved. In addition, of those patients that do have an allergy status that isn’t flagged as ‘no known allergies’, the number of allergies that are recorded from a coded table as well as the number of allergies that have content in the reaction field is also presented.

Medicines: The ‘reason for prescribing’ for current medications is extracted, where the clinical software supports this data being recorded in a coded pick list.

Medical history: This indicator refers to the number of diagnoses entered in the past history that have been entered in a coded format, compared with the total number of diagnoses.

Health risk factors: This collection of indicators analyses smoking data, including whether smoking status is recorded, the number of cigarettes per day, and a cessation date for past smokers. The recording of waist circumference for patients with BMI over 25 and BMI under 18.5 is also reported on, as is the recording of alcohol status for both quantity and frequency for patients 14 years and over.

Immunisations: Compares the number of active patients with immunisations recorded in the system to the total number of active patients.

Relevant family history: Compares the number of active patients with family history recorded in the system to the total number of active patients.

Relevant social history: Provides a report on whether living arrangements, ethnicity, occupation, employment status and relationship status are recorded, as well as whether patients are flagged as carers, or they themselves are under such care.

Duplicate patients: This indicator is designed to assist practices to de-duplicate their patient database by comparing key demographic details such as names and dates of birth, in addition to various identifiers such as those provided by Medicare and DVA.

The Canning Tool

Developed by Ian Peters of the Canning Division, the Canning Tool is reported to be used in around 1200 practices across Australia. Originally sold through licensing agreements with a large number of divisions, the Canning Tool is now being made freely available starting with version 4.10, which is the version that introduced the CDSA module.

While the Canning Tool can extract and analyse data from seven different clinical products, the CDSA functionality currently only works with Medical Director 3 and Best Practice. However, the developers have indicated that the CDSA functionality will be extended to Medtech32, practiX and Zedmed.

Clinical Audit Tool

More commonly known as CAT, Pen Computer Systems’ Clinical Audit Tool is currently available to around 85 per cent of GPs via licensing arrangements with their Medicare Locals and Divisions. Licensed users of the product may already have access to the CDSA functionality via CAT’s auto-update features, however for those practices that do not have access to CAT presently, Pen Computer Systems has made available at no charge a version of the tool that only includes the NEHTA-funded CDSA module.

Only a subset of CAT’s software extractions – which work with Best Practice, Communicare, Medical Director 2, Medical Director 3, Genie, Medinet, Medtech32, Practix and Zedmed – currently support the CDSA module at this point in time. Best Practice and Medical Director 3 customers can use the software now, with Practix compatibility coming soon, according to the developers.

Pen Computer Systems has advised that other clinical software developers wishing to provide CDSA functionality to their customers via the Clinical Audit Tool will first need to update their data export routine to version 1.13 of the CAT extract.

Posted in Australian eHealth

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