CAT: King of the jungle

The development of the Clinical Audit Tool (CAT) by Pen Computer Systems has put GPs, practice managers and practice nurses back in the drivers seat by giving them easy access to their own data.

Groups such as pharmaceutical companies and Government have a long history in harnessing the power of data and taking advantage of its myriad uses. However, till now, general practices have had to be content with having a “feel” for what their practice is like but never actually knowing for sure. Enter stage right, the Clinical Audit Tool.

Developed by Pen Computer Systems, the tool works by extracting practice data and enabling analysis at a population level. Pen Computer Systems became the RACGP’s preferred supplier of health informatics in March 2008.

CAT is distributed via Divisions of General Practice who provide much of the technical and training support. The RACGP’s role is to coordinate this work at a national level. There are many Divisions doing great work and the College would like to help in sharing that knowledge where possible.

A piece of the pie

CAT works by taking a “snapshot” of a practice population and extracting data related to a number of filters and clinical measures. This allows data to be filtered by demographics (age, gender, timeframe, postcode etc.), condition (diabetes, respitory, cardiovascular etc.), medication and provider. Once data is filtered by the appropriate channels you can explore your population through specific clinical measures. These include those that are relatively straight-forward (eg. allergy status) through to structured information (eg. diabetes SIP item).

Quality solutions

The development of the Clinical Audit Tool by Pen Computer Systems has put GPs, practice managers and practice nurses back in the drivers seat by giving them access to their own data. Exploring patient data enables practices to identify discreet cohorts that may not currently receive consistent care.

A simple example is pap smear. The CAT will automatically identify the practice’s female population between 16 to 70 and note all ineligible candidates (eg. hysterectomy). It then presents a simple pie chart coded by patient number or percentage that displays those who have a pap smear recorded, not recorded, or are ineligible. You may wish to start with your active patients (at least 3 visits in the last 2 years) and recall those who do not have a pap smear recorded.

Once you have the “no pap smear recorded” figure at a level the practice is happy with, you might decide as a next step to explore the pap smear data by last date recorded. You could then recall patients whose last pap smear was over 4 years ago and so on.

Data solutions

Many doctors use their desktop systems to suit their consultation style. Not all doctors fill in specific data fields, and where the user is not forced to enter information by the software (eg. to enable a record to close) human nature dictates that variability will occur. Previously this has not been of great importance, as the record was used for individual care.

Using the CAT enables practices to identify gaps in their data and “clean” it for future use. By cleansing data, each extraction will enable the CAT to delve further into your practice data and identify even more opportunities for improving the quality of care provided.

A simple example of this is selection of gender. Previously some desktop systems did not force gender as a choice. By looking at the broad practice demographics, you can identify those with the sex “other” and code these patients appropriately.

Business solutions

The other immediate benefit of the CAT is the identification of new business opportunities. By exploring practice data with the CAT, you can quickly and easily see where you might effectively utilise practice staff time and effort.

A simple example of this is use of the CAT by a practice nurse specialising in diabetes or a diabetes educator. This tool will enable them to improve the quality or their patients’ care whilst making the most of enhanced primary care and service incentive payments (SIP) available to the practice. Tracking eligibility of SIPs is less time consuming and frustrating.

The reason that the CAT is so exciting is that previously, practices operated in a feedback vacuum. Traditional audits are unattractive due to the administrative burden and cannot be performed across a whole practice population. The CAT enables practices to get a feel for what services they are performing and which populations they should target for improvement. With quality care, data cleansing and business solutions it is a win/win/win situation.

Posted in Australian eHealth

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