Data Extraction in General Practice
Rationale for Data Extraction
Best practice disease management (i.e. disease based registers and effective use of
lM/lT systems) can be optimised in General Practice through:
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‘Clean’ data
Consistent coding of information and recording information in the correct places
Effective implementation and maintenance of registers
Proactive call and recall systems
Regular monitoring and review/update of systems
Practice commitment to use of these systems, ideally with a whole of team approach
Practice wide agreements on common coding and recording
Data extracted from clinical software is a tool that enables the measurement of
systematic improvement in these processes. Additionally once these systems are in
place, extracted data allows practices to see how well they are meeting the guidelines
and goals for evidence based care.
What are the benefits to my practice?
Through appropriate use of a data extraction tool, your practice will have increased
capability to manage your patient population, particularly your chronic disease patients,
more effectively and more efficiently. Good examples of these are the ability to search
for diabetes patients that have returned an elevated HbA1c, or those patients with a
chronic disease not on the required medications.
There are some limitations with all data extraction tools but the benefits of use can be
summarised as follows:
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Pro-active health care
Improved patient outcomes
The quality, accuracy and completeness of the practice’s clinical data will be
improved
Enhanced team-based care
The software can be used for existing initiatives, e.g. the APCC and Accreditation
The software can be used for business planning
The ability to measure the progress of systematic quality improvement initiatives
within the practice
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What is the Pen Computer Systems Clinical Audit Tool
(CAT)?
The Pen Computer Systems Clinical Audit Tool (CAT) is a data extraction tool created
by Pen Computer Systems Pty Ltd. Following assessment in General Practice and a
state-wide agreement, Divisions in Victoria are now offering CAT to their members.
CAT works with Medical Director 2, Medical Director 3, Best Practice and Genie
(additional software capability is expected to follow). CAT scrutinizes the practice’s
aggregated patient information and presents it in an easy to understand graphical
format. The data analysis functions can be customised to suit practice needs, filtering by
demographics, conditions and medications, practitioners and immunisations allowing
practices to target patients with particular needs or specific health risk profiles. The
reports meet the requirement for APCC reporting.
How do Data Extraction Tools work?
Data extraction tool software is installed on your practice system with assistance from
the Division’s Practice Support Team members.
Once installed:
1. The software reads your clinical software and creates a rich clinical subset (data
extract) of information for review. The data subset represents a snapshot of clinical
data at that time.
NB. Any alteration to the clinical software records will not be
reflected in extracted data until an updated snapshot is created. (To minimise any
potential down-time risk, this is a task that should be performed during a quiet time
and after a backup has been completed.)
2. The GP, Practice Manager, Practice Nurse or practice staff can use the data extract
file at any time without further reference to your clinical software. Staff can quickly
build a picture of practice population health information status. This will help the
practice identify areas of further interest.
3. The NPI tool and CAT enable you to view registers of identified patients and export
them to Excel for further analysis.
4. Regular reports can be run using the NPI tool and CAT, enabling practices to
monitor and measure quality improvement initiatives within the practice to
demonstrate improvement over time.
5. The NPI tool has an optional function to send de-identified and aggregated data to
SDGP.
NO data leaves the practice without the practice’s knowledge.
Data Management
It will be the Practice’s responsibility to ensure that a backup of your clinical system is
taken before the extraction tool creates an extract of your data for review. This is a ‘read
only’ process that does not affect any data in your clinical system. This means that risks
to your clinical information system are minimal.
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What commitment is required by my practice?
Practices should be prepared to explore the information capabilities of the system in line
with individual practice’s current focus and direction, which effectively means allocating
time and resources. AWRGPN staff can support the practice by assisting with training so
that the relevant practice staff understand how the data extraction tools work, what
capabilities they have and how they can help to systematically improve patient
outcomes. We will also prepare longitudinal reports so you can easily measure your
progress.
To get the best out of the information we suggest you spend some time on a weekly
basis reviewing the extracted data and planning how you will manage this. We suggest
this will require at least one GP plus a Practice Nurse or Practice Manager using the tool
on a regular basis. This could become part of your regular practice review process and
staff meeting content. It is likely to generate worthwhile practice activity for all levels of
practice staff - from reception to clinical, and as such it is beneficial to find ways of
sharing improvements with the whole team.
The AWRGPN, Data Use and Privacy
AWRGPN understands the need to protect practice information and confidential data
and would like to assure you that your information is held in confidence.
The Privacy Act does however place a special emphasis on ‘health information’ that
identifies a particular patient. Health information is specifically defined to include any
personal information collected by a health service provider during the course of providing
treatment and care to an individual. This will apply to all general practices but will
ordinarily not be the case for the Division, who obtains aggregated data.
When a member of the Division provides support for a practice, be it with an individual
General Practitioner, Practice Nurse or other practice staff member, it is clearly
understood that any patient data is data owned by the practice.
It is the responsibility of each General Practice to ensure they have a comprehensive
privacy policy in place. Unlike information collected by the Division (where patient
information and data sets are aggregated and de-identified by the time the information is
collected by the Division) information at each General Practice will contain identifiers and
will be considered ‘health information’ within the meaning of the National Privacy
Principles.
The Division takes no responsibility for the suitability or otherwise of the policies in place
at each General Practice it services, but would expect at a minimum that a policy is in
place that sets out who is responsible for overseeing the implementation and effective
operation of the privacy policy, and a single point of contact for privacy issues, to ensure
compliance with the relevant legislation.
As a matter of best practice, each General Practice should inform their patients of the
possible uses of the statistical data, and should ensure that no patients have any
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objections to its use in this manner, by providing ability for patients to register those
objections or bring them to the attention of the practice.
The process of consent relating to the individual patient rests with the patient and the
General Practice. When the patient provides any information or data to the practice,
there should be a clear explicit understanding between the patient and the GP, that the
GP and his/her support team will use the data for ongoing quality improvement in clinical
assessment, practice systems and service delivery, and care of the patient.
AWRGPN’s Privacy Policy is available at www.bordergp.org.au.
Information to third parties
The installed data extraction tool will not send information to any third parties without the
practice’s knowledge and authorisation.
Sending data to AWRGPN will only occur if initiated by and therefore with the consent of,
the participating practice. No data will be sent to AWRGPN without the knowledge
and authorisation of the practice.
De-identified data collected by AWRGPN is further aggregated, so it is not possible to
identify individual practices or patients of those practices. Data will be aggregated at the
Division level to provide population health data for our region and demonstrate regional
improvements against evidence based practice and can be benchmarked against peer
data. Aggregated, de-identified regional data may be reported to Department of Human
Services and Department of Health and Ageing in line with national performance
indicators.
Please note that NO identified patient data leaves the practice with the data
extraction tool provided by AWRGPN.
With thanks to the Southern Division of General Practice Inc.
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