[log in to unmask],Net writes:
>Adrian wrote: We could look at the time from bellyache to knife, and the
>time of day
>of operation, in appendicitis.

>How often does the average GP see appendicitis?  Once a year at most?  I
>don't think you can really audit someone's work on that basis......

100% missed my point.
All the cases of appendicitis in the PCG go to the DGH.
What we would be looking at as a performance indicator is an indicator
of the _system_ function in acute surgical conditions which cross from
primary to secondary care.

This is important for pateints, important for GPs, important for the
organisation of the service, and for the interface between medical and
managerial activities.

And, not having looked up my figures, if each GP sees one event per
year, and there are 60 GPs in the firm, then over 5 years there will be
300 observable events, quite sufficient to be worth looking at without
being a huge workload.

As to the accuracy of coding, part of the example given relates to the
poor use of Read version 2 in current systems (something which Torex
have addressed in Premiere) and the non-uptake of Read 3 which does
have some qualifiers for certainty.
Surgery Manager, the lamented and foully murdered system I used to use
offered provisional diagnosis as a category as well as confirmed
diagnosis - so it is quite feasible to indicate a lack of certainty
there -

BUT - if you have an effective treatment available for a mortal
illness, I don't see the problem being a coding one - surely you wish
to get it sorted out whether they have G3 or not.  Once you have, fine.
Get away from the coding bit, what we are talking about is making
adequate notes, and looking after patients.



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