In message <000c01bdacb6$b8c6bee0$75e8b094@trowell>, Dr Mark Trowell
<[log in to unmask]> writes
>Just got back from Manchester.  Not only was it an excellent opportunity to
>meet other computer literate techies :), I was also able to spend some time
>talking to Richard Caves and Andrew Carpenter, which was helpful.
>
>The main thrust was communication.  Without comms between interested
>parties, PCGs will fail.
agreed
>
>The conference has highlighted the fact that although we haven't yet got
>guidance from central government, we have to start thinking about the
>future.  The future is going to based on data quality, warehousing and
>extraction.
But it still has to be satisfactorily annonymised!!
>
>Data quality is critical to clinical governance (CG) and contracting.
>Examples were given of projects that had been unable to look at issues of CG
>because of poor data quality.  Unless we can improve our coding structures
>we will not be able to look much beyond simple prescribing issues, as this
>is the only area that GPs are 100% electronic.  As a GP the easiest way to
>sabotage CG would be to record incomplete data;  expect carrots and sticks!

we could be miles ahead of the field if we build on the Somerset project
(morbidity)-speaking as a Somerset GP - or similar CHDGP projects
>
>Data warehousing is the idea that we should store lots of information in one
>or more interconnected servers.  Where should these be situated?  More
>importantly, who owns the data and is able to control the questions that are
>asked of this data? 
IMHO this should be at Practice level, using Miquest searches to feed
into a county wide database.

> Somerset HA feels that they should provide a county
>wide warehouse, from which PCGs would receive reports.  But if a PCG does
>not own the data, nor ask the questions, how can we go to our colleagues to
>discuss their CG?  This also ignores the question of security and consent to
>access of patients' records.
which cannot be ignored.

i would suggest that ALL data flows into the GP computer systems - which
are designed to hold such read coded data - matched there - and then the
county wide warehouse has standard searches fed back via NHS net to
populate its databases. this would mean that there would need to be
little "fuzziness" about the matches, and the GP's would be in the best
place to ensure the data went into the correct record. All the masses of
investment SHA has provided for GP computing may finally be used for
near its potential.
>
>Data extraction, thankfully, seems to be rather less of a headache!  As we
>only have EMIS and Meditel in Sedgemoor, we are lucky that MIQUEST2 is able
>to extract from both, and is already up and running.  I suggest that we look
>no further.  The only (viable?) alternative would be to convert all
>practices to one or other system; this _might_ be an option in the future,
>or a new common front end may appear for both systems.
>

agreed
>Other developments:
>* Frank Burns has put NHSnet roll out into GP on hold
>* Blair says that the Electronic Patient Record (EPR) should be made
>available countrywide 24 hours a day, with access between GPs and summaries
>for different purposes e.g. alerts, emergency information only.
nope - unless the password is given to the Patient, who can then
authorise on a "need to know basis???"
>
>What next?  As Ewan Davis of AAH Meditel said: "Don't Panic"
>* DON'T:  Buy Commissioning Systems, Virtual Private Networks, new GP or
>Community systems
>* DO:  Wait for further guidance, Frank's IT strategy, make sure your
>systems are RFA4 accredited and are able to data extract with MIQUEST2, get
>connected to NHSnet, improve your data quality.
>
>More at: http://www.avongp.demon.co.uk/umist_prog98b.htm
>
>Some of the talks haven't been uplinked (yet!)
>
>
>Dr G Mark Trowell
>Highbridge Medical Centre
>Pepperall Road
>Highbridge
>Somerset
>TA9 3YA
>
>Hakunamatata
>
>(01278) 783220
>(01278) 795486 (Fax)
>
>
interesting..!!

-- 
Huw Thomas


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