In article <00c301bdbe0e$911c1c00$0100007f@localhost>, Paul Galloway
<[log in to unmask]> writes
>
>>
>Chance would be a fine thing, even within a practice! Ve vant conformity at
>all costs, a
snip
> money but ze bloody non-conformists spent it on
>Costloadastatin!!
Surely it is of benefit for a PCG to know how many patients have
cataracts (early or otherwise) so we know how many to purchase for next
year. all it would take is for a practice to use one code rather than
the several available?

IMHO " I insist on doing it my way, and hang the validity of the data"
is not a valid arguement I'm afraid. Surely you can see how useless this
makes the data. We need IT guru's to adjust the systems - perhaps with
laminated sheets next to the screens - so it is EASIER to use the agreed
(note i dont use the word "proper") code .:^)
>
snip
>A disease register at pratice level, certainly. At PCG or regional level,
>yet to be conviced of benefits out weighing risks.
Risk would be minimised if data goes into GP system and only MIQUEST
searches come out - fed into PCG database (my preferred option)
>
>As for it being a small step !!! you are joking aren't you ? Even amongst
>the switched on practices a lot only code for a handful of items that they
>think might be the most useful

>, mostly chronic disease monitoring driven
>stuff.
it will be interesting to see how many perople do this, less or more??

It was certainly this opinion that the CHDGP agreed with. We don't know
what's round the corner though.. Some is certainly better than none :^)

If we are recording, perhaps  60% of consultations with chronic disease
related codes, why not record UTI's, flu, hay fever etc?? 
My point is that the discipline (perhaps a bad word) is important,
unless you can guarantee you always code important morbidity. Taking the
UTI example above, it would be easy to check that all <5yrs UTI have
been followed up +/-referred?? ...or those with >4 episodes in a year??
>
>>variation). We need to be urging as many GP's as possible to collect and
>>record "morbidity data" from all consultations - and this needs to begin
>>ASAP!
>
>
>So apart from "urging",  what renumeration and incentives do you offer for
>this laborious data collection exercise, as I have not seen the requirement
>to do it within the TOS? yet? :-(
>
>Does your health authority give 100% reimbursement of the staff time, and
>computer expenses of the practices?
nope, but perhaps PCG's??
>
>> Most recently
>>is the CHDGP project, but unfortunately this has felt unable to insist on
>>the discipline of recording information at EVERY consultation, and has not
>>insisted on validation. The one thing I know a lot about is "busy GP
>>surgeries" and  unless these disciplines are forced upon them, data on
>>Monday mornings, Friday afternoons and visits is likely to be very
>>incomplete!
>
>Too right! Thanks for considering forcing it on me though, after all it's
>for my own good! ;-)
Always the realist :^)
>
snip
>
>I spoke to a very nice chap from Agora Health (you know the guys who are
>bankrolling the "free" MDIntranet service, no strings attached honest guv).
>They have a second piece of software up their sleeves designed to do just
>the sort of things you want to do.

>
>However, I remain unconvinced that GP's are particularly keen to act as
>unpaid data entry clerks for the wannabe Public Health Physicians of PCG's.
>There may be a few who don't want their data "extracted" :-)
So how about funding the clerk time, allowing GP's to opt out and pay a
clerk to enter data indirectly from the notes.... others can do it
themselves and pay for the Summer hols???


I have been through a lot of this before trying to recruit practices to
the Somerset Project. We only had one refusal about of 12 approached
(all already computerised though - to a greater or lesser extent)

IMHO the way to get this data is to make it more straightforward to
record, and pay.. I hope PCG's realise the importance of this data and
strive to obtain it.

We'll see

Regards

huw
-- 
Huw Thomas


%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%