In message <[log in to unmask]>, Andrew
Herd <[log in to unmask]> writes
>Years ago, I ran a 'morbidity club,' may God have mercy on my poor soul, get
>a life, Herd etc.
>
>Apart from highlighting all the problems with merging data from different
>computer systems (a problem which still hasn't gone away, and won't until
>MIQUEST or something like it becomes standard in use,)
MIQUEST can only extract the codes it asks for - the real problem is
further back with firstly diagnosis ( "wheezy bronchitis" vs. "asthma" ,
and "stress related problem" vs. "neurotic reactive depression" for
example) , and secondly with the codes selected; have you *looked* at
the choice for depression in ver 5? ;-<<
> the major difficulty
>we faced was the fact that data on GP clinical systems is collected for the
>purpose of managing individual patients, not for epidemiogical purposes. The
>lesson I learned is that using aggregated GP data for population purposes is
>a dangerous thing - it wasn't collected for that purpose, and shouldn't be
>used for it.
First law of informatics?
>
>Looking at the RCGP morbidity collection project, which does collect
>population data, it should be noticed that GPs have to work to certain
>standards, and get paid in recognition of the extra work involved. I don't
>think most GPs would have the time or interest to work to these standards.
Agree.
Although finance *is* an issue, it isn't the only one... and a couple of
questions arise about the RCGP morbidity collection - genuine curiosity
- I've not seen the items to be collected, nor the codes selected.
1. Is it comprehensive? i.e. does it hope to cover *all* possible
diagnoses, and if so, in how much detail? What provision is there for
collecting information on new problems or diseases?
2.Does it influence the choice of diagnosis? e.g. between Influenza and
Viral Illness?
3.Does it demand a diagnosis at each consultation?
If the PCGs (or anyone else) think that there is reliable and
extractable morbidity data in GP systems, which can be used as a basis
for planning the provision of health care, heaven help us all!
Mary
Mary Hawking Kingsbury Court Surgery Church Street Dunstable LU5 4RS
tel:01582 663218 (surgery)fax:01582 476488 (surgery)
Member of British Healthcare Internet Association
Dunstable and Houghton Regis Locality Commisssioning Pilot
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