Dumfries & Galloway were / are seriously looking at this route but for
various reasons the project has hit a sticky patch. The prinicpal reason is
eactly that alluded to by Adrian Midgely - GPs already have much of the
data. We have seen a revolt by the ITliterate practices against a duplicate
data collection. Adrian doesn't expand further however that
(a)many practices don't have that much good data (or at least aren't
reliable at collecting it)
(b) not all primary care info systems are good at having data extracted or
useful data stored (particular problem in Scotland until GPASS improves)
(c) but only practices know of all the cases
I think parallels with cancer registries are somewhat naive. Oncology
services tend to be almost wholly specialist led. Cardiac services (whether
your new consultant colleague likes it or not) will continue to have a mixed
provision.
Either you invest in primary care info (and I mean more training / thinking
through systems rather than just buying boxes) and MIQUEST the data out of
it
OR you create a central database which will be resented by GPs (who will no
doubt be asked to hoover the data from their own computerised and paper
records) particularly when the consultant then uses the data GPs have
collected to tell them they're not doing things right.
If you are to go ahead with this line (aesthetically unappealing as it is to
me to do it this way, it may be the quickest way to get things done) you
will need incentives galore to sell it to the GPs. And it will become a
giant data hole, sucking more and more information in at ever increasing
cost and diminishing accuracy whereas once set up teh GP systems shouold
have fairly even running costs.
Go ask your PCGs / GPs what they want.
Cheers
Chris
Dr Chris Burton
GP, Sanquhar, Dumfriesshire
Member of WestNet, The West of Scotland Primary Care Research Network
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of
> [log in to unmask]
> Sent: 08 January 1999 14:25
> To: [log in to unmask]
> Subject: Registries for cardiac services
>
>
> This message is seeking help in developing a system to monitor
> the clinical processes and outcomes of the cardiac service in a
> district hospital.
>
> A newly appointed consultant cardiologist has asked me to
> collaborate in developing a registry system for tracking the
> treatment and outcomes of patients referred with coronary heart
> disease. The aim is to understand more about where patients come
> from, what prognostic scores they have, whether treatment
> standards (such as those in the forthcoming national service
> framework) are met and what their subsequent clinical course and
> outcomes are. Linkage of clinical episodes is clearly essential.
>
> Such an approach is routine in cancer services, but existing
> cardiac registries only cover tertiary care and do not include
> long-term follow-up.
> We would be very interested to hear from anyone who is already
> undertaking such a project, either to learn from your successes
> and problems or even to collaborate formally.
>
> Dr Tom Dent
> Consultant in public health medicine
> North and Mid Hampshire Health Authority
> Harness House, Aldermaston Road, Basingstoke RG24 9NB, UK.
> Tel: 01256 312251
> Fax: 01256 312299
> E-mail: [log in to unmask]
>
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