| Project Objectives / Summary:
This project sought to demonstrate a model of how improved use of computerised information management strategies by GPs could inform clinical interventions that improve patient outcomes. The approach to the use of data in general practice was built on the experience of DiNCQUM GPs nationally recognised collaborative inter-Divisional program for the Quality Use of Medicines (QUM).
The project required a high degree of participation by GPs as to the means of identifying patients most likely to benefit from identified information management strategies in general practice and which strategies are most appropriate.
The broad aim of the project was to provide education, information and support to GPs to facilitate the use of IM/IT to improve patient outcomes. The specific objectives identified by the management group during the development of the project were to:
- Improve the identification of linkages between GPs' use of computer based decision support systems (CDSS) and interventions that improve patient outcomes in routine general practice.
- Develop a GP clinical audit program requiring GPs to use a CDSS to prescribe and manage patients identified as at risk of negative outcomes due to the use of multiple medications.
- Develop a model how GPs learn to adopt sustainable information management systems identified as meaningful to the improvement of the health of their patients.
- Development of a CD ROM and other resources.
Project Collaboration:
- Two Divisions of General Practice in WA (Fremantle & Osborne)
- Health Insurance Commission (HIC)
- The Pharmaceutical Alliance (TPA)
- NSW Medicines Information Centre (MIC)
- Integration SERU
- Consumers' Health Forum
Project Outcomes:
- The CDSS tool was developed to provide evidence based treatment and prescribing guidelines, as well as patient information handouts, on a CD-ROM. A difficulty lies in compatibility between the CD-ROM and Apple McIntosh computers.
- Development and dissemination of the GP resource kit. At the request of GPs, the resource kit is as paperless as possible.
Recommendations:
The funding for this project was approved and granted over three years ago, and in this time there have been major advancements in technology such that audit, based on a CD-ROM, is no longer innovative. However, this project highlights that GPs would continue to benefit from training in this area.
Disseminating Project Information:
- Production of CD ROM and consequent dissemination to all participating GPs.
- The National Divisions of General Practice Forum 2000, Brisbane, Queensland 24-26 August 2000
Lessons / Assessment:
The project is transferable to other Divisions, as all resources can be provided, including the CD ROM. However, the guidelines contained within the CD ROM will date, and the Division recommends they not be used after December 2001 unless reviewed and updated as necessary.
There are reasons why the project may not be sustainable. These are:
- The Division offered payment to the GPs who participated, and these payments would not be sustainable by most Divisions (although if the GPs wanted to utilise the CD ROM without being paid, this could be overcome);
- The guidelines for prescribing were developed using current evidence and expert opinion, and would need to be reviewed and updated regularly (for example, at 6 monthly intervals), and this would be very costly and time consuming;
- There is now a great deal of competition from drug companies and other companies that are producing CD ROM based guidelines, and these are often provided free to GPs. It would be very difficult to justify charging GPs for the audit CD ROM (to cover costs only) when they know they can get similar information from another source for free;
- The Therapeutic Guidelines are now being produced on CD ROM for those GPs who prefer to access their information in this way; however,
- If funding could be gained (from government) to continue to update the guidelines, perhaps the audit could be sustained.
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