S de Lusignan

..The EFMI Primary Care Informatics Working Group held a workshop to explore interventions used across Europe to improve the data quality in primary care computerised medical records...

..The Hayes report was written as an independent review of health and social care IT in England...

..To report the lessons learned from eight years of feeding back routinely collected cardiovascular data in an educational context..

..The Primary Care Data Quality (PCDQ) programme is an audit-based educational intervention...

..To report current levels of obesity and associated cardiac risk using routinely collected primary care computer data...

..National guidelines recommend bisphosphonates for secondary prevention of osteoporotic fractures; however, poor compliance may result in sub-optimal prevention...

..The relevant principles were set out in a treaty of the Council of Europe and subsequent policy has been based on these. However, little has been written about implementing policy and the role of health informaticians in this process...

..A taxonomy is proposed to describe the barriers to clinical coding. This can be used to identify barriers to coding and facilitate the development of strategies to overcome them...

..Much of European primary care is computerised and many groups of practices pool data for research. Technology is making pooled general practice data widely available beyond the domain within which it is collected...

..Routinely collected data is an underused resource, yet little has been written about the wide range of factors that need to be taken into account if we are to infer meaning from general practice data...

..They are also progressively computerising family practice. We set out to identify and report where these countries might learn from each other's experience...

..This study set out to promote a systematic approach to reporting CKD prevalence...

..The aim of the study was to measure the accuracy of diabetes diagnostic data and explore the scope for identifying errors...

..ALFA has been used to compare different brands of primary care computer systems; nurse case-load selection and consultation in psychiatry...

..Finally, we will conduct an economic evaluation based on a comparison of the cost effectiveness of each intervention. CLINICAL TRIALS REGISTRATION: ISRCTN56023731. ClinicalTrials.gov identifier...

..There is a lack of tools to evaluate and compare Electronic patient record (EPR) systems to inform a rational choice or development agenda...

..This preceded the development of a National Health Service information strategy and an ambitious National Programme for IT...

..Landmark reports suggest that sharing health data between clinical computer systems should improve patient safety and the quality of care. Enhancing the use of informatics in primary care is usually a key part of these strategies...

..To determine the extent to which routinely collected general practitioner computer data could be used to create disease registers of patients with osteoporosis, and to report any improvement in data quality since previous studies...

..This study set out to examine the barriers to recording structured information in computerised medical records; and to explore whether managers and clinicians had different perspectives in how these barriers should be overcome...

..With further refinement, this rating scale may become a useful tool that will inform software developers of the effectiveness of their programmes in the consultation, and suggest where they need development...

..The system was acceptable to patients and functioned satisfactorily in the home. An important facet of home telemonitoring may turn out to be its greater reliability in collecting objective data...

..However, recent quality based targets for diabetes in the UK only allow for people with Type 1 or Type 2 diabetes to be included in the disease register...

..To develop a computer processable algorithm, capable of running automated searches of routine data that flag miscoded and misclassified cases of diabetes for subsequent clinical review...

..First, they had a cardiologist's assessment. They were then randomised into telemonitored patients who measured pulse, BP, weight and video consulted, and controls...

..This consists of financially remunerated 'quality points' for specific disease areas, including stroke. Achievement of these quality points is measured by extracting a limited list of computer codes from practice computer systems...

..The aim of this study was to examine the effect of an educational intervention on data quality in primary care...

..If this proved possible it would provide, for the first time, an objective quantitative measure of computer use and a measure of the attention and responsiveness of the general practitioner towards the patient...

..The sensitivity of the use of the diagnostic code was 79%, and the positive predictive value 75.3%. CONCLUSIONS: The method provides a tool to help practices and localities assess their diagnostic data quality...

..Implications for the three-channel video technique for training, monitoring GP competence and providing feedback are discussed...

..We sought to identify what systems are currently used and to what extent they were subject to local adaptation...

..This is strongly for the end-digit zero. However, there is more use of other end-digits, notably 8 and 5. This bias potentially carries important treatment consequences for this high-risk population...

..Unified Modelling Language (UML) is a standard modelling and specification notation widely used in software engineering...

..The New Opportunities for Early Renal Intervention by Computerised Assessment (NEOERICA) project aimed to assess whether people with undiagnosed CKD who might benefit from early intervention could be identified from GP computer records...

..The Working Group wishes to encourage shared definitions and an understanding of the practical application of structured data to improve quality in clinical practice...

..This study set out to identify the patients with atrial fibrillation and modifiable risk factors for stroke...

..Practitioners should be encouraged to use the single recommended ethnicity coding hierarchy...

..End-digit preference (EDP) is a known cause of inaccurate BP recording. Distortion has been reported around pay-for-performance (P4P) indicators...

..Process modelling provided a rational basis for the critical appraisal of a clinical data processing system; its potential maybe underutilized within health care...

..Such a mapping would aid healthcare professionals to retrieve relevant data from our digital library as it would enable links between clinical systems and indexed material...

..However, gaps exist in the literature about how to find relevant data, select appropriate research methods and ensure that the correct inferences are drawn...

..However, there is disparity in the prevalence of diabetes found in epidemiological studies compared with that reported through the UK's national quality improvement scheme...

..Over 1,000 resources in the Primary Care Electronic Library (PCEL - www.pcel.info) were classified with MeSH...

..In an attempt to provide data of adequate quality to support such operational needs, increasing emphasis is being placed on the standardisation of data recording...

..This method could be utilised dynamically to supply digital library resources to a clinical system with SNOMED-CT data used as the standard of reference...

..Risk factors for cardiovascular disease can be modified in primary care. Electronic patient record (EPR) systems include embedded cardiovascular risk factor calculators and should facilitate this process...

..In the UK routinely collected computerized clinical data is used to assess progress towards financially incentivised quality targets for chronic disease management including hypertension...

..However, despite the near universal availability of computerised prescribing support in the UK, errors continue...

..A new method has been developed for assessing the impact of the computer on doctor-patient interaction through detailed observation of the consultation and computer use...

..The biggest gap in current knowledge identified is how to perform needs assessment and quality improvement using aggregated routinely collected, general practice computer data...

..CONCLUSIONS: Automated searching of general practice computer records could provide a reliable and valid way of identifying people with stages 3-5 CKD who could benefit from interventions readily available in primary care...

..These principles and examples of their practical application were largely derived from the extensive knowledge base which has been built up in countries that have developed PCI over the last one to two decades...

..CONCLUSIONS: Open source tools provide useful data which can be used to evaluate online resources. Improving the functionality of PCEL has been associated with increased use...

..This paper sets out to demystify our data processing method and makes the PCDQ metadata system available to clinicians and data processors who might wish to adopt it...

..Primary care informatics is defined as a science and as a subset of health informatics. The proposed definition is intended to focus the development of a generalizable core theory for this informatics subspecialty...

..This analysis explores what proportion of the UK population with cardiovascular disease (CVD) and TC levels at or below target may still be at risk because of residual dyslipidaemia...

..Data quality markers are collated and fed back to the participating general practitioners. The authors examined whether this feedback had a significant effect on data quality...

..Routinely collected general practice computer data are used for quality improvement; poor data quality including inconsistent coding can reduce their usefulness...

..However, no systematic review has been conducted to explore the effectiveness of quality-improvement interventions to lower blood pressure in people with CKD...

..To report problems implementing a data quality programme in osteoporosis...

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..To determine the effectiveness of self-audit tools designed to detect miscoding, misclassification and misdiagnosis of diabetes in primary care...

..George's has developed a first benchmarking statement - which defines the skills knowledge and understanding a biomedical informatics student should acquire by the time they complete the course...

..To evaluate the implementation of a primary care, nurse-led, near patient anticoagulant monitoring service...

..This study set out to model the impact of nicotinic acid therapy on cardiovascular risk in these patients, based on Framingham risk assessments on a cohort of patients drawn from UK general practitioner records...

..It highlights the need for more sustained educational and quality improvement initiatives to encourage greater collaboration and understanding between healthcare professionals...

..Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint...

..In the UK, guidelines have been developed to facilitate case identification and management. Our aim was to estimate the annualized cost of implementation of the guidelines on newly identified CKD cases...

..Many principles may be extended to the management of any chronic disease. While new developments are necessary to improve care, wider implementation is required to be able to see if improved outcomes are achieved...

..The practice is now fit to be part of any move towards integration of records within its local health community, and can demonstrate from its computer records that it meets the quality targets for primary care...

..The management of cardiovascular risk factors in people with diabetes in primary care was compared with National Institute of Clinical Excellence guidelines...

..The model was developed as part of a research project on the influence of customized computer software used on nurse consultations with patients with heart disease...

..These features include electronic prescribing, improved quality and consistency of care, practice efficiencies that have both timesaving and revenue generating effects, and potential shielding from malpractice claims...

..Further research is needed to discover whether such an intervention would be cost-effective...

..Previously developed rating instruments to assess medical websites have been criticized for failing to report their reliability and validity...

..Provision of IT was poor across all the staff studied, with health visitors and community nurses lagging slightly behind others. The reasons for the low levels of use need further research so that barriers to using IT can be overcome...

..Only three of these patients (2.8%) had blood test results that revealed a potential secondary cause. The rates of positive findings are low; further research is needed to see if they are justified in postmenopausal women...

..CONCLUSION: Despite some access difficulties, community nurses have a positive attitude to IT and would like to receive more training...