Practice Update – Summer 2013

Published in Practice Update

Date published: About this date

Clinical content may change after this date. This information is not intended as a substitute for medical advice from a qualified health professional. Health professionals should rely on their own expertise and enquiries when providing medical advice or treatment.

From the MedicineInsight National ManagerMeet the MedicineInsight teamPractice improvement around the worldMedicineInsight in the newsWhat MedicineInsight is telling usFor more information

From the MedicineInsight National Manager

Nancy Huang, national manager of the MedicineInsight program

Nancy Huang, National Manager MedicineInsight

Welcome to the Summer edition of Practice Update. Since our last update the number of practices participating in MedicineInsight has doubled to 140. We have also visited 13 practices with data quality reports and the response so far has been very positive.

MedicineInsight is now active in Victoria, NSW, South Australia and Tasmania and we are expecting practices in Queensland to join shortly. We are also excited to release our first clinical report on type 2 diabetes.

In this update you’ll get a snapshot of our new MedicineInsight type 2 diabetes report used in practice visits. We describe a study from The Netherlands that confirms our approach to the development of this report. We also outline the controls we have in place to ensure we are protecting the privacy of you and your patients.

With 2014 on the near horizon, we’re very excited that MedicineInsight is nearing the completion of its pilot phase. We’ll be communicating to all practices in early January what that means, but in essence we will require all GPs to re-affirm their consent for the next phase of the program. This will allow us to continue providing ongoing, individualised feedback and reports on prescribing and clinical activity to participating GPs. It’s also a good opportunity to remind those non-participating GPs to provide consent for MedicineInsight so they too can receive this tailored support.

I wish all participating practice staff a relaxing Christmas and I hope that 2014 is a productive and prosperous year for you all.

Nancy HuangDr Nancy Huang
National Manager, MedicineInsight

Meet the MedicineInsight team

Kelly Hoffman, MedicineInsight Governance Program Officer r

Kelly Hoffman, MedicineInsight Governance Program Officer

It is vital that in collecting patient, practice and GP information that the MedicineInsight team complies with ethics and privacy requirements. Kelly Hoffman is our governance officer and steps us through some of the measures we have put in place.

”NPS MedicineWise takes privacy and confidentiality very seriously, so for MedicineInsight we have created a governance framework that ensures we have tight control over the data we collect from practices.”

”For example, our data collection tool has been designed to forbid the collection of any identified personal information from patients. By ensuring that MedicineInsight patient data is not identifiable we are able to offer significant and responsible protection to our stakeholders.”

”We understand that individual GPs may be concerned about being indentified. So we restrict the use of identified information to the provision of individualised reports and we seek GPs’ consent for this information. We aggregate all data for any third parties, such as government, and no individual GP or practice can be identified.”

“Practices can be assured that MedicineInsight is committed to complying with all privacy laws and ethics requirements.”

Practice improvement around the world

Click to see PubMed abstract

Click to see PubMed abstract

GPs and practices play a critical role in responding to the increasing prevalence of type 2 diabetes in our community. MedicineInsight’s first clinical report is focused on this condition.

In developing the report it was clear to us that simple treatment targets do not tell the full story, and a recent research paper based on over 10 years of work in Dutch general practice confirms this.1 The study evaluated the usefulness of a multitude of performance measures. It concluded that measures of annual HbA1c monitoring and treatment intensification predicted better patient outcomes than measures of treatment status (e.g. whether HbA1c targets are met). Patient characteristics are also an important dimension in determining how well an indicator can predict outcomes.

The approach MedicineInsight has taken is to contextualise the care provided by the practice with a description of the patient cohort and the clinical care journey from prevention to the management of HbA1c, blood pressure and cholesterol levels. From this information, we are working in partnership with practices to identify patient lists that can be used to review or recall patients for further action.

1.  Sidorenkov G, Voorhma J, Haaijer-Ruskamp F, et al. Association between performance measures and glycemic control among patients with diabetes in a community-wide primary care cohort. Medical Care 2013; 51: 172–179.

MedicineInsight in the News

Click to see full text of Lynn's letter

Click to see full text of Lynn's letter

Recently, the Medical Journal of Australia published a letter written by Lynn Weekes (CEO of NPS MedicineWise) about the role of MedicineInsight in supporting better clinical care. This letter was in response to an editorial calling for health data standards for primary care across Australia.

While Lynn endorsed the call for better data standards, she also reminded readers that despite the current limitations of GP electronic health data MedicineInsight has made significant progress. With your participation, we are paving the way to establish the first longitudinal primary care data repository that can be used flexibly and to better understand current clinical practice.

Weekes LM. The Bettering the Evaluation and Care of Health (BEACH) program: where to from here? Med J Aust. 2013 Aug 19;199(4):240.

What MedicineInsight is telling us

Sample report - click to download pdf

Sample type 2 diabetes report -
click to download pdf

MedicineInsight has recently developed and delivered its first report on the management of type 2 diabetes. The report has been positively received, with practices describing it as highly relevant and useful. Over time these reports will provide practices with insight into the clinical care of their patients, allowing practitioners to explore their care and see the impact they are having on their practice population for specific conditions.

We have provided an excerpt of this report for your information, which highlights HbA1c and related treatment intensification. In addition to patient care indicators, the report also covers areas such as practice profile, preventive health, coordination of care, data quality and relevant support from NPS MedicineWise.

When we present the report at a practice visit, we will assist with interpreting the information and discuss with practice staff whether the results ring true. Patient lists can also be generated to assist practices in further quality improvement activities.

Data quality tip

Blood pressure

Remember to use the designated boxes in your clinical software to record blood pressure instead of entering the information into the free text progress notes. This will make it easier to retrieve a patient’s past blood pressure results and track their blood pressure over time.

For more information

If you would like any information on MedicineInsight, email us on or call 1300 721 726.