Case study: closing the information gap

Timely access to high quality patient information is at the heart of the Department of Health’s consultation on a new information strategy for the NHS.

The consultation document points out that “good commissioning…relies on high quality, timely data about needs and services” so “it will be vital to ensure that commissioners have the right information available to understand patient needs and provision options, and to monitor outcomes.”

Liverpool Primary Care Trust was quick to realise the potential of EMIS’ new system, EMIS Web, to streamline the collection and analysis of potentially the richest source of patient information available to it – the patient’s ‘cradle to grave’ GP medical record.

By introducing real time, live streaming of data from the majority of its GP practices into EMIS Web – enabling a PCT-wide view – it has transformed its business intelligence function.

Audits in minutes, not days

Audits of key performance indicators that previously took days or even weeks to complete, due to the time-consuming process of physically visiting GP practices to extract the data, are now conducted in minutes. For example, a full audit of MMR vaccinations across the 84 GP practices that have agreed to share their data for searches can now be completed in just 25 minutes.

The dramatic improvement in the speed of information-gathering through EMIS Web has enabled the PCT to move from quarterly reporting to monthly reporting.

It now uses the system to produce nine automated reports each month, covering performance indicators around: childhood immunisations and vaccination, CVD, CKD, COPD, diabetes, HPV, MMR, flu and heart failure.

The automated process saves time for the PCT and GP practices alike – as well as providing quicker and better quality management information. It has also enabled the PCT to significantly reduce its staff costs around information collection.

Kate Warriner, deputy head of IM&T at Liverpool PCT, said: “EMIS Web has given us the tools to close the information gaps that were there previously.

“We can now provide timely information to help our clinicians deliver better quality care for patients. The monthly searches we conduct around chronic diseases are particularly valuable – helping to inform commissioning decisions at local and neighbourhood level.”

Information for GP commissioning

The PCT has even more ambitious plans for the future, as it starts to consider the information requirements for GP commissioning and the new-look NHS that will be brought about by the July white paper, ‘Equity and excellence: Liberating the NHS’.

It is currently in discussion with its local medical committee about enabling new and more detailed searches in EMIS Web. This would mean using the Reports module of EMIS Web, which not only extracts aggregate data in response to a particular query but also provides the detailed patient information behind the topline figures.

For example, conducting a search on patients with a diagnosis of CVD would also extract information such as their latest blood pressure, smoking status and BMI – giving individual practices the detailed information they need to change or improve a service.

The PCT also wants to adopt a more standardised approach to collecting data through EMIS Web. Helen McManus, the PCT’s commissioning intelligence manager, explained: “Instead of collecting data each month for numerous individual searches, we want to extract core information through EMIS Web Reports.

“Then, we want to use it as a support tool to give GPs near real-time information to drive quality improvement against local commissioning plans.

“As well as streamlining the process further, this approach will allow us to be quicker and more responsive to ad hoc requests for information from general practice, as we will be able to interrogate the standard GP dataset rather than having to run a new search each time we get a new request.”

The PCT also plans to move from monthly to weekly and ultimately even daily reporting of routine requirements back to GP commissioners. This near real-time reporting would combine the rich primary care data from EMIS Web with other data sources such as secondary care and community information – providing a big picture view of how patients are using services.

Dr Simon Bowers, a Liverpool GP and chair of the Matchworks Practice Based Commissioning Consortium, said: "It's very clear that GP commissioning can only succeed if the consortia have access to accurate, up-to-date data to guide their decision-making.

“Practice-based Commissioning has shown this to be a crucial, but very difficult area to get right. Any system that allows this will be a valuable tool."