Computerisation Survey of GP Practices within Lothian

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• Computerisation Survey of GP Practices within
  Lothian
• Dr Colette Fulton - Lothian Primary Care Research
  Network Coordinator
• Dr Brian McKinstry - Lothian Primary Care
  Research Network Director

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What I want to cover..

• Rationale for the study Overview of the role of
  the Lothian Primary Care Research Network
• Method adopted in the survey
• Results of the survey
• Discussion

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The remit of the Network

• To manage high quality projects relevant to
  primary care which are carried out in the primary
  care setting
• To develop the culture of research in primary
  care in the Lothians and Borders
• To develop protocols and to complete high quality
  studies that will make a difference to the
  provision of primary care
• To maintain and update a database of
  professionals and practices interested/ involved
  in research

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Current Membership

• 80 practices
• 370 individual primary care practitioners

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Research in the Trust
well women services
mental health
maternal and child health
service delivery
community services
occupational health
Rehabilitation e.g. after stroke MS
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Background to the present study

• Network required to recruit practices to studies
  often studies state strict inclusion/ exclusion
  criteria in relation to study e.g. patients with
  COPD on particular medication patients with
  varicose veins who have not had surgery
• Letters asking for recruitment are sent to all
  practices poor uptake and poor recruitment
• More focussed recruitment required to those
  practices which code/ or hold computerised
  information specifically related to pathologies
  etc.

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Aim of the present study

• to ascertain the level of computerisation of
  particular diagnostic information and test
  results within each practice.

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Method

• A questionnaire was sent to practice managers in
  80 practices which included questions on the
  degree to which summarised information on a
  variety of important chronic and acute diseases,
  test results and prescribing were recorded on
  computer and also the use of scanning of hospital
  letters and use of SCIMP codes.

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Results

• Response rate 66 practices returned completed
  questionnaires (an 82.5 response rate)
• information relating to diabetes, asthma,
  ischaemic heart disease and hypertension are most
  commonly computerised
• data on the presence of stroke/ TIA and COPD are
  not commonly computerised.

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• The majority of practices (41) reported they
  summarised over 90 of other major diagnoses on
  computer 30 summarising over 50 and 21
  summarising under 50 of major diagnoses.

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• practices were universally summarising repeat
  prescriptions on computer and the majority
  summarising acute prescribing.
• additional information such as routine bloods, X
  ray/ ultrasound and MRI results, and the scanning
  of hospital letters were rarely summarised on
  computer.
• 78 also utilised SCIMP codes or equivalent.

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Discussion

• From the information received, at least in
  Lothian, the long-term objective of practices
  becoming paperless appears to be still a long
  way off.
• For the Research Network, the recruitment of
  practices to assist in large multi-centre trials
  is hindered by the lack of comprehensive
  information systems in the primary care setting.
• This survey was, however, conducted before the
  details of the new GP contract were made known
  and this may be a driver for increased
  computerisation.

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Further research ideas to explore

• To undertake follow- up survey to explore
  accuracy of information obtained by survey e.g.
  COPD study currently underway targeting only
  those studies that responded that they could code
  for COPD.
• Undertake follow up study once new contract in
  place.