Influenza as Risk Factor for Ischaemic Cardiac Events and the Effects of Influenza Vaccination. Outcomes from a Three-Year Prospective Case–control Study Conducted in the Australian Winters of 2008–2010 (HEART-FLU Study)

Abstract

Objective: To develop and validate HealthTracker -an electronic decision support (EDS) tool to assist primary care practitioners in guideline implementation for cardiovascular disease (CVD) risk management.Methods: HealthTracker is based on an algorithm which synthesises screening and management recommendations from 10 national guidelines related to CVD risk management. It is fully integrated with the two most popular Australian primary care software systems, Medical Director TM and Best Practice TM via the Pen Computer Systems PrimaryCareSideBar TM . There are four features to HealthTracker: (1) automatic pre-population of essential risk factor and treatment information from the primary care record; (2) provision of a CVD risk assessment and tailored management plan at the point of care; (3) an interactive risk communication interface for discussion with patients about current and projected risk; (4) a data extraction facility which allows practitioners to assess performance, view disease registers and implement recall systems.Results: HealthTracker has undergone an extensive validation and testing process. A database of 9076 routinely attending primary care patients was used to assess statistical correlation/agreement between the outputs generated from the algorithm within the PrimaryCareSideBar TM and those obtained from an independently programmed version in STATA 11. Near perfect correlation/agreement between the two programs was achieved for all 71 calculated variables. User acceptability testing was then conducted with 20 General Practitioners who trialled the software, checked for guideline consistency and provided recommendations to refine the system.Conclusion: A fully integrated, self-populating EDS tool is now practice-ready for large scale implementation and evaluation in Australian primary healthcare.