Perceptions of primary care staff on a regional data quality intervention in Australian general practice: a qualitative study

Abstract

BackgroundTechnological advances in clinical data capturing and storage systems have led to recent attempts at disease surveillance and region specific population health planning through regularly collected primary care administrative clinical data. However the accuracy and comprehensiveness of primary care health records remain questionable.MethodsWe aimed to explore the perceptions and experiences of general practice staff in maintaining accurate patient health data within clinical software used in primary care settings of regional NSW. Focus groups were conducted with general practitioners, practice nurses and practice administrative staff from 17 practices in the Illawarra-Shoalhaven region of the state of New South Wales (NSW) in Australia that had participated in the Sentinel Practices Data Sourcing (SPDS) project - a general practice based chronic disease surveillance and data quality improvement study. A total of 25 respondents that included 12 general practitioners (GPs) and 13 practice staff participated in the 6 focus groups. Focus groups were audio-recorded and transcribed verbatim. Thematic analysis of the data was undertaken.ResultsFive key themes emerged from the data. Firstly, the theme of resourcing data management raised issues of time constraints, the lack of a dedicated data management role and the importance of multidisciplinary involvement, including a data champion. The need for incentives was identified as being important to motivate ongoing commitment to maintaining data quality. However, quality of software packages, including coding issues and software limitations and information technology skills were seen as key barriers. The final theme provided insight into the lessons learnt from the project and the increased awareness of the importance of data quality amongst practice staff.ConclusionThe move towards electronic methods of maintaining general practice patient records offers significant potential benefits in terms of both patient care and monitoring of health status and health needs within the community. However, this study has reinforced the importance of human factors in the maintenance of such datasets. To achieve optimal benefits of electronic health and medical records for patient care and for population health planning purposes, it is extremely essential to address the barriers that clinicians and other staff face in maintaining complete and correct primary care patient electronic health and medical information.

Australian general practitioners’ attitudes to the extraction of research data from electronic health records

“…Australian research analysing the attitudes of practice staff for a specific data extraction project discussed time as a barrier and the desirability of remuneration, which supports the results of the current study. 17 The present research aligns with findings from outside Australia and confirms the gatekeeper role that GPs maintain as custodians of valuable primary care EHR data. 6,[8][9][10][11][12] International studies discuss GPs' strong desire to protect privacy if sharing data and support the current study findings about a lack of trust in the researcher or fears that data might be used by organisations such as insurers and pharmaceutical industries.…”

Gathering data for decisions: best practice use of primary care electronic records for research

“…Nonetheless, research methods can often adjust for poor quality data capture, so long as the data limitations are clearly understood. Data custodians can help to increase awareness among all clinical and non‐clinical general practice staff of the value of accurate and comprehensive data capture . Having clinician researchers involved in data analysis is one way to ensure correct interpretation of the data.…”

Health screening for women with physical disability in Australian general practice: A survey

“…Difficulties in the identification of those in the practice population with a disability creates a challenge in the proactive provision of care tailored to meet their unique needs. Issues with coding and data quality in general practice electronic medical records have been previously identified (Ghosh, McCarthy, & Halcomb, 2016). As electronic records systems become more embedded within clinical practice, and greater attention is placed on these data to inform service planning and funding, it is likely that gains in quality will continue.…”

“…As electronic records systems become more embedded within clinical practice, and greater attention is placed on these data to inform service planning and funding, it is likely that gains in quality will continue. Consideration of data quality measures to facilitate rapid identification of consumers with a disability would create opportunities to ensure that these individuals were able to access recall and reminder screening (Ghosh et al, 2016).…”