Data Quality System - An overview Simon Scourfield Deputy Programme Director

1. Data Quality System - An overview Simon Scourfield Deputy Programme Director Primary Care IM&T Programme

2. Data Quality System • Why we are doing what we are doing • Simple schematic of the DQS • Core components of the DQS • Implementation • Demonstration (Joe Hunt) • Flu vaccination programme • QOF prevalence (age/sex standardised) • Data ‘tidy-ups’

3. History of National Projects in Wales • General Practice Morbidity Database Project (1992-2002)‏ • General Medical Practice data for 10% of Welsh population • Really Useful Read (1999)‏ • ‘A guidebook to the Read Thesaurus’ • Improving Information and IM&T in Primary Care (I3PC) (2000-2002)‏ • Data extraction, remote analysis, facilitative feedback • ICT Foundation Programme’s Data Quality Initiative (2002)‏ • Practice and LHB based software solution • CHD & Diabetes NSFs • Quality & Outcomes Framework (2004 to present)‏ • Practice and LHB based reporting solution 2004-2006 • Web based reporting solution 2006-onwards

4. Primary Care DataSupporting the Bigger Picture in Wales Patient Care Clinical Governance / Clinical Audit Public Health Health Needs Assessment / Health Planning NICE guidelines NSFs Research Quality & Outcomes Framework

5. DQS – Simple Schematic Automated extract – external data transfer utility Endorsed projects e.g. SAIL (HIRU) WAG / LHB / NPHS Practice-based software tool Central repository & web-based analytical tool Software updates / support Supplier updates Anonymised aggregated automated extract

6. The Supplier of DQS • Audit+ (Practice based tool) • CompuFile Consortium • Informatica Producers of Contract+ • CompuFile Support Provider for Contract+ • Insight Solutions Training provider

7. Core Components -‘On site’ data extraction utility • Data extraction from allclinical systems in Wales • Supplier endorsed extracts • EMIS LV & PCS • InPS Vision (LAN & WES) • iSoft Ganymede, Synergy & Premiere • Supplier endorsed extracts (being developed) • Healthysoftware CrossCare • TPP Systmone • BlueBay GPASS • MIQUEST extracts • Ascribe Protechnic Exeter • EMIS GV • Extraction and ‘population’ process – automated and schedulable • Default setting – weekly • Daily setting – in event of pandemic disease monitoring etc.

8. Core Components -‘External Data Transfer Utility’ • Integrated module • Inactive by default • Practices have to actively enable this module for a specific project(s) • Generate specific files in standard format for each external project (e.g. SAIL Project, PRISM etc) • Scheduled to run once a week • Limit impact on performance of clinical system • Configurable for one-off submission for failed submissions • Secure transportation mechanism • DTS, HTTPS etc • As determined by each specific project • Information Governance, Data Protection etc • Responsibility of each specific project • Practice needs to be satisfied prior to activating a data extraction • Sub-group of GMS IM&T Programme being established • Develop information governance policies and procedures • Use of the software, data etc • Prioritising developments • Protect the interests of the GMS stakeholders (e.g. BMA)

9. Core requirements - Audit+ • A ‘base product’ • Modular and adaptable • Functionality • ‘Gap analysis’ • Historical trends • Graphical results • Age-sex banded results • Export to spreadsheets etc • Utilised from any PC within practice (including branch surgeries) • Provide anonymised aggregate data to central web repository

10. Audit+ Modules • NPHS PCQIS Requirements • NPHS PCQIS quality improvement toolkits • Evidence-based • Audit proforma • Validated Read codes • Near Patient TestingDES • INR Monitoring DES • Minor Surgery DES • Depression NES • QOF prevalence (registers) • Age/sex standardised

11. Audit+ Modules • NPHS Flu vaccination reporting • 2004/5 96% (CA) • 2005/6 92% (CA) • 2006/7 57% (MIQUEST / manual) • NPHS Pneumococcal vaccination reporting • NPHS Sentinel Reporting Scheme • Weekly communicable disease reporting

12. Audit+ Modules • Current CHD and Diabetes NSF Requirements • Searches that have previously provided • Read codes need to be in line with latest Read thesaurus • NSFs updated in next 12-18 months • Supported by PCQIS toolkit • Software to be updated accordingly • Data ‘Tidy Up’ searches • QOF Disease Registers • ‘Starter for 10’ • additional ‘tidy ups’ to support each module where appropriate • additional ‘tidy ups’ to support other disease registers • Proprietary / local codes • Major emphasis to support EHR, IHR, GP2GP record transfer

13. Audit+ Modules • Potential future work • IHC’s Long Term Conditions (PRISM) project • Risk stratification project • External data extract utility • National Diabetes Audit • Learning disabilities • Renal NSF • Older People NSF • Chronic Conditions Management

14. Audit+ Implementation • Roll out of Audit+ in late November 2007 • 84% of practices are using the software • Not mandatory • June 2008 • Web based reporting / analytical tool

15. Audit Web • To facilitate LHB and national analysis • Anonymised aggregate results of searches produced within practice software • Functionality • Selection of cohorts (‘Slice and dice’ data) • practices within an LHB • LHBs • cohort of practices within a cohort of LHBs • Mirror practice-based software functionality • Historical trend analysis • Graphical display of results • Export of results • Implementation • Piloting April 2008 • Implementation June 2008

16. A Demonstration… Joe Hunt QOF Technical Manager Primary Care IM&T Programme