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Jan

Jan Radford

Year of Award: 2017 Award State: Tasmania Health And Medicine > General
The Department of Health Churchill Fellowship to investigate how routinely collected GP electronic medical record data can be used to improve patient care - UK, Netherlands
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Major Lessons

  • Australia’s agencies need to engage more closely with community members about the secondary use of e-HR data. A prolonged ‘conversation’ is required.
  • Australia needs to grant a life-long stable unique identifier, not just for healthcare, to each Australian to facilitate the use of e-HR data to improve health outcomes for the Australian population. Inclusion of others such as asylum seekers and refugees should also occur. The need for this could be part of the conversation that must occur with the Australian community about the secondary use of health data.
  • It is recommended the Australian Federal Government finance a collaborative and planned approach to the secondary use of general practice e-HR data led by general practice.
  • The infrastructure to enable best-practice secondary use of e-HR data should include the formation of a well-funded Australian regulatory agency that is independent of government but securely funded by the government. The agency needs to have the skill to keep data safe whilst respecting the cultural context of data origin, such as from general practice. Such an agency does not yet exist in Australia.
  • Noting the need to boost primary care to improve the health outcomes of Australians the infrastructure to generate general practice knowledge requires urgent support for a) the development and secondary use of e-HR datasets, b) general practice-based research networks and c) a much stronger academic general practice workforce.
  • Using the inspiration of the Scottish “General Practitioners at the Deep End” movement which aims to overcome the “inverse care law”, it is recommended that Australia prioritise the development of academic general practice serving the needs of populations most in need of the benefits of general practice care.
  • As we seek to improve the size and quality of the general practice academic workforce it is recommended that a pipeline for research-trained general practitioners be developed starting with medical students, including intercalated PhD training for general practice registrars, and building research career paths for experienced general practitioners.

Conclusions:

It is recommended that Australia strive to surpass the sophistication in secondary use of e-HR data, the support and growth of academic general practice, and the vision to develop learning healthcare systems as exemplified in England, Scotland and the Netherlands.

The development of team members and computing infrastructure to optimally use e-HR data is critical as our communities seek to answer context-relevant, health-related questions at regional, state and national levels.

Keywords: Patient, General Practitioner, General Practice, electronic health record, database, data linkage, health outcomes, academic general practice, health research, Practice-Based Research Networks

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