The Department of Health Churchill Fellowship to investigate how routinely collected GP electronic medical record data can be used to improve patient care

Professor Jan Radford’s Churchill Fellowship enabled her to investigate the secondary use of patient medical electronic record data on visits to England, Scotland and the Netherlands.

Currently in Australia e-health record (e-HR) data is searched by individual general practitioners as they undertake clinical audits of their own practice data to improve the quality of their healthcare delivery. Also currently available are collections of de-identified patient e-HR data from many general practices, such as NPSMedicineWise’s MedicineInsight, which provide comparison of healthcare across general practices, regions and states.

Developing is the ability to preserve patient anonymity while data-linking general practice e-HR datasets to other health care datasets, and datasets relating to other aspects of the life of Australians such as the education they receive, or the quality of the air they breathe. While the future will see new data added to existing e-HRs such as patient genetic data, data from patient smart phone applications, and other patient-generated data.

The potential to improve patient and population health outcomes from this work is large.

Many lessons were learnt from Prof Radford’s meetings with agency staff and academics who currently collate and analyse e-HR data in England, Scotland and the Netherlands. The most significant lesson learnt was the Australian agencies engaged in collecting this data need to conduct a prolonged ‘conversation’ with the Australian community about this activity. We can learn from Scotland where this is done well.

Also learnt was the Australian need to develop the infrastructure to enable best-practice, secondary use of e-HR data via the formation of a well-funded regulatory agency that is independent of government but securely funded by the government. 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.

Overarchingly 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.