Background Danish general practice is well run and of a high standard with good opportunities to strengthen preventive treatments and public health. There is extensive use of IT for internal as well as external communication. In Denmark, the GP’s role as a family doctor and as the gatekeeper to treatments by specialists and hospitals is seen as a major strength (report from the Rockwool Foundation).
However, there is not much documentation of the quality work in general practice due to a lack of data from the primary health care. Relevant research information also suffers from this.
Purpose
The purpose is to collect data for quality development and research - and to do so without bothering the GP unnecessarily.
In cooperation with the Research Unit for General Practice at the University of Southern Denmark, DAK-E – the Danish Quality Unit of General Practice – has developed an IT programme – called Sentinel Data Capture – that automatically collects patient data from the GP’s electronic health record system.
Technique Sentinel Data Capture is designed to collect key data as the data enter into the GP’s electronic health record system. The collected data are prescribed drugs, National Health Service disbursement codes, laboratory analysis results and ICPC diagnoses. The data are stored in DAMD – Danish General Practice Database. Apart from his/her daily work the only additional activity the participating GP has to do is to assign an ICPC diagnosis code to all face to face patient contacts.
Each GP subscribes individually at his/her own PC to the projects in which he/she would like to participate. As for now the projects are Diabetes and COPD – and other special designed research projects. When the GP enters an ICPC trigger diagnosis a pop-up screen will appear and additional information has to be filled in. As for Diabetes, the pop-up screen only has to be filled in once a year in connection with the annual checkup. The rest of the data on the diabetes treatment is automatically collected and transferred to the DAMD database.
DAK-E develops the feedback quality reports which are generated individually for each general practice on the basis of the accumulated data in the DAMD database. The reports are presented online and the GP accesses his/her reports via his/her professional digital signature. This admittance procedure ensures fully confidentiality as the GP’s reports only will be accessible to him/her.
The reports on chronic diseases include a benchmark section which enables the GP to compare his own quality with that of other GPs on a local and a national scale.
DAK-E is able to design pop-up screens to provide almost any thinkable patient data which could be of interest to GPs and researchers in order to improve the quality work in general practice.
DAK-E finds it very important that GPs participate voluntarily and that they receive feedback in order to acquire knowledge about how their practice operates. This knowledge can help general practice to improve quality - possibly in connection with additional training.
