IngentaConnect Secondary uses of clinical data in primary care

Authors: Teasdale, Sheila¹; Bates, David²; Kmetik, Karen³; Suzewits, Jeff⁴; Bainbridge, Mike⁵

Source: Informatics in Primary Care, Volume 15, Number 3, September 2007 , pp. 157-166(10)

Publisher: Radcliffe Publishing Ltd.

Abstract:

This paper, presented as a panel at the American Medical Informatics Association (AMIA) Fall Symposium 2006, explores a number of secondary uses of primary care clinical data derived from point-of-care systems, and the issues arising from those uses. The authors (from the USA and the UK) describe, compare and contrast some secondary uses: pay-for-performance, public disclosure, clinical audit, health resource planning, and clinical system usage; in various environments: national health system, network of small family practice offices, and university teaching centres. In the UK, such data are now being used in pay-for-performance for GPs, and approximately 35% of their salary has been put at risk, which has resulted in close scrutiny. In the USA, pay-for-performance is at an earlier stage but is increasingly prevalent and continues to be hotly debated. Some of the issues that arise from these uses of clinical data - data quality including accuracy, comparability, perverse incentives, effect of secondary uses on care provision, and security and confidentiality among others - were discussed. Finally, options and opportunities for improving secondary uses of data in the light of the issues covered earlier were considered.

Keywords: DATA QUALITY; PRIMARY CARE; SECONDARY USES OF DATA

Document Type: Research article

Affiliations: 1: Strategic Director PRIMIS+; Editor, Informatics in Primary Care; University of Nottingham, UK 2: Medical Director of Clinical Quality and Analysis, Partners Healthcare, Boston MA, USA 3: Clinical Performance Evaluation, American Medical Association, Chicago IL, USA 4: Associate Professor of Clinical Family and Community Medicine, Southern Illinois University School of Medicine, Springfield IL, USA 5: Senior Clinical Architect, NHS Connecting for Health, Leeds, UK