Development and evaluation of an electronic feedback system,

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Development and evaluation of an electronic feedback system, a tool for optimizing diabetes care in general practice. T.L. Guldberg(1), P. Vedsted(2), J.K. Kristensen(1), V. Zoffmann(3), T. Lauritzen(1) Institute of Public Health, Aarhus University - PowerPoint PPT Presentation

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Dias nummer 1

1Development and evaluation of an electronic feedback system, a tool for optimizing diabetes care in general practice.

T.L. Guldberg(1), P. Vedsted(2), J.K. Kristensen(1), V. Zoffmann(3), T. Lauritzen(1)Institute of Public Health, Aarhus University 1)Dept. of General Practice 2)Research Unit for General Practice,3) Steno Diabetes center

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university12Aim:

To evaluate the effect of an electronic feedback system to GPs concerning their type 2-diabetes care in a randomized intervention design. Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university23Intervention:

90 general practitioners clinics have been randomised to either admission or no admission to an electronic feedback system. GPs cared for 5148 people with type 2-diabetes

Intervention nested in Region Syddanmark and Region Midtjylland.

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university34Electronic feedback system:

Distributed on CD Rom,Initially installed by visiting project worker.Updated quarterly.

Launched in 2007 and ran for one year.

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university45

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university56

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university67

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university78Evaluation:

Quantitative evaluation on register data and log data

Qualitative evaluation on interview data with intervention GPs Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university89Primary output:

Usage of the electronic feedback systemUsed at overall level?Used at individual patient level?

Impact of system in intervention clinics

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university910 InitialLog data

Interview data

IntermediateInterview data

Long termRegister data:Data on laboratory testsData on medicinal useData on diabetes-related eye examinations

Interview data

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1011 InitialGPs used the sortable lists to get an overview of the patient population.

Interview data

IntermediateInterview data

Long termRegister data:Data on laboratory testsData on medicinal useData on diabetes-related eye examinations

Interview data

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1112 InitialGPs used the sortable lists to get an overview of the patient population.

The lists generated attention to problem areas in the diabetes care.

IntermediateInterview data

Long termRegister data:Data on laboratory testsData on medicinal useData on diabetes-related eye examinations

Interview data

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1213 InitialGPs used the sortable lists to get an overview of the patient population.

The lists generated attention to problem areas in the diabetes care.

IntermediateIncreased attention led to :

Organisational changes in two of four GP clinics

Additional education of practice nurses

Allocation of diabetes care to practice nurses,

Long termRegister data:Data on laboratory testsData on medicinal useData on diabetes-related eye examinations

Interview data

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1314 InitialGPs used the sortable lists to get an overview of the patient population.

The lists generated attention to problem areas in the diabetes care.

IntermediateIncreased attention led to :

Organisational changes in two of four GP clinics

Additional education of practice nurses

Allocation of diabetes care to practice nurses,

Long termIntervention GPs have more:Cholesterol controls (p=0,036)Patient eye examinations (p=0,005)Use of statins (p=0,016), metformin (p=0,004) and ACE inhibitors (p=0,008)

Interview data

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1415 InitialGPs used the sortable lists to get an overview of the patient population.

The lists generated attention to problem areas in the diabetes care.

IntermediateIncreased attention led to :

Organisational changes in two of four GP clinics

Additional education of practice nurses

Allocation of diabetes care to practice nurses,

Long termIntervention GPs have more:Cholesterol controls (p=0,036)Patient eye examinations (p=0,005)Use of statins (p=0,016), metformin (p=0,004) and ACE inhibitors (p=0,008)

GPs felt liberated by allocating diabetes care to nurses,GPs spend more time on other patient groups.

OutcomeTrine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1516Problems discovered:

No usage on individual patient level due to:No real time dataPractice in-house IT systems superior in data and familiar to use.

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1617Perspectives:An electronic feedback system containing sortable lists generated newinsight into the quality of diabetes care in GP clinicsNew attention to quality of diabetes care led to organisational changes in GP clinics, allocating diabetes care to practice nurses.An electronic feedback system led to better quality of care for peoplewith Type 2-Diabetes in general practice.

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university1718Thank you.

Trine lignell guldberg14 May, 2009dept. Of general practiceschool of public healthAarhus university18