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- Does the RACGP Require ethics approval before using the CAT plus products?
Checklist for Practices
Important Phone Numbers Numbers
General
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Why are GP practices using the PHN's Data Quality Improvement Plan and installing CAT Plus?
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Do CAT4 and Topbar rely on each other to work at a practice? Is one or the other optional?
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CAT4 is an audit and extraction tool, Topbar is a decision support tool. CAT4 works with the patient population in your clinical system, Topbar provides relevant notifications about the patients at your clinic. The two products can work completely independent of each other, but there are some important and very useful links. In particular the CAT Plus Prompts (more information here: CAT PLUS PROMPTS) where patients identified through a CAT4 search can be flagged for a notification to be shown if they visit the clinic. CAT4 and Topbar compliment each other but don't rely on each other. Improvements to data quality made by using Topbar can be easily measured in CAT4.
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What is PAT CAT?CAT Plus is a population health planning CAT Plus is a population health planning and reporting platform for PHNs who manage a data quality initiative. The tool has the unique capacity to compile statistics, reports, indicators, timelines. This information is used to assist each PHN in understanding and interpreting their catchment epidemiology. The next step is for the information gathered to be analysed, and interpreted so that the PHN can accurately plan the type of services and interventions that are required within their catchment to meet their KPI's. For this to be possible the CAT4 needs to be installed at the practice, the scheduler to deidentify and send the information, and PAT CAT to receive the information. http://www.pencs.com.au/products/pat-cat/
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PENCS released a version of scheduler V2 and it relied on a windows username and password to be created. If the password was changed this meant that the scheduler did not run and the impact was that their monthly extract not being collected on the day they had set up. PENCS have developed a new version of the software V3 that will run runs in a different way. This software can also receive updates without the need for PENCS to remotely log in.
In consultation with the PHN PHNs we have developed the new version of the software and are working to update this software with all the practicesstrongly encourage all practices to book an appointment to update their V2 Scheduler to the new V3.
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What is Scheduler?
Scheduler is a piece of software when installed on the server that runs on a regular basis usually monthly and saves the practice staff from having to remember to run the software to have the de-identified data extracted in a regular interval. The monthly extracts can from an important part of the clinical and business information for the practice. Scheduler can also send a deidentified extract to the PHN upon the involved patients' agreement and nomination requestif agreed to by the practice.
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What is the benefit of Scheduler?
This software allows the practice to compare the changes in the data on a monthly basis, or over the entire three year period. The practice can use the data and quality improvements that can be easily described using the graphs.
The RACGP requires in the Quality Improvement activities that "Our Practice can describe aspects of our practice that we have improved in the past three years" http://www.racgp.org.au/your-practice/standards/standards4thedition/safety,-quality-improvement-and-education/3-1/quality-improvement-activities/
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Yes, practices can run the software each month and manually prepare an extract. The extract can be sent to the PHN, or provided to the PHN on a USB drive for upload. Practices should discuss this arrangement with their PHN and if it meets the contractually agreed terms.
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Where is the PAT CAT data stored?Pen CS do not store the data, the data is stored on the PHN's servers. The de-identified data is sent directly from the practice to the PHN server in a zipped file send over securely and encrypted (HTTPS). | Anchor |
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Does any identified information leave the general practice?CAT4 de-identifies the information within the practice before submitting the de-identified extract to PAT CAT. Practices are encouraged to follow the RACGP guidelines on privacy:
"In general, a practice's quality improvement or clinical audit activities for the purpose of seeking to improve the delivery of a particular treatment or service would not be considered a directly related secondary purpose for information use or disclosure. In other words, it is likely the practice would need to seek specific consent for this use of patients' health information for clinical audit activities.
To ensure patients understand and have reasonable expectations of quality improvement activities, practices are encouraged to include information about quality improvement activities and clinical audits in the practice policy on managing health information. Ideally, express consent for these activities will be obtained upon patient registration." http://www.racgp.org.au/your-practice/standards/standards4thedition/practice-management/4-2/confidentiality-and-privacy-of-health-information/ | Anchor |
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Can I exclude patients that do not wish to have their data shared with the PHN?Yes. Individual patients can have their data withheld from being submitted. Instructions can be found on the PENCS website. http://help.pencs.com.au/display/CG/Patient+Consent+Withdrawn | Anchor |
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Will other practices see my data?No identifiable information ever leaves the practice. The PHN may do benchmarking comparisons as part of the quality improvement program you can discuss with the PHN how they use the data. Other practices can NOT see your data, only the total for the PHN if at all. | Anchor |
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What is de-identified data?De-identified data means that the information that would identify the patient is removed. |
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Only the age in years, gender and ethnicity remain in the data after de-identification. | Anchor |
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Do the CAT Products write back to the Clinical System?No. No CAT Plus products write back to the practices clinical system, we have read only access to your clinical data. | Anchor |
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Does CAT Plus always connect to the Clinical System every time it runs?No. The CAT Plus runs independently from the clinical system and uses the extracts |
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when you are running queries, the only time a connection is made is when a new snapshot is created, during the data collection. |
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Ethics...
For a quality improvement activity to be undertaken within a general practice, where the primary purpose is to monitor, evaluate or improve the quality of healthcare delivered by the practice, ethics approval is not required.
Clinical audits using a tool such as the Clinical Audit Tool (CAT) (see Criterion 3.1.1 Quality improvement activities) or 'plan, do, study, act' cycles undertaken within a general practice as part of a quality improvement activity do not require ethics approval. For example, a practice wishing to determine how many of its pregnant patients are given advice on smoking cessation, or how many patients with heart failure are prescribed ACE inhibitors and beta blockers, may complete an audit on their practice data.
In general, a practice's quality improvement or clinical audit activities for the purpose of seeking to improve the delivery of a particular treatment or service would not be considered a directly related secondary purpose for information use or disclosure. In other words, it is likely the practice would need to seek specific consent for this use of patients' health information for clinical audit activities.
To ensure patients understand and have reasonable expectations of quality improvement activities, practices are encouraged to include information about quality improvement activities and clinical audits in the practice policy on managing health information. Ideally, express consent for these activities will be obtained upon patient registration.
Source:http://www.racgp.org.au/your-practice/standards/standards4thedition/practice-management/4-2/confidentiality-and-privacy-of-health-information/
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Checklist for Practices
- Our practice has Best Practice Software, Communicare, Genie, Medical Director, Genie, CommunicareMedinet, Medtech32, MMeX, PractiX or Zedmed.
- I know what billing system we have installed.
- I am able to install software on the main computer, or server.
- If needed I know the password to install software on the server.
- I have the contact details of our IT person and if needed I can contact them to obtain passwords.
- If our IT contact is unavailable I understand that another call may be needed to
- If using Best Practice, I am aware that a the database browser password may be required.
Important Phone Numbers| Anchor |
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Pen CS Support 1800 762 993 support@pencs.com.au help.pencs.com.au
Best Practice Support 1300 40 1111 www.bpsoftware.net support@bpsoftware.net
Communicare 08 6212 6900 communicare@healthconnex.com.au
Genie Solutions 07 3870 4085 support@geniesolutions.com.au
Zedmed 1300 933 000
Practix www.isofthealt.com
Medical Director 1300 788 802 www.medicaldirector.com
Medinet 1300 723 938
MMEx 08 6250 9170 info@isahealthcare.com
Medtech32 1800 148 165 support@medtechglobal.com
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