Progress in using the electronic health record to improve primary care.
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Volume
70
Pagination
e215 - e220
Publisher
DOI
10.3399/bjgp20X708281
Journal
British Journal of General Practice
Issue
Metadata
Show full item recordAbstract
Improvement science has been transformed by the electronic health record (EHR) making it
possible to share data for patient and population benefit across primary and secondary care
organisations, with further linkage to public health, social services, and national registries.
Health data analysis is an enabling technology for systems of improvement, promoting
behavioural change in professionals and social change and innovation in organisations for
patient and citizen benefit. The ability to learn from every patient contact and provide
appropriate organisational responses to population needs has been termed a learning health
system. The development of IT enabled learning health systems is a journey on which health
services have only recently begun.
This report describes the impact trajectory over three decades of the Clinical Effectiveness
Group (CEG), a quality improvement (QI) organisation serving a population of 2 million in east
London. The core aims include delivering improvements to primary care disease management
and reducing health inequalities. Commissioning support, public health and research linkage
are further derivatives enabled from the curated EHR. CEG has built capacity for real-time
monitoring of services from all inner east London GP practices, with support for QI
programmes helping to transform service delivery across the primary/secondary interface.
The clinical performance of these localities now rank top in national and some international
performance metrics. CEG also supports new initiatives to deliver an integrated EHR platform
for all primary, secondary and other health and social data sources to provide both direct
clinical care and data for secondary uses. This agenda is aligned with national strategy in the
NHS England Forward View and the Wachter Report both of which highlight the synergistic
gains from aligning improved data uses, quality improvement and health data science.