Introduction to Electronic Audit

Contents

Introduction

The aim of electronic audit is to integrate data collection into our daily work, so that accessing audit data becomes a by-product of clinical activity, rather than an end in itself. 

Electronic audit is about using to use our clinical systems in ways that are friendly to both clinical use and audit. Although audit is intended as a by-product, the intellectual and practical discipline entailed in audit provides a useful, structured and stepwise way into using our clinical systems effectively for clinical purposes. Quite apart from the massive time-savings, getting involved in electronic audit is a relatively painless way of dipping ones toe into the sea of a paperless practice.

The organisational changes that are needed for electronic audit are also the ones that facilitate the move to both a paperless and better organised chronic disease management. Staff can become familiar with using computers for recording data and issues around coding can be produced in one area, in a way that prepares the ground well for progressive moves towards a paperless system.

PCAG provides help for getting data into clinical systems by providing some templates and advice on coding. See Getting Data In.

We also provide Miquest query sets (a standard way of extracting clinical data from GP systems) for a wide range of topics aimed at creating and maintaining disease registers (Housekeeping sets), audit and recalling patients for follow-up.

The basic idea is that you download sets of files called 'Miquest Queries' from the web site. (If the set is one that is analysed in the practice you will also get a spreadsheet to run the analysis in the same download file). These files each contain a specific question for the clinical database related to the topic in question. They are contained in Winzip files, which come in 2 varieties

a)      a plain Winzip file which you need Winzip software to open (available at www.winzip.com) or

b)      a Winzip EXE aka self extracting file (digitally signed by us) which can be run directly by clicking on the hyperlinks on the download part of this site.

Using one of these methods you make the files available to your clinical system and run them using the clinical system's Miquest Software. This generates another group of files called Response files, which contain the answers to the questions posed by the queries you ran. You copy these to your PC or floppy drive. For query sets like housekeeping, recall or enhanced services, on opening the spreadsheet you downloaded these files will be automatically analysed for you. For audits, where we give comparative feedback like the CHD audit, you need to return the response files to PCAG for analysis. This can be done via email using Winzip or our own Packtosend package. We then return a spreadsheet with the results and comparative analysis.

 See Getting Data Out. We have put some Powerpoint presentations on the site which you might find useful when learning how to do this.

Way into Electronic Audit

How do you get started in electronic audit?
     

     
Here is a suggested route to good data on your good patient care.

  1. Familiarise yourself with the website. The basic structure is audit theory, getting data into your system and getting data out again.

  2. Start by sorting your practice out with appropriate templates/guidelines and get your head around our double coding convention for accurate register construction

  3. Run a housekeeping set to get the feel of how much work your registers initially need.

  4. Run a baseline audit so you can show how much things have changed once you start!

  5. Engage your practice team in the idea

  6. Encourage your practice team by selling the potential advantages to you and your patients

  7. Enthuse your practice team – no more paper audit, more money under the new contract(?)

  8. Organise your practice team. They need to understand how to register patients using the template. You need a system for capturing data relevant to the audit as part of your routine practice procedures. Define roles and responsibilities. Devise workarounds for those stuck in the Cretaceous Period, who think PC means post cibum.

  9. Run your first formal audit and housekeeping set

  10. Re-enthuse your practice team with the improvements already seen from baseline and remind them re registers

  11. Action plan your improvements in care. Use the Recall set to focus attention on your identified priority patients and recall them first. Use Recall set quarterly to recall for the next quarter.

  12. Run an interim audit after a few months to assess progress

  13. Feedback to your team

  14. One year on complete your second formal audit and housekeep your registers

  15. Pat yourself on the back and congratulate your team!

Overview of the PCAG Electronic Audit process

Click here for a pictorial representation of the PCAG Electronic Audit process.