The use of electronic health record data for audit & feedback to improve quality of care in general practice.

Bert Vaes, Jettie Bont, Steve Van Den Bulck

Keywords: Electronic Health Record, Audit and Feedback, Quality of care, General Practice

Introduction:

Audit and feedback (A&F) is a well-known healthcare intervention to improve the quality of care that can be defined as ‘any summary, which was delivered to healthcare providers of their clinical performance over a specific period in time’. A&F has been proven to be effective, but there is no gold standard available for the design and implementation of an A&F intervention.
The electronic health record (EHR) of general practitioners is the most comprehensive patient record in healthcare. Registries collecting data from the general practitioner's EHR are often used to study epidemiology and trends in general practice but can also be used to provide feedback to the caregiver. The Intego network in Belgium and the Academisch Netwerk Huisartsgeneeskunde Amsterdam UMC (ANHA) in The Netherlands are two examples of routine care data registries in Europe that are also used to implement A&F for the participating registrators in their network. Furthermore, in Belgium a federated data network starting from the general practitioner's EHR was installed to give all Belgian general practitioners the possibility to participate in a nationwide automated A&F system.
However, receiving feedback does not necessarily mean this will guaranteed lead to an improved quality of care. Which tools can be used to help general practitioners to define goals in their practice, put this into action and follow up on the impact of their actions and what are the barriers and facilitators? In Amsterdam the Spiegelaar method was developed to guide general practitioners to reflect on and improve their quality of care. In Belgium an antibiotic stewardship program using A&F was installed in general practice.

Aim(s):

- To present and discuss the barriers and facilitators of A&F and discuss examples of how A&F can be implemented in general practice
- To share experiences from workshop participators how A&F is implemented in their own country/practice
- To present and discuss possible strategies to put A&F into action and improve the quality of care
- To share experiences from workshop participators on putting feedback into action

Programme:

- Steve Van den Bulck: What is A&F and what are barriers and facilitators for the implementation of A&F? (10 min)
- Bert Vaes: the implementation of A&F in general practice in Belgium: the Intego and Barometer projects (15 min)
- Jettie Bont: the implementation of A&F in general practice in the ANHA network, the Spiegelaar method, The Netherlands (15 min)
- Discussion (35 min)

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