How will practices cope with information for the new GMS contract? Coronary heart disease data recording in five Scottish practices

Abstract

Objectives: To investigate whether practices will be ready for the data reporting requirements for the new General Medical Services (GMS) contract, using coronary heart disease (CHD) as an example.

Design: Cross-sectional survey.

Data sources: Electronic general practitioner (GP) records of all CHD patients in five Scottish practices, validated by manual searches in 50 randomly selected patients in each practice.

Main outcome measures: Recording of family history, smoking status, blood pressure (BP), diabetes testing, aspirin therapy and cholesterol measurement.

Results: It is extremely easy for practices with completely electronic patient records to extract a disease register (mean 10 min, range 38 sec to 3 hr 6 min). Extraction of a complete dataset takes several days if it involves checking through paper records, whereas setting up and running a search from electronic records is possible in less than two hours. If practices use the same clinical system and identical data entry templates, the data can be directly compared. Some items that are easily recorded as part of routine clinical practice, such as prescribing of aspirin, are well recorded, but others, such as BP recording, are more of a problem. One hundred percent of the CHD patients sampled had a BP recording within the previous year, but some practices had these data in the paper records where they were not readily accessible.

Conclusions: We have shown that in Scotland there is a high level of testing and recording of all the important information regarding patients with recorded CHD, irrespective of whether practices have fully electronic records, paper-based records, or a mixture of the two. If practices have fully electronic patient records, the information can be extracted easily, but unless there is a standard template, the information can only be viewed in isolation and is of little value for comparative purposes.