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. 2020 Jun;27(1):e100147.
doi: 10.1136/bmjhci-2020-100147.

Developing the infrastructure to support the optimisation of antibiotic prescribing using the learning healthcare system to improve healthcare services in the provision of primary care in England

Victoria Palin  1 , Edward Tempest  2 , Chirag Mistry  2 , Tjeerd P van Staa  2
Affiliations

Developing the infrastructure to support the optimisation of antibiotic prescribing using the learning healthcare system to improve healthcare services in the provision of primary care in England

Victoria Palin et al. BMJ Health Care Inform. 2020 Jun.

Abstract

Introduction: The learning healthcare system (LHS) underpinned by data analysis and feedback to clinical care providers is thought to improve quality of care. The work aimed to implement an LHS for antibiotic prescribing in primary care in England.

Method: Deidentified patient-level data from general practices were processed and analysed at regular intervals (fortnightly increments). A dashboard application was developed and implemented displaying analytical graphics to give periodic feedback to clinicians, tailored to each clinical site. Benchmarking parameters were established by the analysis of two large national primary care datasets allowing peer-to-peer comparisons. To date, the dashboard is available to 70 English practices.

Conclusions: Successful implementation and uptake of the secure technical LHS infrastructure for the analysis and feedback to clinicians of their antibiotic prescribing demonstrate a great appetite for this type of frequent prescribing review in primary care, combining advanced data analytics with tailored feedback.

Keywords: information systems; medical informatics; patient care; primary health care; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
An example of the general practitioner (GP) antibiotic prescribing dashboard where prescriptions may deviate from recommended guidelines. Incidence (acute) antibiotic prescriptions for each infection are compared with the first-line and second-line recommended antibiotic for common infections by the National Institute for Health and Care Excellence. GPs can see the frequency and rate of deviating antibiotic prescription (left) as well as they type of antibiotic prescription (right) by indication. COPD, chronic obstructive pulmonary disease; EHR, electronic health record; LRTI, lower respiratory tract infection; URTI, upper respiratory tract infection; UTI, urinary tract infection.
See this image and copyright information in PMC

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