LIES - Damm lies & STATISTICS!

Yes - I know - statistics can prove or disprove anything, yet we (?) in the scientific and medical community are constantly pouring over and analysing them to seek out 'evidence' of where we do well, and where we need to improve.

SO for me another confession - the result of running an audit of activity 'on-line' at my surgery in the last year. The 'audit tool' we are provided with is very basic, producing a single massive file - too big to fit into excel! So first note to self (and suppliers):

1)  Provide us some basic tools to report on activity - please.

So for the last year from April 2011 to March 2012:

Activity	Count
Repeat Medication Items ordered	5135
Stop Access	5
Make appointment	2254
Log-in	9141
File Change of Address	106
Failed log-on	799
Change Address	109
Cancel Change Address requests	1
Cancel Appointment	711
Archive change of Address	3
	18264

It appears I vastly under assessed the number of patients who use our 'on-line' facility, based on information from another part of my surgery IT system reporting (confusing!!!). We have had 808 individual patients access the surgery system at least once in the last year, which means almost 9% of my surgery list.
So, second note:

2)  Ensure reporting 'on-line' activity is consistent in all modules of IT system.

Before I sit back in bask in the 'warm-glow' of self satisfaction I have to point out there are some wide variations in usage by individuals - evident only by detailed filtering and sorting of the combined report (almost beyond the skill of an ageing, non-technical GP).
The range of 'on-line' usage is from 1 to 857 log-ins per year! There are a number of 'high users' who access our system 100-175 times in a year - using many of the transactional options, however a single user stands out as 'atypical' with 857 successful log-ins in the year and an additional 13 failed attempts. Maximum number of log-ins for that individual is 28 in one day.
Clearly there are other reasons and issues that need addressing separately for this individual, and questions about the benefits and disadvantages for them, the surgery and the wider population and care services.
So third and fourth note (to self and future guidance):

3)  What will be the 'accepted' reasons for withdrawal of Records Access privileges, and the mechanism for appeal?
4)  Can we  have individual reports on usage from the clinical system?

SO totting up the activity I come to an average of 11.3 log-ins per year for active users (or 10.3 discounting our practice enthusiast). So WHEN patients are registered for transactional activity it IS well used - and I am confident it provides a valued additional service AND saves time and money for my surgery.

Last (wishful) note:

5)  Please can I have working reports on patient access to the full GP records that I have enabled? How often are they viewed, and what in particular are patients looking at?

Peter S

21 and counting....

It may not be a landmark in terms of activity, but we have 21 patient requesting access to medical records at the surgery so far. This may be around 0.23% of my practice list, but it is still considerably more than most practices in England. Leaflets advertising the service are prominently place on the main reception desk, and disappear regularly!

Now perhaps where this gets interesting is in comparison to the number of patients who are active users of  'on-line' transactions. Contrary to my previous publications and claims, it turns out we only have 272 active users out of a practice list of more than 9,000. This is despite ACTIVE encouragement, and offering leaflets about on-line access to all who newly register at the surgery, So:

• 3% of my practice list are enabled users of on-line service
• 7.7% of those registered for 'transactional services' have asked for full Records Access

Perhaps the figures are starting to make some sense?

If I had 25% of my surgery list registered for 'transactional services' then I could expect around 170 people asking for Records Access - if all the trends continue.

SO - priority of work at the surgery is to get as many people as possible registered for, and using, transactional services. RA may well follow-on naturally. This is likely to bring the most immediate benefit for patients in terms of convenience and 24 hour access to appointment booking and medication requesting, AND for the surgery in terms of efficiency and reducing front-desk and telephone contacts.

The other question to address is how difficult do patients find it to register for simple transactional services, let alone full records access. I wonder if the RCGP, BMA and System Suppliers can come up with ways to make this easier - and if the Information Governance review being led by Dame Fiona Caldicott will give any direction to remove barriers?

Peter S

Medication Requesting

So - no surge in demand to see records yet...

I will be targeting specific individuals in January - but how do my surgery patients request repeat medication throughout this year?

Well it seems they average 550-600 items per month ordered 'on-line', without a major variation across the seasons. I am at a loss to explain activity in February 2011 - no major snowfall to blame and the shortest month of the year - perhaps they had finally depleted the Christmas and New Year stockpiles?

I hope they are all stocked-up for Christmas 2011!

Peter S