The Clinical Effectiveness Group at Queen Mary University of London, one of our partners, has been successfully using online tools to improve care in a number of ways. In this case study, we hear about how it works and what it’s helped achieve in three East London boroughs.
Three east London CCGs (City & Hackney, Tower Hamlets and Newham) have performed exceptionally well on a wide variety of metrics in the 2015/16 Quality and Outcomes Framework results by optimizing IT systems for Quality Improvement.
City & Hackney and Tower Hamlets came either 1st or 2nd in 18 out of 65 (28%) of clinical indicators, while Newham was in the top 20 in 5 of the indicators. The outstanding performances of these CCGs are especially significant given the historic health inequalities in the region.
How does the system work?
Much of their successes can be attributed to Queen Mary University of London’s Clinical Effectiveness Group (CEG). The CEG provides support to primary care in east London and develops novel IT solutions. Dr John Robson, Clinical Lead of CEG, explains “we’ve been building up an infrastructure that means we can use a single IT system in Primary Care, to gather useful knowledge from every patient contact.” Their support programmes primarily focus on long term conditions such as diabetes, chronic obstructive pulmonary disease (COPD), asthma, and cardiovascular disease.
“These systems that we have set in place have pushed us to be performing about 5 years ahead of the average in England, and if you compare us with more deprived areas we are about 10 – 15 years ahead. Our GPs face the same difficulties as other areas, but what we do have is a system that is very effective and that’s what’s promoting our quality”, says Dr Robson. The three of the CCGs that the CEG works with serve patients that live in local authority districts which are amongst the 25 most deprived in England.
How does the system work?
CEG’s system follows a three step process:
- engaging stakeholders in a discussion of what key performance indicator they would like to change,
- designing tools to facilitate the change, and
- motivating improvement by comparing results with other practices and providing financial incentives to meet improvement goals.
One of the tools the CEG has developed allows GPs and nurses to quickly enter patient data while receiving prompts by the software and an offer of a diagnosis made through a diagnostic algorithm. This is algorithm is based on the information that has been entered. It also calculated risk scores, sets task reminders informed by NICE guidelines and the latest quality improvement research.
The tool is integrated with EMIS web, the largest clinical IT system in the UK, so that data entered into the template is automatically applied onto the electronic health record. Other tools include evidence based clinical guidelines and care pathways, as well as a real time performance dashboard.
What do doctors think of it?
Dr Tahseen Chowdhury, consultant in diabetes at the Royal London Hospital, says “We work closely with the CEG around network enhanced services, guidelines in diabetes, and educational updates. They provide regular real time data to compare practice outcomes and enable improvement. Without the CEG we would not have achieved such outcomes.”
The CEG is currently extending its support to other CCGs who are hoping to achieve similar achievements in quality improvement. In addition, they have uploaded their data entry templates, which are aligned to current clinical guidelines, online for anyone to use. Dr Robson believes that many GP practices “are not making the best use of their IT systems. Rather than being stand alone practices, a group of practices in a CCG could connect, share data, and have a very powerful tool for quality improvement that would tell them how they were all doing.” At a time when there is increasing pressure for the healthcare community to maintain high standards while meeting growing patient demand, The CEG has tapped into the potential of IT systems to deliver impactful quality improvement for higher quality and more efficient care.
You can find out more about the Clinical Effectiveness Group at Queen Mary University of London here and the online data entry templates, which are aligned to clinical guidelines, here.
You can also contact our team here by emailing firstname.lastname@example.org.