Cervical screening stalls, height data rises: PIP QI data

The number of cervical smears logged in GPs’ records has remained constant in the past year – despite the introduction of universal access to self-testing – while height and weight measurements have increased slightly, new figures show.
 
These are among the details published today by the Australian Institute of Health and Welfare (AIHW), which has released data collected through the Practice Incentives Program Quality Improvement (PIP QI) for the most recent financial year.
 
Its new report includes details of 10 Quality Improvement Measures (QIMs) from 5531 general practices nationwide, with all 31 Primary Health Networks (PHNs) contributing to the dataset.
 
One of the measures, current from July 2023, shows that 37.5% of women aged 25–74 years had a cervical screening test recorded in their GP record after 1 December 2017. This compares to 38.2% a year previously, and follows the introduction of universal self-collection cervical screening in July 2022.
 
Details on whether height and weight have been tracked over the past 12 months rose slightly, with 23% of patients having that in their GP record, up from 21% in the previous year – perhaps in part due to more face-to-face consultations than 2021–22.
 
Other measures captured as part of the PIP QI include the number of influenza immunisations for those aged 65 and over, patients who have CVD assessments, as well as those who have had their alcohol consumption and smoking status recorded.

For Dr Michael Bonning, a member of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), there is ‘significant health value’ in the information gathered, which he says is ‘critical to good general practice’.
 
However, he noted limited variations year on year.
 
‘What strikes me is the consistency,’ he said. ‘[I think] that occurs … because practices and practitioners who already record data are consistent in doing so, hence resulting in stable data, as opposed to improvement because more practices are focusing on their quality improvement measures.’
 
The AIHW says the figures are not designed to assess general practices or GP performance, and that there are no set targets for the improvement measures.
 
According to Dr Bonning, the PIP QI information does not provide the same tangible actions for general practices as Lumos data collected in NSW.
 
‘We know that better care happens if we make sure we do certain things that we’ve seen in the Lumos data, we see actionable insights,’ he said.
 
He believes the value of general practice is in the longitudinal relationship of GPs with patients and that meaningful measures are required to analyse that.
 
‘GPs’ ongoing argument that they are not sufficiently recognised in the health system for the contribution of primary care could be overcome by consistent and accurate data on our patient population,’ he said.
 
‘Whether that is achieved by PIP QI or by some other approach remains to be seen.
 
‘For many GPs continuous improvement is part of their DNA but in other circumstances, when faced with huge demand, it can be difficult to then also find time for new projects.
 
‘The high workload, workforce pressures and post pandemic burnout being experienced across general practice makes getting team members interested in data-driven continuous quality improvement difficult at times.’
 
Dr Emil Djakic also sits on REC–FHSR and like Dr Bonning finds the data interesting, but believes there is scope for improvement.
 
‘This is a valuable piece of information in the sense that it shines a light on potential work in the prevention space,’ he told newsGP.
 
‘It really speaks to the need for us to have better utilisation of either our nurse workforce or assistance workforce to help create a more effective use of this subset of data.
 
‘There are deficiencies in the completion of this data set that can only be resolved by better investments in general practice.’
 
Under PIP QI, general practices share de-identified data drawn from electronic records – the AIHW says most used the Best Practice (65.8%) or Medical Director Insights (28.8%) clinical information systems – with their local Primary Health Networks (PHNs), which is then collated by the AIHW.
 
The AIHW has highlighted data quality issues, including one method of file extraction that had to be excluded from its results. Some illustrations in its report only relate to figures from January to the end of June this year.
 
Its figures only include patients defined by the AIHW as ‘regular clients’, meaning those who have visited the clinic at least three times in the previous two years.
 
The PIP QI started in August 2019, following a $200 million Federal Government investment aiming to create a greater understanding of the health of Australian residents and highlight gaps.
 
Services Australia outlines payments of $5 per patient – the Standardised Whole Patient Equivalent (SWPE) – capped at an annual maximum of $50,000 per practice. 

 Log in below to join the conversation

health data PIP practice incentive payments QI