Investigating the benefits of electronic health data

‘I have always thought electronic health record data should be used for secondary purposes and have pursued that vision,’ Jan Radford, Associate Professor of General Practice at the School of Medicine, University of Tasmania, told newsGP.
 
Associate Professor Radford’s medical education research focuses on increasing the capacity of general practice to offer clinical placements to medical students, while her clinical research involves the secondary use of general practice electronic health record data and use of practice-based research networks.
 
She received the Churchill Fellowship in 2017 for her investigations on how routinely collected general practice electronic health record data can be used to improve patient care, and travelled to the UK and the Netherlands in 2018 to compare the countries’ health systems with Australia’s.
 
A key finding of Associate Professor Radford’s research was that Australia can learn from these countries about the processes of electronic health record data.
 
‘Australia has a lot of ground to make up in training and supporting academic GPs, as well as the rest of the research team who can make use of this data,’ she said.
 
‘We need to have GPs working in this space, not just handing over data for others to interpret.
 
‘Another lesson was that the countries I visited had many organisations approaching practices for data ... [I would advise] Australia to have one organisation to collect and manage our data as a goal.’
 
Associate Professor Radford also recommends GPs become informed about what other countries are doing to adopt methods of collecting health record data to improve patient care.
 
‘As a profession, general practice must lead in this space to ensure the data we own is used wisely,’ she said.
 
‘[GPs can] use electronic health records well by putting data in the correct place and using it as though they may not be the next person to see this patient.
 
‘What should the record contain for an ideal in-house clinical handover? For example, if you have prescribed a drug, put the reason in the appropriate space.’
 
According to Associate Professor Radford, while collated electronic health records data can be used to improve patient care, the process also presents some challenges.
 
‘The time and technical ability while maintaining the privacy and security of the data, interpretation of the raw data, cost of collecting, storing and cleaning the data, and the administration of access to datasets for uses leading to improved patient care,’ she said.
 
‘[Collecting health record data] is challenging and expensive to do, but a less expensive activity than using other systems to gain the same information.’
 
However, Associate Professor Radford believes the benefits of general practices adopting systems to routinely data outweigh the challenges, facilitating valuable exchanges across healthcare settings.
 
‘Linkage of data from various datasets, including general practice, could enable richer pictures to be painted about what influences health outcomes and to see if interventions made a difference,’ she said.
 
‘For example, noting all the people who visit their GP at least yearly, a population picture of obesity could be painted if all GPs did a height and weight measurement and placed the numbers in the electronic health records.
 
‘This background data could then be linked to other data such as proximity to space for exercise, levels of community food security, use of mental health services, etc.
 
‘Linking data from general practice to secondary care data allows patient outcomes leading to hospitalisation to be incorporated into the picture of the patient.’
 
In addition to her continuing academic work, Associate Professor Radford works one day a week in clinical practice and some after-hours care. She is also undertaking a part-time PhD in medical education.

Churchill Fellowship eHealth electronic health record research