IM&T DES e-Audit

1. IM&T DES e-Audit Dr Dai Evans Clinical Advisor, PRIMIS+

2. IM&T DES global Data Quality Accreditation (Work in progress) Overview

3. IM&T DES part 1 Prepare plan, TNA, training, N3, smart cards (40p/pt) IM&T DES part 2 Accreditation for paper-light practices (44p/pt) IM&T DES part 3 Demographic validation & EPS (27p/pt) IM&T DES part 4 Moving to a hosted system (22p/pt) Context 1

4. Practice Data is “fit for sharing” ** Standards as in “Good Practice Guidelines” Mixture of practice submission, e-audit and practice visit by assessor Occurs after “preparation” (formative) phase Outline details in the DES specification Context 2: IM&T DES Part 2

5. Practice must be “paperlight”. Entering consultations contemporaneously where appropriate Should be “accredited” Pre-Requisite for DQA

6. Information Governance Addresses, locum, supports; telephone consultations Data protection; recovery; Caldicott guardian Non-audit Requirements

7. PRIMIS+ MIQUEST CHART Terminology

8. Drug to Disease Audits (MIQUEST) Presence of some Disease codes (MIQUEST) Presence of other expected codes (MIQUEST) Event Date inconsistencies (MIQUEST) Other audit sources (QoF/QMAS) to support process (i.e. re disease prevalence etc.) System specific for those general aspects not handled by MIQUEST (location, ? Reg data, significance) There will be a “Bank” of audits – how implemented e-Audit *

9. KEELE GPRN work

10. Two broad query sets: - preparation for accreditation - accreditation Will need to be fed back to: - practice - facilitator/assessor - PRIMIS+ (anonymised) Standard output proposed to CHART Other Aspects

11. E-audit output will be broadly anonymised BUT, assessors may need to see patient identifiable records There is guidance from DoH “permitting” this in this circumstance (?reference) A good idea to inform patients in the month before the assessment re any objections Patient Confidentiality

12. Read and understand Good Practice Guidelines (2005) Support practices in submission preparation and throughout process Deliver baseline assessment and Training Needs Assessment (TNA) for practices Understand Information Governance and Data Quality re practices What Facilitators need to do (1)

13. Run pre-accreditation queries and assist practices in their interpretation Run Accreditation set Assist compilation of material for Assessors Facilitators Role (2)

14. E-Audit

15. Remember the e-audit is only one part of the assessment & accreditation process. It does NOT test all aspects of Data Quality. E.g. system specific nuances, local codes etc E-Audit role

16. Read codes / Hysterectomy

17. No. of event dates for each pts Hysterectomy

20. How do you do this…? Minor information on summary? Important information not on summary Duplicated information Multiple events Summary Significance

21. Look for the presence of one code/event from a number representing a disease Not look at minor problems on summary For 1 or 2 areas check no events are “not flagged” Summary Proposal

22. CHART/ Chart Online Handle MIQUEST & supplier queries Give feedback to practice Provide reports for facilitator & PCT assessor Feedback to PRIMIS online (comparison, benchmarking) Proposed Tools

23. Looking at query design Testing software functions In Autumn looking at whole process Bearing in mind may be subtle changes twixt now & then Ongoing Pilot Work

24. So what’s a fail then?

25. The process formalises what some practices have been doing for a while (with £) It brings it up the practice agenda Mixture of formative preparation & summative assessment Summary