Using available data in the electronic patient file EPF to assess a communitys health needs Using available data in the electronic patient file EPF to assess a communitys health needs ID: 767147
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Using available data in the electronic patient file (EPF) to assess a community’s health needs
Using available data in the electronic patient file (EPF) to assess a community’s health needs V.Vyncke , Piessens , V., Ryssaert , L., Art, B., Deserrano , I, & Roobaert L. Community Health Center Nieuw Gent Department of Primary Care & Family Medicine, Ghent University Association of community health centers
BackgroundCommunity oriented primary care (COPC)A process to systematically identify and address community health needs
Theoretical base: the COPC-model
Theoretical base: the COPC-model Community participation
BackgroundCommunity oriented primary care (COPC)a process to systematically identify and address community health needsC ontributes to call for population-based & responsive primary careIn line with Alma Ata declaration “PC tackles the main health problems in the community— providing promotion, preventive, curative, and rehabilitative services as appropriate” (Gillam, 2008)
Challenging context for COPCPC in BelgiumAlmost exclusively fee-for-service financing without patient list (subscription )Free choice of patient central Limited gatekeeping role of PC Challenges for integrated , responsive & community- oriented PC
Belgian community health centers
Belgian community health centers
Belgian community health centers
CHC Nieuw Gent (°2010)+- 4000 patients25 care providersGP, nurse, PT, social workers, dietitianDeprived community Social housing, diversity in nationalities (91), poverty, ..
Research questionWhat are the health needs in our community How can we detect these in our primary care facility?
2 year research project “community- in-sight”
2 year research project “community- in-sight” Integrating data from EPF and external databases
2 year research project “community- in-sight” 2 focus groups multidisciplinary team Individual interviews with care providers within the community Individual interviews with patients and non-patients
On the menu for today
On the menu for today Motivation Available ‘objective measure’ Reflects knowledge of health care team
On the menu for today What is the role of the electronic patient file (EPF) within the process of the community diagnosis ? What are necessary conditions & pitfalls
What did we do? MethodsData in interdisciplinary patient filessociodemographic characteristicshealth care useICPC-coded prevalence and incidence of mental and physical diseases/therapies Period between 01 06 2015 and 31 05 2016
Sample
Sample
Sample
Sample Comparison of members of the community of interest with surrounding communities/Flemish population
Process
What did it teach us?Some support of pre-existing knowledge of PC teamSome nuancing/deepening But mainly a lot about the process!
Necessary conditionWhat is the quality of your EPF?
Quality of EPF‘what you see is what you get’Coding broadlyE.g. social determinants of health Requires clear agreements within team Diagnosis? Reason for encounter ? Consult? Episode?
Pitfalls: “isolation”The need for collaborationBetween researcher and PCteamKnow which questions to pose To frame results and check for mistakes W ith social partners in community and other disciplines With patients / and or neighbourhood inhabitants => Can not be considered as only source/input to define health needs of the community
Clear return for practice & patients Return for practice & patients Positioning practice & tool for reflection What needs to be done ? What are we doing ? motivation & insight for team Improvement of data registration Contributes to quality of care patients receive Tool for quality improvement in practice
Clear return for practice & patients Tool for lobbying health needs of patients /communitySupports GPs in their lobbying role Input for community action Input for collaborative process with patients and community members reality and organisation of practice In light of funding etc.
Further information?leen.roobaert@ugcnieuwgent.beveerle.vyncke@ugent.beWelcome for the presentation tomorrow