ࡱ> AC@y bjbjEE *"''KKKKK____ k_$tbbb$$$$$$$$ &(=$Kbbbbb=$KKR$~~~bKK$~b$~~"#0*t_+#$h$0$?#`)~`)(#`)K# bb~bbbbb=$=$~bbb$bbbb`)bbbbbbbbb :  LMC Position Paper on Release of Activity Data to PCTs and other Organisations Summary Over the next few years there will be an increasing expectation that PCTs will be expecting practices to submit activity data in electronic form. This is valuable and sensitive information that must be protected. Data Extraction Software It has already been established that only data which is properly anonymised may be removed from practice records without the specific and informed consent of the patients involved. It is arguable that even when anonymised data is used patients should be aware that this is being extracted routinely. At present PCTs are extracting data using a standardised query set (MIQUEST) that has versions that inferface with all RFA 99 approved GP clinical systems. Under the proposed new GMS contract we anticipate that much more information will be required for practices to demonstrate that they have reached the standards anticipated in the quality programme. Problems with data extraction Confidentiality MIQUEST reliably removes patient identifiers, but it may still be possible To identify individual practitioners from the data. This is not necessarily a Problem, but in small practices especially clinicians need to be aware that this is the case. GPs will need reassurance that any new software reduces the risk that either a patient or an individual clinician can be identified from data extracts without the relevant parties being aware that this is the case. Accuracy The LMC is reasonably confident that MIQUEST searches on EMIS and Torex systems are technically valid, and will identify the Read codes that they claim. In Somerset we do not have enough experience of other GP systems to form a view about the reliability of data extracted from them. However, there is a major problem in making comparisons between practices using MIQUEST, as Read code recording conventions vary hugely between practices and practitioners. Unless standardised recording is agreed well in advance the LMC view is that such comparisons are of little or no value. Data Content Practices must be fully informed about the data that is being extracted, what Read codes are being searched for, what range of records are being searched, and for what purposes the in formation is to be used. There has been concern that up to now this has not always the case. Technical Problems Complex data searches may run into technical problems arising from the search programme, the way in which the search has been written, the clinical software itself, or the way in which the practice records and stores data. Long searches may also degrade system performance if run during the working day. Such problems may be a significant nuisance to the practice LMC Advice on Rules for Data Extraction Consent In view of these potential difficulties, the LMC recommends that practices consider the following guidance before agreeing to the disclosure of any information: No data should be released unless the practice has previously agreed to this is writing. Practices should ensure that before consent is given the practice Caldicott guardian, IT lead, and practice manager have all agreed to the disclosure and are fully informed as to what data is being sought, and for what reasons. Practices should do their best to ensure that no data that identifies either the patient or clinician involved in a consultation is disclosed. This may be a particular problem if data relating to a rare condition is sought from a small practice. A full report on the data extract should be returned to the practice for them to review as soon as it is prepared. Practices should seek reassurance that no comparisons between practices will be published until all the participants have had an opportunity to see the information and comment upon it. PCTs should not use such information for clinical governance, planning, or payment purposes until they have assured themselves that the data extract corresponds with actual activity, and that the extract has been made from the Read codes used by the practice. PCTs should ensure that data is requested once only. 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