PINGR: Harnessing Opportunities for Quality Improvement From Primary Care Electronic Health Records

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Research lead: Ben Brown, University of Manchester

Researchers from The University of Manchester have developed computer software for GP practices that analyses patient data to suggest what steps could be taken to improve their care.

The Challenge

Often patients do not receive care recommended by best practice guidelines. Data that already exists within medical records can be analysed by software to help doctors change this. The problem is that existing software does not do this in a very effective way.

The Research

Instructions were developed from existing scientific literature to guide how best to design such software and make it fit for purpose. This was used to design PINGR – the Performance Improvement plaN GeneratoR. PINGR was tested in laboratories with software experts and GPs to make sure it could be used easily. Then it was put on trial and given to a number of GP practices for them to use on their patients. In this final stage, information was collected to track how the GPs used the software and evaluated whether it had the potential to improve care.

The Results

The software instructions suggested that this type of software should provide suggested actions for a patient to GPs alongside the traditional methods of analysing medical record data. We incorporated this feature into PINGR, which users in the laboratory thought was a good idea.

PINGR works by analysing data from patient’s medical records and comparing it to best practice guidelines. Where there is a gap between the two, PINGR suggests things that doctors and patients can do to close it. PINGR is now being used in five GP practices in Salford and has already helped improve patient care by highlighting missed diagnoses, suggesting changes to patient treatment, and reducing unnecessary investigations and diagnoses.

The Impact

The instructions we created can be used to guide the design of software similar to PINGR, which has the potential to help patients get better care anywhere in the world. PINGR itself is being rolled out in more practices within Salford, with plans to extend this throughout Greater Manchester and beyond. This means more patients will benefit from the suggestions PINGR makes to GPs. The wider health system may also be able to save money because of the reduction in unnecessary tests and diagnoses that PINGR identifies.

Benjamin Brown, Panos Balatsoukas, Richard Williams, Matthew Sperrin, Iain Buchan, Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system, International Journal of Medical Informatics, Volume 94, 2016, Pages 191-206,

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