A real-world, data-driven view of general practice prescribing

In my years of working in the health sector, one of the biggest ongoing challenges we are yet to resolve is how to get access to quality population-level data. In this era of progressive health informatics, and despite our incredible advancements in technology, it continues to be a tricky problem.

In 2012, NPS MedicineWise set out to develop a way to better understand prescribing behaviour in Australian general practice — how medicines are prescribed, for whom and why, and what happens when new medicines become available. This program is called MedicineInsight and over 300 practices nationally are now participating, representing over 1500 general practitioners and 3.5 million patient encounters to date.

So how does it work? Using a custom-built data extraction tool that operates seamlessly and securely in the background with the practice's clinical software, non-identifiable patient and clinical care information from participating practices is collected and analysed. Regular reports and whole-of-practice facilitated discussions assist GPs to track their patient care over time, and in particular their prescribing of medicines. This provides a better understanding of the effect of those medicines on patients and where health care improvements could occur, either in practice or in policy. The program is government-funded and received ethics approval from the Royal Australian College of General Practitioners. Early evaluation indicates that participants greatly value the tailored reports they receive to inform and improve their clinical practice and patient care.

MedicineInsight has the potential to be the primary source of real-world general practice data on patient care, from diagnosis through to medicines used, tests ordered and clinical impacts of management. These unique longitudinal data will inform health services planning, monitoring and evaluation at all levels — from the individual patient to the whole health system. However, realising this potential relies on more practices becoming involved. More information on the program and how to register is available at http://www.medicineinsight.org.au.