Automated data extraction from general practice records in an Australian setting: Trends in influenza-like illness in sentinel general practices and emergency departments

Gösta Th Liljeqvist,Michele Puech,Hans Blom,Siranda Torvaldsen,Michael Staff

doi:10.1186/1471-2458-11-435

Gösta Th Liljeqvist, Michele Puech + Show 3 more

Open Access

https://doi.org/10.1186/1471-2458-11-435

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Abstract

BackgroundInfluenza intelligence in New South Wales (NSW), Australia is derived mainly from emergency department (ED) presentations and hospital and intensive care admissions, which represent only a portion of influenza-like illness (ILI) in the population. A substantial amount of the remaining data lies hidden in general practice (GP) records. Previous attempts in Australia to gather ILI data from GPs have given them extra work. We explored the possibility of applying automated data extraction from GP records in sentinel surveillance in an Australian setting.The two research questions asked in designing the study were: Can syndromic ILI data be extracted automatically from routine GP data? How do ILI trends in sentinel general practice compare with ILI trends in EDs?MethodsWe adapted a software program already capable of automated data extraction to identify records of patients with ILI in routine electronic GP records in two of the most commonly used commercial programs. This tool was applied in sentinel sites to gather retrospective data for May-October 2007-2009 and in real-time for the same interval in 2010. The data were compared with that provided by the Public Health Real-time Emergency Department Surveillance System (PHREDSS) and with ED data for the same periods.ResultsThe GP surveillance tool identified seasonal trends in ILI both retrospectively and in near real-time. The curve of seasonal ILI was more responsive and less volatile than that of PHREDSS on a local area level. The number of weekly ILI presentations ranged from 8 to 128 at GP sites and from 0 to 18 in EDs in non-pandemic years.ConclusionAutomated data extraction from routine GP records offers a means to gather data without introducing any additional work for the practitioner. Adding this method to current surveillance programs will enhance their ability to monitor ILI and to detect early warning signals of new ILI events.

Highlights

Influenza intelligence in New South Wales (NSW), Australia is derived mainly from emergency department (ED) presentations and hospital and intensive care admissions, which represent only a portion of influenza-like illness (ILI) in the population
Building on the Canning Data Extraction Tool, we developed the Canning Flu Tool to conduct automated searches and extractions of both coded and free-text fields from two of the most commonly used general practice (GP) medical record packages used in Australia (Best Practice and Medical Director 3)
Sentinel GP data compared with Public Health Real-time Emergency Department Surveillance System (PHREDSS) data Between 2007 and 2010, clear seasonal peaks can be seen in the GP data, the 2% threshold being exceeded in all four years (Figure 1)

Summary

Introduction

Previous GP surveillance for ILI in Australia has required some form of additional work by GPs, either filling in reports or actively following surveillanceguided medical reporting using coded sections of medical records programs [5]. In NSW, notifications of laboratory-confirmed cases [6] and the Public Health Real-time Emergency Department Surveillance System (PHREDSS) [7] are the main data sources for influenza surveillance. Increasing numbers of GPs use software packages for keeping medical records [8], which has improved the uniformity and the quality of the records [9] This may facilitate timely, comprehensive GP surveillance, which would enhance our ability to achieve early detection of new trends and identify and monitor clusters of cases [10]

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