Abstract
Research is scarce where most patients are found. One of the main reasons is the difficulty in extracting data from traditionally conducted paper-based medical records. Thus, until now most existing patient records have originated from invoicing-tools. Endeavours to truly reflect a doctor's consultation have been rare. FIRE (Family Medicine ICPC-Research using Electronic Medical Records) is an ambitious project to establish a proper knowledge base in primary care by using the ongoing implementation of EPR (electronic patient records). FIRE will enable many questions on epidemiology and performance within the PC (primary care) setting to be answered. GPs (general practitioners) throughout Switzerland working with EPR were eligible for participation. Workshops were held to train and standardise ICPC-coding (International Classification of Primary Care), a classification system especially designed for the PC-setting. The recorded data included administrative information on the GP and patient, vital signs, ICPC codes, laboratory analysis and medication. Data exporter software was developed for extracting anonymised data automatically from the EPR onto a database for further statistical analysis. From 1.1.2009 until the beginning of April 2010 24 GPs were successfully recruited providing standardised information on 127,922 consultations in 29,398 patients and 159,956 medical problems according to the ICPC-2 classification. The project proves the feasibility of standardised ongoing collection of research data embedded in routine clinical practice. FIRE provides a unique database for research in PC and highlights the potential of broad implementation of EPR in a PC-setting. Studies resulting from the ongoing project have the potential to assess the quality of care provided by GP's.
Highlights
In many countries a proper knowledge base on the characteristics of PC does not exist, even though computerised PC records are fundamental components for any national health information system [2]
Workshops were held to train and standardise ICPCcoding (International Classification of Primary Care), a classification system especially designed for the PC-setting
The project proves the feasibility of standardised ongoing collection of research data embedded in routine clinical practice
Summary
In many countries a proper knowledge base on the characteristics of PC (primary care) does not exist, even though computerised PC records are fundamental components for any national health information system [2]. Data on PC in Switzerland have mainly originated from invoicingtools. A majority (87%) [3] of GPs (general practitioners) in Switzerland still solely use paper-based patient records, making data evaluation extremely time-consuming [4] and incomprehensive. EPRs (Electronic Patient Records) include administrative patient data, documented vital-signs, medications and laboratory results. Specific elements of the doctor-patient encounter, such as reasons for consultation, medical problems and procedures, are usually filed in free text. It is crucial to establish a reliable database with an appropriate documentation system that reflects the above
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