The principal information system used in Norwegian primary healthcare - the electronic medical record (EMR) - is a rich but underused source of data for quality improvement purposes.
This paper describes two systems that aim to make better use of the EMR. First, ‘Best Possible Practice’ provides general practitioners with online support for the treatment of urinary tract infections and sore throats, tailored to the patient via the EMR. The second system, ‘QTools’, will allow health professionals, researchers and others to create a wide range of quality improvement tools.
Studies with both systems are under way. Early results from ‘Best Possible Practice’ provide information on antibiotic use, use of laboratory tests and use of telephone consultations. These data will be used to assess the ability of the system to change the behaviour of health professionals. ‘QTools’ is under development but several elements of the system are in place, primarily a flexible data extraction tool.
EMR systems offer many possibilities for quality improvement systems tailored to individual patients. Although working in this area is a challenge, such systems have the potential to chart and change practice at the local, regional and national levels.
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