QUESTIONS UNDER STUDY/PRINCIPLES:
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. Endeavors 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 standardize 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 November 2011 60 GPs were successfully recruited providing standardized information on over 500000 consultations in > 100000 patients and over 600000 medical problems according to the ICPC-2 classification. CONCLUSION:
The project proves the feasibility of standardized 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.
Initiator: Heinz Bhend, Switzerland (heinz.bhen[at ]sgam.ch