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Access to automated comparative feedback reports in primary care - A study of intensity of use and relationship with clinical performance among Swedish primary care practices

Anell, Anders LU ; Arvidsson, Eva ; Dackehag, Margareta LU ; Ellegård, Lina Maria LU and Glenngård, Anna LU (2024) In BMC Health Services Research 24(1).
Abstract
Background
Digital applications that automatically extract information from electronic medical records and provide comparative visualizations of the data in the form of quality indicators to primary care practices may facilitate local quality improvement (QI). A necessary condition for such QI to work is that practices actively access the data. The purpose of this study was to explore the use of an application that visualizes quality indicators in Swedish primary care, developed by a profession-led QI initiative (“Primärvårdskvalitet”). We also describe the characteristics of practices that used the application more or less extensively, and the relationships between the intensity of use and changes in selected performance... (More)
Background
Digital applications that automatically extract information from electronic medical records and provide comparative visualizations of the data in the form of quality indicators to primary care practices may facilitate local quality improvement (QI). A necessary condition for such QI to work is that practices actively access the data. The purpose of this study was to explore the use of an application that visualizes quality indicators in Swedish primary care, developed by a profession-led QI initiative (“Primärvårdskvalitet”). We also describe the characteristics of practices that used the application more or less extensively, and the relationships between the intensity of use and changes in selected performance indicators.

Methods
We studied longitudinal data on 122 primary care practices’ visits to pages (page views) in the application over a period up to 5 years. We compared high and low users, classified by the average number of monthly page views, with respect to practice and patient characteristics as well as baseline measurements of a subset of the performance indicators. We estimated linear associations between visits to pages with diabetes-related indicators and the change in measurements of selected diabetes indicators over 1.5 years.

Results
Less than half of all practices accessed the data in a given month, although most practices accessed the data during at least one third of the observed months. High and low users were similar in terms of most studied characteristics. We found statistically significant positive associations between use of the diabetes indicators and changes in measurements of three diabetes indicators.

Conclusions
Although most practices in this study indicated an interest in the automated feedback reports, the intensity of use can be described as varying and on average limited. The positive associations between the use and changes in performance suggest that policymakers should increase their support of practices’ QI efforts. Such support may include providing a formalized structure for peer group discussions of data, facilitating both understanding of the data and possible action points to improve performance, while maintaining a profession-led use of applications. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Feedback, Sweden, Quality Improvement, Primary Health Care, Diabetes Mellitus
in
BMC Health Services Research
volume
24
issue
1
article number
33
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85181511162
  • pmid:38178188
ISSN
1472-6963
DOI
10.1186/s12913-023-10407-9
language
English
LU publication?
yes
id
a3635db3-00e9-4d98-8526-6ee4e3a84026
date added to LUP
2023-12-08 09:43:34
date last changed
2024-04-25 17:59:15
@article{a3635db3-00e9-4d98-8526-6ee4e3a84026,
  abstract     = {{Background<br/>Digital applications that automatically extract information from electronic medical records and provide comparative visualizations of the data in the form of quality indicators to primary care practices may facilitate local quality improvement (QI). A necessary condition for such QI to work is that practices actively access the data. The purpose of this study was to explore the use of an application that visualizes quality indicators in Swedish primary care, developed by a profession-led QI initiative (“Primärvårdskvalitet”). We also describe the characteristics of practices that used the application more or less extensively, and the relationships between the intensity of use and changes in selected performance indicators.<br/><br/>Methods<br/>We studied longitudinal data on 122 primary care practices’ visits to pages (page views) in the application over a period up to 5 years. We compared high and low users, classified by the average number of monthly page views, with respect to practice and patient characteristics as well as baseline measurements of a subset of the performance indicators. We estimated linear associations between visits to pages with diabetes-related indicators and the change in measurements of selected diabetes indicators over 1.5 years.<br/><br/>Results<br/>Less than half of all practices accessed the data in a given month, although most practices accessed the data during at least one third of the observed months. High and low users were similar in terms of most studied characteristics. We found statistically significant positive associations between use of the diabetes indicators and changes in measurements of three diabetes indicators.<br/><br/>Conclusions<br/>Although most practices in this study indicated an interest in the automated feedback reports, the intensity of use can be described as varying and on average limited. The positive associations between the use and changes in performance suggest that policymakers should increase their support of practices’ QI efforts. Such support may include providing a formalized structure for peer group discussions of data, facilitating both understanding of the data and possible action points to improve performance, while maintaining a profession-led use of applications.}},
  author       = {{Anell, Anders and Arvidsson, Eva and Dackehag, Margareta and Ellegård, Lina Maria and Glenngård, Anna}},
  issn         = {{1472-6963}},
  keywords     = {{Humans; Feedback; Sweden; Quality Improvement; Primary Health Care; Diabetes Mellitus}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Health Services Research}},
  title        = {{Access to automated comparative feedback reports in primary care - A study of intensity of use and relationship with clinical performance among Swedish primary care practices}},
  url          = {{http://dx.doi.org/10.1186/s12913-023-10407-9}},
  doi          = {{10.1186/s12913-023-10407-9}},
  volume       = {{24}},
  year         = {{2024}},
}