Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar
<p><strong>Objectives: </strong>Chronic kidney disease (CKD) is an important cause of excess cardiovascular mortality and morbidity; as well as being associated with progression to end stage renal disease. This condition was largely unheard of in English primary care prior...
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| Format: | Journal article |
| Language: | English |
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Korean Society of Medical Informatics
2013
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| _version_ | 1811140472277565440 |
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| author | de Lusignan, S |
| author_facet | de Lusignan, S |
| author_sort | de Lusignan, S |
| collection | OXFORD |
| description | <p><strong>Objectives: </strong>Chronic kidney disease (CKD) is an important cause of excess cardiovascular mortality and morbidity; as well as being associated with progression to end stage renal disease. This condition was largely unheard of in English primary care prior to the introduction of pay-for-performance targets for management in 2006. A realist review of how informatics has been a mechanism for national implementation of guidance for the improved management of CKD.</p>
<p><strong>Methods: </strong>Realist review of context, the English National Health Service with a drive to implement explicit national quality standards; mechanism, the informatics infrastructure and its alignment with policy objectives; and outcomes are describe at the micro-data and messaging, meso-patient care and quality improvement initiatives, and marco-national policy levels.</p>
<p><strong>Results: </strong>At the micro-level computerised medical records can be used to reliably identify people with CKD; though differences in creatinine assays, fluctuation in renal function, and errors in diabetes coding were less well understood. At the meso-level more aggressive management of blood pressure (BP) in individual patients appears to slow or reverse decline in renal function; technology can support case finding and quality improvement at the general practice level. At the macro-level informaticians can help ensure that leverage from informatics is incorporated in policy, and ecological investigations inform if there is any association with improved health outcomes.</p>
<p><strong>Conclusions: </strong>In the right policy context informatics appears to be an enabler of rapid quality improvement. However, a causal relationship or generalisability of these findings has not been demonstrated.</p> |
| first_indexed | 2024-09-25T04:22:31Z |
| format | Journal article |
| id | oxford-uuid:b1dce829-d28b-47dc-9642-67fd3eea2bc4 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:22:31Z |
| publishDate | 2013 |
| publisher | Korean Society of Medical Informatics |
| record_format | dspace |
| spelling | oxford-uuid:b1dce829-d28b-47dc-9642-67fd3eea2bc42024-08-14T14:27:35ZInformatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplarJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b1dce829-d28b-47dc-9642-67fd3eea2bc4EnglishSymplectic ElementsKorean Society of Medical Informatics2013de Lusignan, S<p><strong>Objectives: </strong>Chronic kidney disease (CKD) is an important cause of excess cardiovascular mortality and morbidity; as well as being associated with progression to end stage renal disease. This condition was largely unheard of in English primary care prior to the introduction of pay-for-performance targets for management in 2006. A realist review of how informatics has been a mechanism for national implementation of guidance for the improved management of CKD.</p> <p><strong>Methods: </strong>Realist review of context, the English National Health Service with a drive to implement explicit national quality standards; mechanism, the informatics infrastructure and its alignment with policy objectives; and outcomes are describe at the micro-data and messaging, meso-patient care and quality improvement initiatives, and marco-national policy levels.</p> <p><strong>Results: </strong>At the micro-level computerised medical records can be used to reliably identify people with CKD; though differences in creatinine assays, fluctuation in renal function, and errors in diabetes coding were less well understood. At the meso-level more aggressive management of blood pressure (BP) in individual patients appears to slow or reverse decline in renal function; technology can support case finding and quality improvement at the general practice level. At the macro-level informaticians can help ensure that leverage from informatics is incorporated in policy, and ecological investigations inform if there is any association with improved health outcomes.</p> <p><strong>Conclusions: </strong>In the right policy context informatics appears to be an enabler of rapid quality improvement. However, a causal relationship or generalisability of these findings has not been demonstrated.</p> |
| spellingShingle | de Lusignan, S Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title | Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title_full | Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title_fullStr | Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title_full_unstemmed | Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title_short | Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar |
| title_sort | informatics as tool for quality improvement rapid implementation of guidance for the management of chronic kidney disease in england as an exemplar |
| work_keys_str_mv | AT delusignans informaticsastoolforqualityimprovementrapidimplementationofguidanceforthemanagementofchronickidneydiseaseinenglandasanexemplar |