1. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas1 The Practice Health Atlas Setting Up Good Directions Graeme Berry Wednesday 23 rd April,2008

2. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas2 The PHA is a resource for informed decision making, both clinical and financial. It provides disease profiles. Matches your practice billing details with EPC items. What is it?

3. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas3 Creating PHAs for practices (at no cost) – facilitating discussion of the results – assist in what actions can be taken – aggregating the data from different practices (compare with other practices and national benchmarks) What is the division doing?

4. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas4 A quality database. A comprehensive team-based care program. A pro-active approach to patient care. A ‘best practice’ clinical care program. What can be the outcomes of follow up actions?

5. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas5 A cost effective business model. An efficient practice accreditation program. A personal and practice focussed professional development program. A evidence based marketing of the practice services. What can be the outcomes of follow up actions?

6. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas6Wednesday 23rd April, 2008Overview of the Practice Health Atlas Number patients Your total population:6990 Your total cleansed population6729 15-month patient population*: (3/28/2007) 4631 Aboriginal or Torres Strait Islanders:5 Pensioners:1445 DVA patients:93 Patients on 5 or more current medications:930 30-month patient population:5600 * Excludes patients with no postcodes or with post boxes, and those where date of birth was not recorded. It is referred to as your ‘patient population’ in this report, and is the cohort upon which the majority of the Practice Health Atlas TM analysis is based. Patient Population Overview - characteristics of your patient population

7. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas7 Example of patient population profile mapped by postcode.

8. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas8 Practice Health Atlas (PHA) Epidemiology Chart 1. Patient population profile: Top 10 postcodes by percentage Table 1. No. of patients seen versus no. of total persons in the top 10 postcodes Patient population postcode profileMarket share of the patient population The patient population seen in last 15 months is distributed over 267 postcodes. Chart 1 shows the top 10, in which 81.78% of these patients live.

9. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas9 Age/Sex profile Profile Graphs and related Charts Number% Males:598942.85 Females:744053.23 Sex not recorded:5473.92 Total:13976100.00

10. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas10 Case Study 1 – No. of patients attending Total Number of Patient Records12, 412100% Patients attending in last 30 months9,74879% Patients attending in last 15 months8,27667% What actions would you recommend to the PMs, PNs and GPs? What are the outcomes of the appropriate actions?

11. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas11 Case Study 2 – No. of patients with diabetes What actions would you recommend to the GPs and nurses? What are the outcomes of the appropriate actions? Number of identified diabetics1811.9% Expected no. of diabetics4875.8% Conclusion: the number of diabetics is either under-recorded and/or under diagnosed.

12. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas12 Example Diabetes Profile by postcode. Profiles provided for eight chronic diseases.

13. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas13 Prevalence of diabetes profile by age group

14. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas14 Prevalence of diabetes profile by age group

15. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas15 Prevalence of diabetes profile by age group

16. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas16 Case Study 3 – No. of patients on 5 or more medications What actions would you recommend to the GPs and nurses? What are the outcomes of the appropriate actions? Number of patients on 5 or more medications956 No. of HMRs2

17. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas17 Case Study 4 – Comparative demographic and clinical data Practice Num records 30 mth % 15 mth % % diabetics % asthma % mental health % cvd % bone diseas e % 5 or more meds % 5+ meds w HMR Practice A1205851.5%45.4%2.4%9.9%9.0%1.4%2.7%7.9%2.5% Practice B2214853.5%45.1%3.8%10.6%7.9%3.0%3.9%13.4%1.6% Practice C890150.2%39.7%5.6%11.4%17.5%3.9%4.2%17.7%0.0% Practice D250494.9%86.1%18.0%6.8%32.2%5.3%25.1%41.5%40.0% Practice E2656232.6%25.0%2.7%6.1%7.9%2.8%3.7%14.3%1.8% Practice F1083950.3%40.1%2.4%7.9%7.4%2.7% 17.5%2.8% Practice G3231422.6%18.6%2.7%9.1%9.7%1.7%3.3%15.8%11.7% Practice H1466633.6%26.7%7.2%5.4%12.3%8.2%7.2%30.4%10.4% Practice I688281.6%67.6%3.9%11.3%12.8%4.7%6.4%17.4%0.7% Practice J916578.2%64.7%5.0%9.4%9.1%6.2%6.4%26.7%0.8% Practice K1184153.5%39.6%4.2%10.1%13.3%9.0%4.7%18.1%2.9% Average 54.8%45.3%5.3%8.9%12.7%4.4%6.4%20.1%6.9%

18. North East Valley Division of General Practice 23rd April 2008Overview of the Practice Health Atlas18 A total of 16 practices have already participated in the PHA. One of these practices has requested a second PHA. – It is their intention to use some of the statistics and mapping contained in the PHA to demonstrate the need for funding of specialised services. PHA now uses 2006 ABS data. Other endorsements to follow… In Conclusion