1. LAMBETH COMMUNITY DATANET Making Patient Profile Data Useful – And Used?

2. BRIEF BACKGROUND 2002 COLLECTION OF PATIENT PROFILE PILOTED IN 9 PRACTICES IN LAMBETH PCT ROLL OUT OF PROFILING TO ALL PRACTICES STARTED 2004 PROFILE CHANGED TO 16+1 ETHNICITY CATEGORIES, QUESTIONS ON POOR VISION AND HEARING, COUNTRY OF BIRTH AND NATIONALITY ADDED TO LANGUAGE PREFERENCE, NEED FOR INTERPRETER, AND RELIGIOUS AFFILIATION DATANET PROJECT STARTS NOVEMBER 2004 (SUPPORTED BY THE GUYS+ST THOMAS CHARITY)

3. DATANET COLLECTION LEVELS END MAY 2007 30 PRACTICES TOTAL LIST ETHNICITY % ALL >16 LANGUAGE PREFERENCE % ALL RELIGIOUS AFFILIATION % ALL COMPLETE % ALL >16 HIGHEST 15 91,35471 74 65 6462 65 HIGHEST 23 157,00965 68 60 5656 59 ALL >16 208,169 173,423 61 64 56 5352 55

4. PROFILE LEVELS OF THOSE ON DISEASE REGISTERS 22 Practices combined list 147,428 % Ethnicity recorded % Complete (E/L/R) CHD 85 68 Heart Failure 83 66 Stroke 81 65 Hypertension 83 68 Diabetes 87 70 COPD 85 68 Epilepsy 80 51 Hypothyroidism 84 70 Cancer 83 67 Mental Health 78 54 Asthma 74 50 Depression 80 49 CKD 85 71 Atrial Fibrillation 80 71

5. PROFILING IN OLDER AGE GROUPS (22 PRACTICES-LIST 147,428) AGE BANDS 55 - 64 65 - 7475 - 84 85 - 89 90+ PATIENT TOTALS 9693 5789 3388 759 362 ETHNICITY RECORDED 6236 4431 2759 589 257 LANGUAGE 5628 4008 2507 518 224 RELIGION 5310 3938 2478 510 216 LARGE PRINT 166 (1.7%) 132(2.3%) 101(3%) 31(4%) 17(4.7%) LIP READING 9 14 10 3 0 SIGN LANGUAGE 14 15 9 5 1 POOR LITERACY 101 87 56 8 8

6. LINKING TO CLINICAL WORK DEVELOP THE RELEVANCE OF PROFILE COLLECTION AND USE FOR FRONT LINE CLINICIANS DATANET CONTRACT FOCUS MODULE (DEVELOPED BY QUALITY MEDICAL SYSTEMS) USES PRE-WRITTEN MIQEST QUERIES LINKING QOF ACHIEVEMENT TO PROFILE DATA AT INDIVIDUAL PATIENT LEVEL LINKS ETNICITY AND OTHER PATIENT CHARACTERISTICS TO LONG TERM CONDITION MANAGEMENT TOOL FOR PRACTICES - POTENTIAL TO AGGREGATE DATA

7. NO NEUROPATHY SCREEN - BY LANGUAGE

8. HbA1c >10 - BY ETHNICITY

9. HbA1c >7.5 - BY RELIGIOUS AFFILIATION

10. HYPERTENSIVES BP >145/80 - BY ETHNICITY

11. CURRENT USE OF THE PROFILE DATA FORWARDING PROFILE WITH REFERALS PRACTICE LEVEL USE – ANALYSING A+E ATTENDEES BY LANGUAGE PREFERENCE – TARGETING VITAMIN D DEFICIENCY CASE FINDING USING LANGUAGE DATA TO SUPPORT PUBLIC HEALTH MESSAGES EQUITY AUDIT – CVD RISK FACTOR DATA EXTRACTION RESEARCH

12. CHALLENGES NEED TO ESTABLISH THE UTILITY OF THE DATA AT LEVEL OF CLINICAL CARE MAINSTREAM SUPPORT FOR DATA USE DEFINE AND REWARD CULTURALLY COMPETENT HEALTH CARE DELIVERY ‘DRIVE’ THE AGENDA DEMONSTRATE BENEFITS TO USERS EXTEND CURRENT MODELS