Condition   Expression Quick Search
When you enter More than two words, please use 'and , or' operation by means of putting ',(Comma Mark)' between each word.
 
19(01) 9-15
Informatics as Tool for Quality Improvement: Rapid Implementation of Guidance for the Management of Chronic Kidney Disease in England as an Exemplar
Simon de Lusignan, MD(Res), FHEA
Department of Health Care Management and Policy, University of Surrey, Guildford, UK
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
Healthcare Informatics Research 2013 Mar; 19(01) 9-15
Keyword : Medical Informatics, Renal Insufficiency, Diabetes Mellitus, Computerized Medical Records Systems, Kidney Function Tests, Health Policy, Quality of Health Care

Copyright © 2014 The Korean Society of Medical Informatics. All Rights Reserved.
1618 Kyungheegung Achim Bldg 3, 72 Naesoo-dong Chongro-ku, Seoul 121-841, Korea
Tel: +82-2-733-7637    Fax: +82-2-734-7637    E-mail: journal@e-hir.org    Powered by INFOrang.co., Ltd