Project

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Establishing a nationwide collection of medical routine data in primary care - expanding the FIRE project

Applicant Chmiel Corinne
Number 167233
Funding scheme NRP 74 Smarter Health Care
Research institution Institut für Hausarztmedizin UniversitätsSpital Zürich Universität Zürich
Institution of higher education University of Zurich - ZH
Main discipline Public Health and Health Services
Start/End 01.01.2017 - 31.12.2020
Approved amount 473'519.00
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All Disciplines (2)

Discipline
Public Health and Health Services
Methods of Epidemiology and Preventive Medicine

Keywords (9)

Practice Based Research Network; Quality of care; Data quality; Medical routine data; Health data exchange; Implementation barriers; Electronic Medical Record; Primary Care; Pay for performance

Lay Summary (German)

Lead
Während für die stationäre Gesundheitsversorgung in der Schweiz eine breite statistische Grundlage besteht, fehlt diese für den ambulanten Bereich. Die Studie will die standardisierte Erfassung von Routinedaten in Schweizer Hausarztpraxen stärken.
Lay summary

Routinedaten sind eine wichtige Grundlage, um Fragen zum Gesundheitszustand und zur Behandlung von Patientinnen und Patienten zu untersuchen. Die Datenbasis im ambulanten Bereich ist in der Schweiz jedoch schwach, fragmentiert oder für die Forschung unzugänglich. Die umfassendste Datenbank im hausärztlichen Bereich der Schweiz besteht seit sieben Jahren und bezieht 132 Arztpraxen in 13 Kantonen ein.

Das Ziel der Studie ist es, Hausarztpraxen für die standardisierte Erfassung von Routinedaten in einer bestehenden Datenbank zu gewinnen und die optimale Höhe für deren finanzielle Entschädigung zu bestimmen. Zudem soll die Qualität der Daten geprüft und bei Bedarf verbessert werden. Auf diese Weise wird eine repräsentative Datenbasis im hausärztlichen Bereich der Schweiz geschaffen.

Die Studie verbessert die Datenlage im ambulanten Versorgungsbereich der Schweiz. Auf dieser Basis können ein Monitoring der ambulanten Behandlungsqualität errichtet und vergleichende Analysen durchgeführt werden. Zudem werden Erkenntnisse über finanzielle Anreize für Hausarztpraxen gewonnen, welche wieder in Vergütungsmodelle einfliessen können.

Direct link to Lay Summary Last update: 17.08.2017

Lay Summary (English)

Lead
The wide-ranging statistical basis that exists for the in-patient healthcare setting in Switzerland is not available for out-patient care. The study seeks to reinforce the standardised recording of routine data in general practitioners’ practices in Switzerland
Lay summary

Routine data provide an important basis for investigating questions relating to patients’ health and treatment. The data available for the out-patient setting in Switzerland are, however, limited, fragmented or inaccessible for research purposes. The most comprehensive database for the general practitioner (GP) setting in Switzerland was set up seven years ago and covers 132 practices in 13 cantons.

The aim of the study is to encourage general practitioners to record routine data in an existing database in a standardised format and to determine the optimum level of financial reward for this work. In addition, data quality will be reviewed and improved if necessary. This will create a representative database for general practice in Switzerland.

The study will improve the data situation in the out-patient care setting in Switzerland. The basis it provides will make it possible to institute monitoring of the quality of out-patient care and carry out comparative analyses. In addition, it will deliver knowledge about financial incentives for GP practices that can be input into compensation models.

Direct link to Lay Summary Last update: 17.08.2017

Responsible applicant and co-applicants

Employees

Publications

Publication
Guideline Concordance of Statin Treatment Decisions: A Retrospective Cohort Study
Rachamin Yael, Markun Stefan, Grischott Thomas, Rosemann Thomas, Meier Rahel (2020), Guideline Concordance of Statin Treatment Decisions: A Retrospective Cohort Study, in Journal of Clinical Medicine, 9(11), 3719-3719.
The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice
Meier Rahel, Rachamin Yael, Rosemann Thomas, Markun Stefan (2020), The Impact of the 2019 European Guideline for Cardiovascular Risk Management: A Cross-Sectional Study in General Practice, in Journal of Clinical Medicine, 9(7), 2140-2140.
Trends and between-Physician Variation in Laboratory Testing: A Retrospective Longitudinal Study in General Practice
Schumacher Lisa D., Jäger Levy, Meier Rahel, Rachamin Yael, Senn Oliver, Rosemann Thomas, Markun Stefan (2020), Trends and between-Physician Variation in Laboratory Testing: A Retrospective Longitudinal Study in General Practice, in Journal of Clinical Medicine, 9(6), 1787-1787.
Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Development of a Tool by Adapted Delphi Procedure
Falck Leandra, Zoller Marco, Rosemann Thomas, Martínez-González Nahara Anani, Chmiel Corinne (2020), Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Development of a Tool by Adapted Delphi Procedure, in JMIR Medical Informatics, 8(3), e14483-e14483.
General practitioners’ consultation counts and associated factors in Swiss primary care – A retrospective observational study
Rachamin Yael, Meier Rahel, Grischott Thomas, Rosemann Thomas, Markun Stefan (2019), General practitioners’ consultation counts and associated factors in Swiss primary care – A retrospective observational study, in PLOS ONE, 14(12), e0227280-e0227280.
Indications and associated factors for prescribing intravenous iron supplementation in Swiss general practice: a retrospective observational study
Meier Rahel, Keizer Ellen, Rosemann Thomas, Markun Stefan (2019), Indications and associated factors for prescribing intravenous iron supplementation in Swiss general practice: a retrospective observational study, in Swiss Medical Weekly, 149.
Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Systematic Review
Falck Leandra, Zoller Marco, Rosemann Thomas, Martínez-González Nahara Anani, Chmiel Corinne (2019), Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Systematic Review, in JMIR Medical Informatics, 7(2), e10879-e10879.

Collaboration

Group / person Country
Types of collaboration
Institute of Primary Care, University of Lausanne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Primary Care unit, Department of Community Health and Medicine, University of Geneva Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Institute of Primary Care and Community Care Lucerne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Institute of Primary Care, University of Berne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Centre for Primary Health Care, University of Basel, Basel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Swiss HIV Cohort Study, University of Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Swiss Multiple Sclerosis Registry, University of Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Medsolution Switzerland (Europe)
- Industry/business/other use-inspired collaboration

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
From Evidence to Public Health Policy and Practice Talk given at a conference No Data No Improvement 02.09.2020 virtuel, Switzerland Meier Rahel;
4. Österreichischer Primärversorgungskongress, 2019 Talk given at a conference Vom freiwilligen Datenpool der FIRE Praxen zu Qualitätsindikatoren-basiertem Pay-for-Performance: Lessons learned aus der Schweiz 05.04.2019 Graz, Austria Meier Rahel;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Multimorbitität und Polypharmazie: eine Herausforderung im Praxisalltag Talk 07.12.2017 Bern, Switzerland Meier Rahel; Streit Sven;
Multimorbidität, Polypharmazie und wie hier die elektronische KG helfen kann Talk 15.06.2017 Bern, Switzerland Meier Rahel; Streit Sven;


Self-organised

Title Date Place
FIRE-Usertreffen 26.10.2017 Zürich, Switzerland

Communication with the public

Communication Title Media Place Year
Other activities FIRE Projekt Webseite German-speaking Switzerland 2017

Abstract

In Switzerland, medical routine data that allow an evaluation of patients’ clinical status and treatment outcomes, are scarce, fragmented and inaccessible for health services research. The «Family medicine ICPC Research using Electronic medical records» (FIRE) project is an exceptional case. It represents the first and largest collection of anonymized, structured medical routine data derived from electronic medical records (EMR) of Swiss General practitioner (GPs). The Institute of Primary Care of the University and University Hospital of Zurich leads this project since 2009. Up to December 2015, 132 GPs from 13 German speaking cantons of Switzerland participated in the project. The suggested NRP project aims to expand the FIRE project, achieve representative coverage of Swiss GP practices and establish a continuous monitoring of quality of care measures. For this purpose, a multifaceted approach is proposed, tailored to overcome important technical, organizational and economic barriers that affect data quality and hinder widespread efficient implementation of routine data collection and quality measurement in Swiss ambulatory care to date. All 6 existing Swiss academic institutes of primary care (Zurich, Berne, Basel, Geneva, Lausanne, Lucerne) will collaborate in the suggested project and establish a learning cycle where high-quality health data become available and accessible as demanded by the data manifesto of Swiss scientists and public health specialists.
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