A Study of the Impact of the Use of General Practice Computer Systems on the Ordering of Pathology, Year Ending December 2001 -->
B. User Requirements, Survey Objectives, and Budget
B1 Purpose of survey
Why do you need to conduct a survey? (B1)
Note. Refers to the underlying information requirements that the survey is intended to address. For example, what problems the agency is trying to solve? What decisions need to be made? What specific policies or actions are being determined or assessed? Should detail who requires the information. Survey objectives should be included in "B2" below.
There has been an increase in the content of pathology episodes at a time when there has been a marked increase in the use of computers to generate pathology requests. It has been hypothesised that making it easier for requesting practitioners to order tests has led to more tests being ordered. The increase is a problem as it is leading to an increase in outlays under Medicare. Decisions need to be made about possible conditions or restrictions on the use of practice management systems for the ordering of pathology.
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The objective of the overall study is to determine the extent to which the observed increase in the content of an episode can be explained by the increased uptake of computer systems used for the production of pathology requests. This survey is one phase of the study and has two roles. One is to describe the population from which the sample is drawn and the other is to obtain access to data for a separate analysis (a future phase of the study).
The survey provides the opportunity to:
- assess GP attitudes and behaviour;
- determine the time frame in which individuals began to make use of said systems; and
- obtain permission to examine the relevant pathology ordering data to look for relationships between survey variables (e.g. use of practice management software) and any change in requesting behaviour.
The information is required by the Health Insurance Commission and the Royal College of Pathologists and Department of Health and Aging.
How will the survey outputs meet the needs specified in B1? (B2)
Note. Should include a brief overview of the main topics the survey will cover. If applicable, provides details of any constraints including: fixed costs, fixed sample size, fixed accuracy (eg target RSEs, Confidence Intervals), etc.
The questionnaire is part of phase 2 of a 4 part study to meet the objective:
- Phase 1 - A qualitative assessment based on focus groups to determine the subjects perception of a change in behaviour and attitudes about pathology ordering;
- Phase 2 - A quantitative survey of preference, attitude and stated behaviour of GPs around pathology ordering;
- Phase 3 - A retrospective time-series analysis of Medicare statistics for two cohorts - those known to be using computer produced pathology requests and those using handwritten requests; and
Phase 4 - A prospective study design to be incorporated into a project such as the Pathology and GP Software Integration Project currently being developed by the Coordinated Care section of the DHAC
The phase Phase 2 study referred to above and to which the questionnaire relates is designed to solicit information on the following topics:
- Years in practice of GPs.
- Practice type.
- Use of computer software in ordering.
- Proportions of pathology tests requested using computer and manual systems.
- Self assessed proficiency in use of computerised requesting software.
- Use of software to generate short cuts or batteries of test.
- Point in time when computerised system was taken up.
- Point in time when doctor assessed self as proficient in software use.
- GP self assessment of change in pathology requesting levels.
- GP self assessment of the impact of any change on patient care outcomes.
- GP ratings of the impacts of the following factors on pathology requesting practice.
- Medico-Legal considerations.
- Patient demand.
- Practice approach.
- Business and marketing considerations.
- Health bureaucracy and administrative requirements.
- Ease of ordering/requesting.
- Promotion or advice from pathology practices.
- Other considerations to be specified by the GP.
In addition, the questionnaire seeks consent from the GP to release for individual data related to pathology testing under Medicare claiming the Health Insurance Commission to release Medicare pathology utilisation data for the period 01 January 1999 to 31 December 2001
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These topics will meet the survey objectives by:
- Providing information about GP perception and stated behaviour;
- Permitting an exploration of perception and behaviour across the range of features and GP demographic variables hypothesised to impact on pathology requesting behaviour;
- Securing data required (esp. time spent using software, point of achieving proficiency and specific requesting behaviour) for statistical analysis of the HIC data requested.
The study is to be conducted under a fixed budget.
No regression is planned in analysis of data from this questionnaire. Descriptive eEstimates are planned at the 95% confidence interval permitting accepting that error levels to will vary according to sample and response.
What is the timetable for the survey? (B3)
Note. Should include: testing, the date questionnaires are printed or finalised, the date data collection commences, the date data collection finishes, and when results will be available. SCH approval for the survey is to be obtained before data collection commences.
All dates for Phase 2 are prospective and are controlled by the timing of SCH approval. However prospective dates are set out below:
Weeks after approval by SCH of Phase 2:
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