COVID-19 Quality Improvement Programme

The Covid-19 crisis is not going away. In contribution to the national effort to prepare the health service for patient care post-lockdown and during local flare ups or a second wave, a free novel COVID-19 Quality Improvement Programme has been developed to support GP practices with care of their patients affected by COVID-19, either because of the virus or lockdown. The programme will also enable practices to contribute to urgently needed big data for ethically approved research relevant to primary care on Covid-19 and other studies that will be used to improve care in the future.

Support COVID-19 research

About the Programme

The COVID-19 Quality Improvement Programme will help GP practices identify patients affected by COVID-19, and how it affects them through patient questionnaires combined with patient electronic health records (EHR). Practices will receive COVID-19 reports which highlight various at-risk patient groups with targeted recommendations for managing their care, generally and individually. The COVID-19 reports will enable practices to prepare strategies and target resources according to local needs to manage their patients affected by COVID-19.

Patient Electronic Health Record

Practices are supported with secure remote de-identified data collection from their clinical system (coded and redacted data). Practices on all major clinical systems are supported e.g. Emis, Vision, SystmOne, Microtest. This involves installation of necessary software (OPC and Wellbeing Software Suites) on practice IT system and configuration of clinical system settings to enable data sharing and collection. Please ensure that your IT service provider allows the necessary access for the data collection process. De-identified data is collected remotely and transferred to OPC for producing quality improvement reports for the practice. Patient identifiable information is not collected. OPC QI programmes are provided in compliance with the GDPR / Data Protection Act 2018 (Data Protection Register Ref: ZA197058) and the NHS Data Security and Protection Toolkit (Ref: 8HR5).

Patient COVID-19 Questionnaire

Practices are supported to send SMS text requests to their patients (age 18-75) to complete an online COVID-19 questionnaire. Practices will be provided a list of eligible patients derived from their EHR for review and SMS mailing. The questionnaire has been designed by the clinical and scientific experts for use in primary care. Part of the questionnaire is dedicated to respiratory patients and supports their remote review, as well as help meet health targets e.g. QoF.

Patient Quality Improvement

OPC combine the de-identified EHR data and the COVID-19 questionnaire responses to produce a patient level COVID-19 quality improvement (QI) report, tailored for each practice to guide their patient care. The COVID-19 reports will enable practices to prepare strategies and target resources according to local needs to manage their patients affected by COVID-19.

Practices receive COVID-19 reports which highlight at-risk patient groups with targeted recommendations for managing their care:

  • Patients who had COVID-19 including those hospitalised – require rehabilitation support and respiratory follow-up to monitor any long-term sequelae or complications.
  • Patients who have been inactive through lockdown, including those with limiting comorbidities – require advice or rehabilitation support. o Patients with anxiety and depression during lockdown – require appropriate mental health support.
  • Asthma/COPD patients, with unreported symptoms or have not had review – questionnaires serve as remote review of patients (e.g. symptoms, exacerbations) and help meet health targets.

Practices also receive feedback of the COVID-19 questionnaires responses and any patient concerns. This helps practices safely obtain direct information from patients about COVID-19 and use it to provide patient-centred care when needed.

The programme provides quality improvement or clinical audits and reports that can go directly into appraisal and revalidation portfolios for GPs, nurses, pharmacists, etc. Teaching or training practices may use the programme as a learning tool for GP training and medical student projects.

COVID-19 Research

As part of the programme, de-identified data provided by practices will be contributed to the Optimum Patient Care Research Database (OPCRD; NHS HRA REC ref: 20/EM/0148) for ethically approved research, and made available for COVID-19 research. The programme will also enable practices to contribute to urgently needed big data for ethically approved research relevant to primary care on Covid-19 (and other studies) that will be used to improve care in the future. The programme will provide a rich source of anonymised patient data to help address many unanswered questions relating to COVID-19. The platform will support the conduct COVID-19 related observational studies, questionnaire studies and clinical trials. Practices may participate in any study conducted on the platform, if they have suitable patients. We also welcome practices who only wish to contribute anonymised data towards COVID-19 research. Research findings will be disseminated and shared with the NHS and wider health community for public health benefit.

Proposed model of the covid 19 platform

Partners

  • OPRI
  • Wellbeing Software
  • Interface Clinical Services
  • Respiratory Effectiveness Group

Data source

The platform has been developed through collaboration with many academic and industry partners. The platform is provided to GP practices as part of the OPC Quality Improvement Service. The unique value of platform is bringing together patient data through the Optimum Patient Care Research Database (OPCRD) for COVID-19 research and improving patient care. All patient data collected is de-identified so it is not possible to identify a patient.

  • Patient COVID-19 survey
  • Patient COVID-19 tests
  • Patient GP health records
  • Patient hospital data
  • COVID-19 clinical trials data

OPCRD is approved by NHS Health Research Authority (REC ref: 20/EM/0148) to provide anonymised data for scientific, medical and public health research.

Benefits for GP practices

  • Patient surveys will help practices obtain first-hand information from patients about COVID-19.
  • Patient surveys will help practices to know about COVID-19 cases (actual incidence and prevalence) in their locality.
  • Enable practices to better prepare (strategy, resources) to manage patients, post-lockdown and in the event of second wave (new cases, re-infections).
  • Access to quality improvement service and support for COVID-19.
  • Opportunities to participate in COVID-19 quality improvement initiatives.
  • Opportunities to participate in COVID-19 research including paid studies (if conducted on the platform).

Benefits for health and research community

  • Access to COVID-19 patient reported data for research
  • Access to longitudinal EHR data for COVID-19 research
  • Platform to conduct COVID-19 related patient questionnaire studies
  • Platform to conduct clinical trials in COVID-19
  • Platform for translational activities e.g. implementation programmes
  • Sharing of knowledge, expertise and resources on COVID-19

How to join and take part in the COVID-19 programme

1. Register with OPC

Register with OPC to receive the OPC Quality Improvement Service. To do this, please compete the practice agreement for your GP practice at this link: http://opc-services.co.uk/ServiceAgreement/

2. Remote installation of software

Book an appointment with the OPC Team to conduct secure remote installation of the necessary data extraction and processing software. Please ensure you provide high-level IT access to enable successful set-up.

3. Secure EHR Data Collection

De-identified data is collected and transferred to OPC for producing quality improvement reports for the practice. Patient identifiable information is not collected.

4. Patient Questionnaires

The practice will be supported to send a request via SMS text to their patients to complete the COVID-19 questionnaire online.

5. COVID-19 report and care improvement

Patient data from EHR is combined with data from COVID-19 questionnaires and analyzed to produce a tailored COVID-19 report for the practice, with recommendations for improving their patients’ care.

6. COVID-19 research

Anonymised patient data contributed to OPCRD is made available for ethically approved COVID-19 research. GP practices may also participate in observational and interventional studies or trials conducted on EPIC.

To take part, simply register your interest at the link below or contact us.

https://optimumpatientcare.org/current-studies/epicsignup/

Contact us

Email:  info@optimumpatientcare.org   

Tel: 01223 967855

Data Processing and Protection

OPC quality improvement programmes are provided in compliance with the GDPR / Data Protection Act 2018 (Data Protection Register Ref: ZA197058) and the NHS Data Security and Protection Toolkit (Ref: 8HR5). OPC acts as Data Processors under the guidance of the GP Practice, who are Data Controllers on behalf of their patients. OPC staff undertake certified mandatory annual NHS Data Security and Protection training, and a two-yearly Good Clinical Practice (GCP) training.

Only de-identified data is collected from participating GP practices. Any information that will identify a patient (e.g. name, date of birth, full postcode, contact information, NHS or CHI number) has been removed from the data at the GP practice. Patient identifiable information is not collected, which ensures that patient confidentiality and identity is always protected.

Steering Committee

The platform is steered by committee of clinical experts from both primary and secondary care, doctors and clinicians, scientists, epidemiologists and data scientists, health data and technology experts, and patient representation. The committee ensures that the patient questionnaires, quality improvement reports and recommendations, and any research conducted through the platform is is clinically and scientifically relevant and will improve care for patients affected by COVID-19.

Committee Memebers

Prof David Price (University of Aberdeen), Prof Steven Julious, Dr Phil Oliver, Dr Rebecca Simpson, Dr Jen Lewis (University of Sheffield), Dr Rupert Jones (University of Plymouth, Makere University), Prof Salman Siddiqui (University of Leicester), Dr Dermot Ryan (University of Edinburgh, EAACI), Prof Hilary Pinnock (University of Edinburgh, AUKCAR), Dr David Jackson (King’s College London), Dr Katherine Hickman (Bradford, Leeds, PCRS), Prof Ian Pavord (University of Oxford), Tony Megaw, Pam Young (Wellbeing Software), Prof Stephen Holgate (University of Southampton), Prof David Halpin (Royal Devon & Exeter Hospital, NICE), Prof Kamlesh Khunti (University of Leicester, NIHR ARC), Sir Prof Lewis Ritchie, OBE (University of Aberdeen), Dr Tim Bosworth (Norfolk), Steve Davis (Interface Clinical Services), Prof Stephen Holgate (University of Southampton, MRC).