Improved data and encouraging doctors to work together as a team on patient care could be one way to improve conditions for stressed GPs, a new study has found.
With an aging GP workforce and fewer than 14% of final-year medical students listing general practice as their preferred career pathway, primary care in Australia is facing a “perfect storm.”
A team of GPs and researchers at Macquarie University is proposing a series of steps that every GP can take to make life better for themselves, their staff and their patients, while they wait for the urgent reform that is needed at national and state levels.
They have published an editorial in the British Journal of General Practice that proposes the reinvigoration of general practice as a learning health system, using approaches that have worked for many large health systems around the world.
“We’re faced with a perfect storm of an aging general practice workforce, a declining interest in general practice as a career, and widespread burnout exacerbated by the pandemic,” says Dr. Darran Foo, a GP at MQ Health GP Clinic and the lead author of the editorial.
“We need to create a primary health care system that consistently delivers reliable performance and constantly improves, systematically and seamlessly, with each care experience. In short, we need a system with an ability to learn.”
MQ Health GP Clinic has introduced a learning health system developed with the Australian Institute of Health Innovation. Now they are starting to talk with GPs on the steps that every practice can implement.
“Our vision is for practices that operate more as teams without every decision falling back to a GP,” Dr. Foo says.
“GPs will have better access to data, so that accurate patient records are quickly available; clinicians can see that they’re achieving outcomes for their patients, and everyone in the practice can see how effectively they are working for all their patients.”
A learning health system approach has been successfully adopted in the U.S. by Kaiser Health and by the Department of Veterans Affairs, which manages health care for six million veterans.
“I believe that we can quickly make a difference for patients,” Dr. Foo says.
“If, for example, you’re coming to see me with diabetes, I won’t have to spend the first 30 minutes reconstructing your history. I’ll have instant access to your wearable data including a continuous glucose monitor.
“I’ll be able to empower you to manage your own condition, with appropriate measures and targets.
Founding Director of the Australian Institute of Health Innovation, Professor Jeffrey Braithwaite, says successful implementation of learning health systems in the primary care sector could have many benefits.
“We could see improved population health, enhanced patient experience, reduced cost of care, and improved clinician satisfaction,” Professor Braithwaite says.
“We want to start a conversation with GPs to discuss what we can do at a local level, while government works out policy. It’s not a magic bullet, but an important component that will complement the large-scale reforms that are urgently needed.”
Steps to a learning health system
- Science and informatics to measure real-time access to knowledge and digital capture of the care experience.
- Patient-clinician partnerships that engage and empower patients.
- Incentives that reward high-value care and emphasize transparency.
- A continuous learning ethos that focuses on a leadership-instilled culture of learning and provides supportive system competencies.
- Developing organizational structures and governance mechanisms that take into account relevant policies and regulations, and facilitate collaboration, learning and research.
Darran Foo et al, High-performing primary care: reinvigorating general practice as a learning health system, British Journal of General Practice (2023). DOI: 10.3399/bjgp23X731505
British Journal of General Practice
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