Oxygen: Intelligence in Practice

In February 2008, the RACGP commenced the development of an exciting new national education, quality and business improvement initiative for General Practice.

Oxygen: Intelligence in practice will improve the way that patient information can be used to better inform decisions in both clinical and business settings, and continues the range of initiatives developed by the College over many years to enhance the quality of care provided by Australian General Practitioners.

What is Oxygen?
Why is Oxygen important to GPs?
What are the benefits of Oxygen?
How does Oxygen work?
How do I register for Oxygen?
My patient data is confidential and valuable. How do I know it won’t be used for other purposes?
How does Oxygen fit in with the CAT Software?
What clinical software do general practices need to be able to use Oxygen?
How secure is Oxygen?
Who owns and funds Oxygen?
Is the government involved?
Where is the College getting advice from?
When will Oxygen be trialled / launched?
How do I find out more information?

What is Oxygen?

Oxygen is an integrated improvement program that uses two software applications that make it much easier for GPs and practice teams to analyse their clinical data and other practice information to support informed decisions about clinical, business and practice issues.

There are three components to the Oxygen: Intelligence in Practice program:

The Clinical Audit Tool (CAT), a software application used within the general practice that allows analysis of identifiable practice information;
A secure web based data warehouse that builds on the clinical and business improvement opportunities available via CAT, and allows analysis of de-identified practice information against the division, state and national averages;
Analysis of practice information against GP - agreed indicators to permit a practice to undertake clinical improvement, education and other activities relevant to that practice

Education and other activities that support and encourage effective use of the CAT and Oxygen for clinical and business improvement will continue to be developed.

Why is Oxygen important to GPs?

Oxygen puts the profession back in control of their data. The future of health care will rest, in part, on good ehealth systems. General practice data is the most comprehensive data source on patients that we have.

High quality data about clinical encounters is a most valuable resource for GPs and general practices and will allow GPs to:

enhance the quality of health outcomes and greater safety for our patients through practice-directed quality improvement,
support quality improvement through accreditation, information sharing, and benchmarking,
improve the efficiency of service delivery and viability for practices and practitioners,
enhance opportunities for self-directed education in line with practice needs,
permit general practices to be at the front line in biosurveillance and population health activities, and
underpin practice research and implementation.

Oxygen will help Australia’s GPs to participate in any electronic health record, will help GPs to build readiness for e-health programs, help GPs to meet and record current PIP and accreditation requirements.

What are the benefits of Oxygen?

Practices will be able to analyse their patient data and identify inconsistent practice.
Practices will be able to identify business opportunities
Practices will be able to compare their performance against others and determine whether any changes are warranted
Patients will receive more consistent care, based on services provided through the process of quality improvement.

How does Oxygen work?

Once a practice has installed CAT they can register for the Oxygen program. A registered Oxygen user will be able to send their de-identified practice population data securely from the CAT to the secure data warehouse. This data is sent as an XML file via a SSL secure connection to a secure server.

The practice will then be able to log on to a secure website and view their practice population data and comparisons to division, state and national averages. The practice information is reported against a range of clinical, demographic and data quality indicators.

In the first release there will be limited but valuable data reporting. In future releases, the College will focus on building flexibility and greater utility to report on clinical and business indicators that have high value and impact for general practices.

Practice to practice comparison is a high priority development for the program.

How do I register for Oxygen?

If you already have the Clinical Audit Tool, you will be able to register and use Oxygen from 2010.

If you do not have the Clinical Audit Tool, you should visit www.clinicalaudit.com.au to download a trial CAT. At that site you can also find out if your Division of General Practice has an agreement with Pen Computer Systems (developer of CAT). If your Division has an agreement you may have free access to CAT.

If your Division is not on the list, your practice can licence CAT for $195per annum, per FTE. That fee will be quickly recouped, and surpassed, by using some of the ‘recipes’ that we include on the clinical audit tool website.

My patient data is confidential and valuable. How do I know it won’t be used for other purposes?

At the time of registration for Oxygen, you will be given clear and concise information about what your practice data can be used for. If you wish to participate, you will give your consent to the use of your practice data for the purpose that you specify and for that purpose only. This will be part of a formal agreement with the RACGP and in line with privacy legislation and ethical considerations, as laid down by the General Practice Data Governance Council.

In the first phase of Oxygen, CAT will only be used in your practice. No patient data leaves the practice.

In the second phase, participating practices may consent to sending de-identified data to an external secure data warehouse for practice comparison. As part of the agreement with the RACGP:

all patient data is de-identified
no data sent to Oxygen will be used for any other purpose (i.e. participating practices will be the only people to see and use this data)
you and agreed practice staff will only be able to view your own practice data and no other practice will be able to see your data

As the Oxygen program evolves, there is the potential for data in Oxygen to be used for other purposes such as ethics approved research or biosurveillance, or for practice reporting to your Division of General Practice, but only if you explicitly agree to participate!

With Oxygen, GPs are in control! GPs control their own data and determine who they would like to share that data with and why.

How does Oxygen fit in with the CAT Software?

The CAT is both a stand alone program and a component of Oxygen.

You can use CAT for data analysis in your own practice and choose not participate in any other of the Oxygen activities. However, practices that are keen to compare their activity with others, will find that Oxygen provides useful tools and options.

What clinical software do general practices need to be able to use Oxygen?

At the moment, CAT can extract information from Medical Director (2 or 3), Best Practice, Genie or Zedmed. Other clinical software programs will be incorporated over time

How secure is Oxygen?

Oxygen is standards based, and the system (including servers and transmission of data) will undergone rigorous and independent security testing to ensure the safety of the data.

Who owns and funds Oxygen?

Practice data held in the Oxygen program is de-identified patient data. The practice retains ownership of this data.

The intellectual property in the software that aggregates the data, both at the practice level (CAT) and the broader level, is owned by Pen Computer Systems (PCS). PCS does not own and cannot ‘read’ any practice data in the repository.

In addition to this, neither the RACGP nor any other body has rights of access to any data housed within the secure data warehouse. This means that PCS, the RACGP and other professional bodies are not allowed to view, publish, manipulate, distribute or otherwise use any data except for the purposes that CAT and Oxygen are intended for, without express consent from the participating practice.

The RACGP has funded the development of the data aggregation software, the secure data warehouse, the website and improvement activities associated with Oxygen.

Is the government involved?

There is no government involvement or funding in Oxygen.

Where is the College getting advice from?

In the development of the Oxygen program, the College sought advice from data, information security and computer experts. Their reports and advice from international experts in general practice quality improvement have shaped the development of Oxygen.

The College continues to obtain advice from a range of sources. These include external legal and ethical advice, external technical security advice and ongoing advice from the recently formed General Practice Data Governance Council, to ensure the program is robust and secure. The General Practice Data Governance Council comprises the peak general practice organisations to oversee the use of data collected from general practices.

When will Oxygen be trialled / launched?

Trialling of Oxygen has commenced and will continue until early 2010. It is planned that Oxygen will be ready for release in 2010. The security, privacy and legal framework will be addressed before the program is released, and the profession will be consulted as part of this process.

If you would like more information regarding Oxygen please contact admin@oxygeninfo.com.au.

The Royal Australian College of General Practitioners

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