Peter Huntley, now retired from Kent and Medway CCG, talked about the role of the commissioner in setting the direction for pathology. Some persuasive content on how we need to be better at presenting data to clinicians and how we need to start combining data sets eg with prescribing. Users need to know where they stand in relation to peers.
First of 2 speakers to use lithium monitoring as an example of how pathology can change from test provider to system integrator.
Current lack of standardisation of testing approaches and costing between providers cannot be tolerated. Less than £10/test in one locality to more than £14/test in another. Lack of common currency means hard to know what this means, but commissioners can start to insist we adopt this.
Some personal thoughts
- is practice level data adequate for combining data sets? Do we need integration at patient level to allow data to be turned into coherent narratives, and explore the interaction of behaviours?
-how do we get users to engage with the data? Pathology advisors could have a role here in helping users 'find the feeling'. I doubt shame is enough - most will be motivated by the patient stories behind the data.
-users must be allowed to explore and challenge the data, perhaps with the help of an advisor. Peter gave an example of how more junior GPs request more. There is a danger that this becomes implicit criticism which may evoke a unnecessary defensive response. For example, it may be the higher requestor reflects best practice, or they may be the one that nurses write down on nurse-driven requesting. Or not. But if we don't go to this level of detail we may not bring people with us.
-basically we need people who are skilled at using data as a tool for quality improvement, and not as a blunt stick for driving compliance against arbitrary standards
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