Swan D, Hannigan A, Higgins S, McDonnell R, Meagher D, Cullen W
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Ir J Med Sci. 2017 Feb;186(1):191-200. doi: 10.1007/s11845-016-1541-4. Epub 2017 Jan 3.
In Ireland, as in many other healthcare systems, mental health service provision is being reconfigured with a move toward more care in the community, and particularly primary care. Recording and surveillance systems for mental health information and activities in primary care are needed for service planning and quality improvement.
We describe the development and initial implementation of a software tool ('mental health finder') within a widely used primary care electronic medical record system (EMR) in Ireland to enable large-scale data collection on the epidemiology and management of mental health and substance use problems among patients attending general practice.
In collaboration with the Irish Primary Care Research Network (IPCRN), we developed the 'Mental Health Finder' as a software plug-in to a commonly used primary care EMR system to facilitate data collection on mental health diagnoses and pharmacological treatments among patients. The finder searches for and identifies patients based on diagnostic coding and/or prescribed medicines. It was initially implemented among a convenience sample of six GP practices.
Prevalence of mental health and substance use problems across the six practices, as identified by the finder, was 9.4% (range 6.9-12.7%). 61.9% of identified patients were female; 25.8% were private patients. One-third (33.4%) of identified patients were prescribed more than one class of psychotropic medication. Of the patients identified by the finder, 89.9% were identifiable via prescribing data, 23.7% via diagnostic coding.
The finder is a feasible and promising methodology for large-scale data collection on mental health problems in primary care.
与许多其他医疗保健系统一样，爱尔兰的心理健康服务正在重新配置，朝着更多的社区护理，尤其是初级护理方向发展。为了进行服务规划和质量改进，需要初级护理中心理健康信息和活动的记录与监测系统。
我们描述了一种软件工具（“心理健康查找器”）在爱尔兰广泛使用的初级护理电子病历系统（EMR）中的开发和初步实施情况，该工具能够对全科医疗患者的心理健康和物质使用问题的流行病学及管理进行大规模数据收集。
我们与爱尔兰初级护理研究网络（IPCRN）合作，开发了“心理健康查找器”，作为常用初级护理EMR系统的软件插件，以促进对患者心理健康诊断和药物治疗的数据收集。该查找器根据诊断编码和/或处方药物搜索并识别患者。它最初在六个全科医生诊所的便利样本中实施。
通过该查找器识别出的六个诊所中，心理健康和物质使用问题的患病率为9.4%（范围为6.9 - 12.7%）。识别出的患者中61.9%为女性；25.8%为自费患者。三分之一（33.4%）的识别出的患者被开具了不止一类精神药物。在通过查找器识别出的患者中，89.9%可通过处方数据识别，23.7%可通过诊断编码识别。
该查找器是一种可行且有前景的方法，可用于初级护理中心理健康问题的大规模数据收集。
