North Staffordshire Local Medical Committee

 

Good Practice Guidelines on completion of GP reports from the Joint GP IT Committee

 For some time now, many practices have been using software produced by their suppliers to extract a draft insurance report from the medical record, which they then print, edit and post back to the insurers.  Using the same method for extracting the draft report, eGPR uses automation in the request, despatch and payment parts of the process.

Like any other healthcare intervention, eGPR can only be safe and effective if it is used responsibly and appropriately.

For this reason, it is essential that practices and practitioners:

·          Are familiar with the ethical as well as the practical requirements for GPRs

·          Are aware of the sources of information from which to refresh this knowledge when needed

·          Familiarise themselves with the eGPR process before using it 'for real'

·          Have read and do observe the Good Practice Guidelines (GPG) for GPRs

The Good Practice Guidelines have been approved by the RCGP and GPC's Joint GP IT Committee (JGPITC) and will be incorporated in the next release of its 'Good Practice Guidelines for General Practice Electronic Patient records'.

 

General Practitioner Reports (GPR)

The questions asked by insurers of GPs and the content of the reports produced in response are governed by agreements struck between the Association of British Insurers (ABI) and the BMA, most recently revised in Nov 2003.  The major GP system suppliers have written specific extraction routines for these reports (GPRs) and it has become common practice for GPs to use these, edited as needed, for their responses to insurers. Recently, the facility to convey the finished reports electronically to the insurers (eGPR) has become available.

            For both GPR and eGPR:

bullet GPs should be aware that they have the option to decline to complete a GPR in any form.
bullet The responsibility for ensuring the appropriateness, correctness and completeness of a GP report remains as firmly with the GP as if he/she had hand-written the whole of it personally.
bullet In fulfilling this responsibility, GPs must be aware of the fundamental difference between electronic and paper GPRs. A paper GPR is an empty document that the GP populates by adding data to it. The electronic GPR is automatically loaded with data by the GP's computer system and the GP then has to take out (i.e. edit) any information that need not or should not be included:
bullet Negative HIV, Hepatitis B or Hepatitis C test results;
bullet Instances of sexually transmitted disease without long term health implications;
bullet Genetic test results which are unfavourable for the patient;
bullet Information about third parties which was not supplied by the patient.

Specifically for eGPR:

bullet The eGPR service should be treated solely as a mechanism for swiftly despatching a completed report, and not as a further opportunity for editing it.

GP system-specific information on how to use eGPR is available on the eGPR website. Each individual GPR request form contains an explanation of the information required for that report. Comprehensive guidance on such issues as:  access to GPRs, sexually transmitted infections, HIV, hepatitis, genetic testing, family history and third-party information is available from both the ABI and BMA websites, in a document agreed between the two organisations in December 2002. The ethical considerations which are provoked by an insurer's request for a GPR are outlined in a paper on the RCGP website.