title: The eCollaborative: using a quality improvement collaborative to implement the National eHealth Record System in Australian primary care practices.
abstract: OBJECTIVE
  The new national patient-controlled electronic health record is an important quality improvement, and there was a pressing need to pilot its use in Australian primary care practices. Implementation of electronic health records in other countries has met with mixed success.
  
  
  METHODS
  New work was required in general practices participating in the national electronic health record. National implementers needed to engage with small private general practices to test the changes before general introduction.
  
  
  METHODS
  The National E-health Transition Authority contracted the Improvement Foundation Australia to conduct a quality improvement collaborative based on 9 years of experience with the Australian Primary Care Collaborative Program.
  
  
  METHODS
  Aims, measures and change ideas were addressed in a collaborative programme of workshops and supported activity periods. Data quality measures and numbers of health summaries uploaded were collected monthly. Challenges such as the delay in implementation of the electronic health summary were met.
  
  
  RESULTS
  Fifty-six practices participated. Nine hundred and twenty-nine patients registered to participate, and 650 shared health summaries were uploaded. Five hundred and nineteen patient views occurred. Four hundred and twenty-one plan/do/study/act cycles were submitted by participating practices.
  
  
  CONCLUSIONS
  The collaborative methodology was adapted for implementing innovation and proved useful for engaging with multiple small practices, facilitating low-risk testing of processes, sharing ideas among participants, development of clinical champions and development of resources to support wider use. Email discussion between participants and system designers facilitated improvements. Data quality was a key challenge for this innovation, and quality measures chosen require development. Patient participants were partners in improvement.
authors.affiliation: University of NSW, Fairfield, NSW, Australia The Improvement Foundation, Adelaide, South Australia, Australia.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Knight
authors.affiliation: National eHealth Transition Authority, Sydney, New South Wales, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Szucs
authors.affiliation: The Improvement Foundation, Adelaide, South Australia, Australia.
authors.forename: Mia
authors.initials: M
authors.lastname: Dhillon
authors.affiliation: The Improvement Foundation, Adelaide, South Australia, Australia.
authors.forename: Tony
authors.initials: T
authors.lastname: Lembke
authors.affiliation: National eHealth Transition Authority, Sydney, New South Wales, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Mitchell
mesh_terms: D001315:Australia; D057191:Capacity Building; D003142:Communication; D003299:Cooperative Behavior; D057286:Electronic Health Records / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D016247:Information Storage and Retrieval; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards
keywords: ehealth; health system reform; primary care/general practice; quality improvement