title: Optimising the use of observational electronic health record data: Current issues, evolving opportunities, strategies and scope for collaboration.
abstract: BACKGROUND
  With increasing computerisation in general practice, national primary care networks are mooted as sources of data for health services and population health research and planning. Existing data collection programs - MedicinesInsight, Improvement Foundation, Bettering the Evaluation and Care of Health (BEACH) - vary in purpose, governance, methodologies and tools. General practitioners (GPs) have significant roles as collectors, managers and users of electronic health record (EHR) data. They need to understand the challenges to their clinical and managerial roles and responsibilities.
  
  
  OBJECTIVE
  The aim of this article is to examine the primary and secondary use of EHR data, identify challenges, discuss solutions and explore directions.
  
  
  CONCLUSIONS
  Representatives from existing programs, Medicare Locals, Local Health Districts and research networks held workshops on the scope, challenges and approaches to the quality and use of EHR data. Challenges included data quality, interoperability, fragmented governance, proprietary software, transparency, sustainability, competing ethical and privacy perspectives, and cognitive load on patients and clinicians. Proposed solutions included effective change management; transparent governance and management of intellectual property, data quality, security, ethical access, and privacy; common data models, metadata and tools; and patient/community engagement. Collaboration and common approaches to tools, platforms and governance are needed. Processes and structures must be transparent and acceptable to GPs.
authors.affiliation: PhD, FRACGP, FACHI, FACMI, Professor of General Practice, University of New South Wales; Director, General Practice Unit, South Western Sydney Local Health District; RACGP National Research and Evaluation Ethics Committee, NSW.
authors.forename: Siaw-Teng
authors.initials: ST
authors.lastname: Liaw
authors.forename: Gawaine
authors.initials: G
authors.lastname: Powell-Davies
authors.forename: Christopher
authors.initials: C
authors.lastname: Pearce
authors.forename: Helena
authors.initials: H
authors.lastname: Britt
authors.forename: Lisa
authors.initials: L
authors.lastname: McGlynn
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D001315:Australia; D016494:Computer Security; D003226:Congresses as Topic; D003299:Cooperative Behavior; D057286:Electronic Health Records / Q000941:ethics / Q000458:organization & administration / Q000592:standards*; D058006:General Practice; D006801:Humans; D018907:Privacy; D012106:Research; D012984:Software