Investigating diagnostic quality and safety in general practice during the COVID-19 pandemic

Statement of problem:
There was an initial slump in general practice visits across Victoria and NSW during the early months of the COVID-19 pandemic in 2020. This led to major concerns about potential harmful long-term impacts on patient care, especially on the diagnosis of new conditions, disease and cancer screening programs and the monitoring of patients with chronic disease.

Description of the intervention or program:
This project aims to generate timely and critical evidence about the impact of
COVID-19 on diagnostic safety and quality within general practices.The project
utilises near real-time electronic general practice data (from over 800 general
practices across Victoria and New South Wales [NSW]) during the COVID-19
pandemic. The project is a collaboration between Macquarie University, Outcome
Health, Gippsland, Eastern Melbourne, South Eastern Melbourne Primary Health
Networks (PHNs) and the Royal College of Pathologists of Australasia Quality
Assurance Programs. Outcome Health, as a data custodian, uses its Population
Level Analysis & Reporting (POLAR) Data Space to provide a secure and
comprehensive digital health platform that collects data from consenting general
practices across participating PHNs. Data variables include de-identified
demographic information about patients and general practices, as well as service
records (e.g., Medicare Benefits Schedule (MBS) item numbers) and clinical records (including diagnosis, medication prescriptions, radiology, pathology).

Findings to date:
This presentation will outline three case studies (telehealth, cancer screening and pathology testing) that are featured as part of the project’s General Practice COVID-19 Snapshot publications detailing investigations into the impact of COVID-19. The case studies highlight: i) increases in the number of telehealth consultations per week during the first and second waves of the COVID-19 pandemic; ii) major drops in the number of cervical cancer tests ordered in general practice in 2020 associated with surges in the number of COVID-19 cases; and iii) significant decreases in pathology test volumes (33% Victoria and 29% in NSW) during the first COVID-19 wave in 2020.

Lessons learned:
Each of the case studies highlights key features in the Australian general practice
response to COVID-19. The case studies contributed to the development of
translational activities undertaken with PHNs to enhance diagnostic safety and
quality.

Disclosure of Interest Statement:
This work was funded by a grant from the Digital Health Cooperative Research
Centre (DHCRC). The authors have no interests to declare.