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Dr Poly had a number of non clinical activities planned over the next few days. He had a practice partners meeting and he had a meeting as secretary of his General Practice Division where it was planned to determine what the Division’s clinical protocol should be for management of a slightly elevated PSA in the absence of significant symptoms.

As the practice meeting was the next day he decided to focus on that first (Dr Poly was a partner in an eight partner practice where there were also four assistants and fourteen support staff). At the meeting there were a range of issues to be covered and almost all of them would require obtaining reports from the practice computer system.

Firstly Dr Poly decided he would get the aggregate financial data for the practice from the system, including the current month earnings after expenses, year to date figures and current projections compared to budget and last year. [A] Having reviewed this information, and produced a number of summary graphs on overhead transparencies for the meeting [B] he decided to run a set of reports to assess the profitability by doctor of each of the partners and assistants when their use of practice resources was formally allocated (i.e. cost of supplies, proportional use of equipment etc). This revealed that one assistant was performing very effectively and that there were two partners who appeared not to be contributing as may have been desired. [C] Dr Poly decided he would chat with these people before the meeting to minimise the risk of surprise during the meeting.

Having finished that analysis the next thing to be done was to run the inventory status reports to ensure that no disposables were close to expiry and that excessive stock was not being held of items which were not being used. [D] This report identified a variety of disposable speculum which was on regular order for an assistant who had since left the practice. Dr Poly sent an internal e-mail to all those in the practice asking the supply person to cancel the order and asking the other doctors could they see their way clear to using up the excess stock where possible. [E]

Dr Poly then turned to the matter of customer satisfaction. The practice had recently undertaken a customer satisfaction survey and the information had been received electronically and imported into a database for analysis by ‘usual doctor seen’ and distance from practice. [F] Having reviewed this data Dr Poly decided to merge data, by patient, from the appointment system and the Electronic Health Record to examine the impact of waiting time and duration of consultation on patient satisfaction. [G] Unfortunately this data is so sensitive Dr Poly declined to provide the creator of this scenario with the outcome of this analysis but he was able to say that significant changes would be made. The commentary from patients, combined with the data has also resulted in a significant new investment in comfortable facilities for patients who are waiting as the practice was seen my many who were asked as being quite inadequate in that area. Dr Poly is sure that the new facilities and the new tea and coffee machine for the patients will improve the practices competitive position in the area.

Lastly for the practice meeting Dr Poly ran his clinical practice audit reports that compare the current practice performance against a number of published and internal guidelines (e.g. screening rates, vaccination rates, antibiotic use in URTI’s etc). [H] Over the last two years the practice has developed about 20 such reports which are run each month to ensure the quality of care provided is being maintained. [I]

For his last job of the evening Dr Poly turned his mind to the divisional meeting. He was sure all the up to date information he had would help some of his less computerised colleagues appreciate the clinical and administrative value and competitive advantage his practice was deriving from their investment in technology. He then turned back to the keyboard and after a few minutes had developed a report which for the patients in his practice showed the average interval between observation of an elevated PSA and the time some active therapy was undertaken either by one of the practice practitioners or a specialist. [J] When segmented by age, Dr Poly was impressed just how slow growing the disease was in the elderly, and was looking forward to sharing his practice’s experiences with the others at the Divisional meeting.

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