Design of infrastructure for visualising and benchmarking patient data from general practice (CARA)

BACKGROUND: Patient Management Software (PMS) is commonly used for patient consultations. PMS supports individual patient data storage but accessing and using aggregated information is challenging. CARA set out to provide an infrastructure to enable Irish general practitioners (GPs) to understand their patient population, disease management and prescribing through dashboards. This paper explains the design and development of the CARA infrastructure. METHODS: The first exemplar dashboard focused on antibiotic prescribing to develop and showcase the proposed infrastructure. The data integration process involved extracting, loading and transforming de-identified patient data into data models. These, in turn, feed the interactive dashboards for GPs to visualise, compare and audit their data. RESULTS: The architecture of the CARA infrastructure includes two main sections: the ELT process (extract, load and transform anonymous patient data into data models) and a REST API (which provides the security barrier between the data models and their visualisation on the CARA dashboard). CARAconnect was created to facilitate data extraction and de-identification of patient data from the practice database. CONCLUSIONS: CARA includes two dashboards, a practice overview and an exemplar dashboard focused on antibiotic prescribing which includes an audit tool as well as filters (within practice) and between-practice comparisons. Next steps will include the development of additional dashboards for topics such as chronic disease and mental health. KEY MESSAGES: • CARA developed a sustainable infrastructure to enable Irish GPs to better understand their patient population and management through dashboards. • CARA infrastructure consists of CARAconnect to extract and de-identify data, a common data model (to combine data from different PMS systems), and CARA dashboards for use in Irish general practice.