What is the Doctors’ Independent Network?

• A learned society of clinicians
• Run by doctors for the benefit of all
• Nationally organised - based in Surrey
• Non-profit making - charitable status
• Open to all clinicians with a computer interest
• An equal partner in a joint data venture with Industry (CompuData Research Limited)
• Financially independent

Who are the members?

• Any working clinician can join DIN - data provision is not compulsory.
• Our Data Panel consists at present of 360 + Torex Health practices recruited almost entirely from the best data providers used in the original Meditel - CompuFile data scheme.
• The typical DIN panel member has generally had a clinical computing system in place for 5+ years and makes increasingly full use of it as general practice adapts to the demands of the new NHS.
• They are encouraged to express their health care communication needs, interests and concerns among their professional colleagues through the medium of the DIN Supervisory Board.
  
  

Where are DIN members?

How do they provide their data to DIN?

• via DIN RAPID reports (For technical details see Appendix A)

• Provides the GP with a greatly improved Torex Health compatible reports package designed for general practice use.
• Is optimised for simple quick extraction of data on a regular basis by modem. By default the extraction software keeps a record of the date of the last extraction and any subsequent extraction takes all the data added or changed since then.
• Is capable of carrying out automatic data downloads daily via modem directly onto the DIN database.
  

What safeguards does DIN apply to the data?

• Sex
• Year of birth
• Postcode collection (minus space and last 3 characters) is being superseded by CACI socio-economic code collection, further improving confidentiality.
• Internal patient number (patient identifiable by donor practice only)
• Practice identity number (DIN-specific practice identification)
• All data is encrypted on-site before transmission. For the data user:
  DIN uses advanced extraction software which works directly on the data file. (Other organisations use extraction programs, which rely on the index files to the practice’s data. These are known to have been frequently corrupted in the past).
  A comprehensive series of data download trials have demonstrated the extreme robustness of this system and its excellent reliability.
  After transmission and reading into the DIN collector system, the data follows the same path that it did under the original Meditel data collection regime. Pharmaco-epidemiological data is used for drug marketing and research, while the complete set of data is loaded into the DIN Deep Thought research system
  
  

How do we measure data quality?

• List size vs. volume of notes recorded
• List size vs. volume of drugs issued
• Percentage of drugs linked to coded reason for prescribing
• Proportion of acute to repeat prescriptions
• Visits and drugs prescribed entered on computer
• Proportion of ‘firm’ diagnoses vs. symptoms or signs
• Incidence of ‘marker’ read codes (e.g. a practice with all minor ailments recorded but no recorded cases of appendicitis, MS or psychotic illness would be considered atypical!)
  
  

How do we ensure continued data quality?

• carry out clinical audit on PCG performance criteria assisted by DIN.
• audit his personal performance against either his own or pre-defined nationally accepted targets using clinical ratios
• see how he compares with his partners and other GP’s (without identifying them)
  This can make PCG based clinical governance feasible for DIN data providers. The GP can set his own clinical standards and can measure changes in practice activity month by month.
  
  

How do we reimburse our members for their data?

What services does DIN provide for members?

APPENDIX A

• Data collection is by modem, using dial-out from the practice only.
• The DIN software disables the modem port at both the beginning and end of each data transmission to ensure correct dial-out settings.
• Data connections are scheduled automatically using native UNIX ‘cron’ ‘mail’ and ‘uucp’ software.
• Practice systems normally dial out between midnight and 5.30 am, each connection lasting about 2-3 minutes on average.
• They connect to a bank of modems securely located at the DIN Office, using one of two telephone numbers, which are all directly connected to a single UNIX server.
• This DIN collection server has no other local or wide-area network connections active at the time of user connection.
• The amount of collected data averages 30 Kbytes per connection. Connection time per day varies between 30 seconds and five minutes depending on connection speed and line quality. Longer catch-up transmissions may occasionally occur to fill any gaps previous transmission sessions.
• DIN extraction software updates may occasionally be passed back to the connecting system during normal daily connection sessions.
• There are no circumstances in which dial-in access can be obtained to a data provider’s clinical system using the DIN modem.
• Data collection and transmission takes place entirely within the UNIX environment and has no means whatever of establishing a connection with the NHS network at either the practice level or at the central DIN collecting level.
• DIN’s method of data collection has been approved by the NHS Information Authority for use in practices connected to the NHS Network. This approval gives recognition to our network’s excellent intrinsic patient and doctor-centred security and confidentiality.