Preventing Heart Attack and Stroke Events Through Surveillance (PHASES): Evaluation of a Health Analytics System for Primary Care - 28/11/25

Doi : 10.1016/j.hlc.2025.05.098

Penni Russell, MBBS ^a, Ellie Paige, PhD ^b,^c,^d, Mark Morgan, BMBCh, PhD ^e, Alyson Ross, EdD ^f, Rosemary Korda, PhD ^d, Deborah Davies, PGDipNursing ^g, Zoltan Bourne, BMed ^h, Tony Stanton, MBChB, PhD ^a, Michael Fryer, MBBS ^a, Kim Greaves, MBBS ^a,^d,^i,^⁎
^a Department of Cardiology, Sunshine Coast University Hospital, Birtinya, Qld, Australia
^b Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
^c School of Public Health, The University of Queensland, Brisbane, Qld, Australia
^d National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia
^e Faculty of Health Sciences and Medicine, Bond University, Robina, Qld, Australia
^f Gold Coast Primary Health Network, Robina, Qld, Australia
^g Western Australia Public Health Alliance, Subiaco, WA, Australia
^h Maleny Doctors, Maleny, Qld, Australia
ⁱ Griffith University, Sunshine Coast Health Institute, Birtinya, Qld, Australia

^∗Corresponding author at: Department of Cardiology, Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, QLD, Australia.Department of CardiologySunshine Coast University Hospital6 Doherty StreetBirtinyaQLDAustralia

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 28 November 2025

Abstract

Aim

National cardiovascular disease (CVD) risk guidelines recommend population-level screening and pharmacotherapy for high-risk individuals. There is no validated system for surveillance of up-to-date risk factor measurement and treatment. This study evaluated an existing health analytics system as a potential CVD surveillance system.

Method

In a single Primary Health Network, Primary Sense health analytics system was evaluated as a CVD surveillance system. Errors were identified and corrected. Numbers of patients within different risk groups were identified, and proportions on appropriate therapy were reported.

Results

Data transfer from general practice electronic medical record systems to Primary Sense was correct, but errors were found regarding implementation of Australian CVD guidelines. Following corrections, out of a population of 254,357 individuals, 87,487 (34%) were eligible for CVD risk assessment. Of these, 4,199 (5%) had pre-existing CVD, 5,124 (6%) were clinically determined high-risk and 42,132 (54%) had no risk score available. Of those with a risk score available, 2,285 (6%) were high-risk. 11,608 patients had prior CVD, clinically determined high-risk or a high CVD risk score and 6,710 (58%) of these were inadequately treated.