Background The computer-based electronic medical record (EMR) is an essential new technology in health care, contributing to high-quality patient care and efficient patient management. The majority of southern European countries, however, have not yet implemented universal EMR systems and many efforts are still ongoing. We describe the development of an EMR system and its pilot implementation and evaluation in two previously computernaïve public primary care centres in Cyprus. Methods One urban and one rural primary care centre along with their personnel (physicians and nurses) were selected to participate. Both qualitative and quantitative evaluation tools were used during the implementation phase. Qualitative data analysis was based on the framework approach, whereas quantitative assessment was based on a nine-item questionnaire and EMR usage parameters. Results Two public primary care centres participated, and a total of ten health professionals served

BackgroundResearch has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.MethodsThe current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).ResultsThe crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; p = 0.029).ConclusionsThe implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.

The creation of an electronic patient record (EPR) system with a user-friendly interface based on the concept of the episode of care was considered an urgent priority in the present Greek context, where a Health Care Reform program is in progress. This paper reports the procedures of developing an EPR system, and outlines some of its essentials and key issues. We performed a systematic review and analyzed the perceptions and patterns of use of existing EPR systems among Greek general practitioners. On the basis of this analysis, Transhis was selected using defined criteria for appropriateness, efficiency, and feasibility for general practice as a prototype, for creating a Windows-based EPR system using the International Classification of Primary Care (ICPC-2) and International Classification of Diseases (ICD-10) as classifications. The new EPR system seems appropriate for use within the current Greek primary care setting. Further studies are required for its evaluation.

A National Health Care System finally came about in Greece in the early 1980s and there are now 200 Primary Health Care (PHC) centres functioning in rural areas. Today PHC physicians who staff the Health Centres and their rural health posts mainly serve patients, who are living in rural areas. A thesis on the effectiveness of an educational intervention programme has been carried-out over the last few years as the result of the cooperation between the Clinic of Social and Family Medicine with the Lung and Thorax Clinic of the University Hospital Heraklion, Crete. The first results on the assessment of knowledge of bronchial asthma among PHC physicians who are serving the rural population of Crete have recently been published and this contribution reports and highlights some keys issues, including the following: -Bronchial asthma and COPD are frequent health problems, which the primary care physicians meet, in rural Crete.-There is a lack of specific training programmes for the primary care physicians on the management of asthma and COPD and also the guidelines that have been published are not widely used in daily practice. -There is a lack of qualified and educated nursing staff and specific educational and diagnostic equipment on COPD issues. In only a few Health Centres is a spirometer available. In conclusion there is a great deal of room for quality improvement as concerning the management of asthma and COPD in the Greek primary care. Specific actions to improve the current situation were undertaken, and a group of GPs and academics was created in order to review and disseminate practical guidelines (www.cgrg.gr). The current Health Care Reform that gives emphasis to the further development of the primary care and general practice is anticipated to invest time and resources to the development of continued medical education programmes and the implementation of quality improvement procedures. Background : General Practice/Family Medicine (GP/FM) has an important role in the management of chronic obstructive pulmonary disease (COPD), which is receiving an increasing interest in primary care. Aims: A literature review was made with the aim of comparing the clinical practice guidelines for COPD with a relevance to GP/FM and exploring any potential sources of discrepancy among their recommendations. Methods : We searched the computerized database MEDLINE (PubMed) (from 1990 to 2001) using a combination of key words. Six leading journals (New England Journal of Medicine, Lancet, JAMA, BMJ, Thorax and Chest) were thoroughly searched manually. All clinical practice guidelines for COPD and research papers in relation to their dissemination or their implementation in General Practice, written in English, French or German were included in our review. Each paper was independently reviewed twice. The reviewers examined the guidelines and research papers for specific components regarding the management of COPD in GP. Results : 24 articles fulfilled our review criteria. We found significant disagreement among clinical pract...