Barriers to the adoption of computerised decision support systems in general practice consultations: a qualitative study of GPs’ perspectives

Short, Duncan; Frischer, Martin; Bashford, James

doi:10.1016/j.ijmedinf.2004.02.001

Cited by 89 publications

(58 citation statements)

References 18 publications

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“…[26][27] The increased use of computers described by patients has also been previously reported by GPs and practice nurses. 13,21,23,28,29 However, the present finding that many patients appear to value the use of computers in consultations contrasts with GPs' beliefs that this reliance can reduce the quality of interpersonal communication in the consultation. 24 Although computer use can be negatively related to some aspects of communication, such as eye contact with the patient, this study found that patients can be reassured by the availability of their records in obvious electronic form, the opportunity to see how their illness is or is not progressing, and the ability to discuss their health outcomes in detail.…”

Section: Fundingcontrasting

confidence: 70%

Patients' views of pay for performance in primary care: a qualitative study

Hannon

Lester²,

Campbell³

2012

Br J Gen Pract

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BackgroundMany countries use pay-for-performance schemes to reward family practices financially for achieving quality indicators. The views of patients on pay for performance remain largely unexplored. AimTo gain the views of family practice patients on the United Kingdom pay-for-performance Quality and Outcomes Framework (QOF). Design and settingInterviews with 52 patients were conducted in 15 family practices across England. All patients had at least one long-term condition that had been diagnosed before the introduction of the QOF in 2004. MethodSemi-structured interviews analysed using open explorative thematic coding. ResultsFew patients had heard of the QOF or had noticed changes to the structure or process of their care. However, where they were noted, changes to consultations such as increased use of computers and health checks initiated by the GP or practice nurse were seen as good practice. The majority of patients were surprised to hear their practice received bonuses for doing 'simple things'. Some patients also raised concerns over potential unintended consequences of pay-forperformance frameworks, such as a reduced focus on non-incentivised areas. ConclusionThis study adds a unique patient perspective to the debate around the impact of pay-forperformance schemes and consequences on patient care. Patients' views, experiences, and concerns about pay for performance mostly chime with previously described opinions of primary care staff. Patient surprise and concern around incentivising basic processes of care shows how patient views are vital when monitoring and evaluating a scheme that is designed to improve patient care. Keywordspatients; pay for performance; qualitative research. e322

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Section: Fundingcontrasting

confidence: 70%

Patients' views of pay for performance in primary care: a qualitative study

Hannon

Lester²,

Campbell³

2012

Br J Gen Pract

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“…Based on the literature, physicians want existing computer decision support systems to enhance physician-patient relationships, redirect work among staff, adjust to individual patients and provide time-saving tools (12,13,56,64,(68)(69)(70)(71)(72)(73).…”

Section: Discussionmentioning

confidence: 99%

Adherence factors to paperless primary healthcare: a focus group study

Iljaž¹,

Meglic²,

Petek³

et al. 2014

Slovenian Journal of Public Health

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“…These included limitations of practitioners' information technology skills, problems for GPs in understanding the risk output of systems and GP concerns about communicating risk sufficiently well to patients. 20 Concerns over the potential impact of time using a system in a consultation was also identified as a barrier. 8 …”

Section: Advantages For Patientsmentioning

confidence: 99%

Identifying barriers to implementing a cardiovascular computerised decision support system (CDSS): a Delphi survey

Wilson¹,

Opolski²

2009

Journal of Innovation in Health Informatics

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IntroductionIn a technological age, the use of electronic means to assist health professionals in their work appears to have achieved limited adoption. In the USA, for example, it is reported that during 2005, approximately 23.9% of physicians used electronic health records (EHRs) in the ambulatory setting, while only 5% of hospitals used computerised physician order entry systems. Likewise, in the UK, which has an extensive computerised primary healthcare sector, the use of computerised decision support systems (CDSS) is not commonplace. 2 Investigating primary care physicians' use of electronic patient records in Norway, Christensen et al concluded that their full potential had not been reached and that problems of integration and functionality needed to be addressed to achieve this.3 Computerised decision support systems are one type of electronic interface designed to assist clinicians in decision making and risk management and to facilitate shared decision making between health professional and patient. Achieving maximum adoption and usage by primary care professionals requires a comprehensive understanding of which professionals find it attractive and why.This paper -a report of research that obtained health professionals' and industry representatives' opinions on the most effective approach or approaches to the dissemination of an electronic decision support ABSTRACTPurpose This paper reports an evaluation of stakeholders' perspectives and recommendations for the dissemination of a cardiovascular computerised decision support system (CDSS) program. Methods A literature review of dissemination models for health information and decision support aids was undertaken to develop a semi-structured interview protocol outlining a range of dissemination models for distribution. A cross section of eight health professionals and three corporate managers were interviewed to provide as broad a view as possible of eight dissemination models. Data were collected via two questionnaires incorporating the Delphi technique. Perspectives from the corporate managers were collected by telephone interview. Results Financial incentive was the most highly rated dissemination method, followed by joint promotion with a professional body and undergraduate medical education. The lowest average rating was for dividing the program into separate components. Participants provided five other suggestions for dissemination. Suggestions for further exploration include the development of a multi-professional model comprising two or more approaches that is piloted and evaluated. Conclusion Our results provide beneficial information on the potential dissemination of computer decision support systems to health professionals whose uptake of CDSS has not previously been explored. Whether use of a shared decision aid impacts on the decisions made by health professionals working in a team is, however, less evident.

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Barriers to the adoption of computerised decision support systems in general practice consultations: a qualitative study of GPs’ perspectives

Cited by 89 publications

References 18 publications

Patients' views of pay for performance in primary care: a qualitative study

Patients' views of pay for performance in primary care: a qualitative study

Adherence factors to paperless primary healthcare: a focus group study

Identifying barriers to implementing a cardiovascular computerised decision support system (CDSS): a Delphi survey

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