A review of Primary Care Informatics: past progress, present reality, future prospects

S. Teasdale

doi:10.1055/s-0038-1638445

Yearbook of Medical Informatics, Inhaltsverzeichnis

Yearb Med Inform 2005; 14(01): 139-147
DOI: 10.1055/s-0038-1638445

Review

Georg Thieme Verlag KG Stuttgart

A review of Primary Care Informatics: past progress, present reality, future prospects

S. Teasdale

¹PRIMIS Service Director University of Nottingham Nottingham, UK

› Institutsangaben

Abstract

Primary care informatics is beginning to find its feet as a scientific discipline, as evidenced by the increasing number of scientific papers published on the topic over the last three years, particularly those trying to establish the features that distinguish primary care informatics from health informatics more broadly. This paper provides a review of over a hundred scientific papers relating to primary care informatics, and speculates on future directions for primary care informatics.

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Referenzen

References
1 Starfield B. Primary care: concept, evaluation, and policy. New York: Oxford University Press; 1992
2 bInstitute of Medicine. A manpower policy for primary health care: report of a study. Washington, D.C: National Academy of Sciences; 1978: 16-26.
3 Nenonen M, Nylander O, Rintanen H, Suominen T. What might a health information system look like?. Inform Prim Care 2002; 10: 135-8.
4 de Lusignan S. What is primary care informatics?. J Am Med Inform Assoc 2003; 10: 304-9.
5 Weiner M, Callahan CM, Tierney M, Overhage JM, Mamlin B, Dexter PR, McDonald CJ. Using information technology to improve the health care of older adults. Annals of the American College of Physicians 2003; 139: 430-6.
6 Doolan DF, Bates DW, James BC. The use of computers for clinical care: A case series of advanced US sites. J Am Med Inform Assoc 2003; 10: 94-107.
7 Nylander O, Suominen T, Rintanen H, Pelanteri S, Nenonen M. Use of information on the shared customers of healthcare services to support care pathway planning. Inform Prim Care 2002; 10: 139-45.
8 Corkett T. Overview of the PACS procurement project within South West London. Inform Prim Care 2002; 10: 205-9.
9 Andrews JE, Pearce KA, Sydney C, Ireson C, Love M. Current state of information technology use in a US primary care practice-based research network. Inform Prim Care 2004; 12: 11-8.
10 de Lusignan S, Singleton A, Wells S. Lessons from the implementation of a near patient anticoagulant monitoring service in primary care. Inform Prim Care 2004; 12: 27-33.
11 Kidd M. The computerisation of Australian general practice 1998–2001 – what did we get for AU$15,000,000?. Inform Prim Care 2002; 10: 25-9.
12 Anaraki S, Plugge E, Hill A. Delivering primary care in prison: the need to improve health information. Inform Prim Care 2003; 11: 191-4.
13 Benson T. Why general practitioners use computers and hospital doctors do not—Part 1: incentives. BMJ 2002; 325: 1086-9.
14 Benson T. Why general practitioners use computers and hospital doctors do not—Part 2: scalability. BMJ 2002; 325: 1090-3.
15 Teasdale S. Culture eats strategy for breakfast!. Inform Prim Care 2002; 10: 195-6.
16 Valdes I, Kibbe DC, Tolleson G, Kunik ME, Petersen LA. Barriers to proliferation of electronic medical records. Inform Prim Care 2004; 12: 3-9.
17 Kuruvilla S, Dzenowagis Pleasant A, Dwivedi R, Murthy N, Samual R. et al. Digital bridges need concrete foundations: lessons from the Health InterNetwork India. BMJ 2004; 328: 1193-6.
18 Rotich JK, Hannan TJ, Smith FE, Bii J, Odero WW, Vu N, Met al. Installing and implementing a computer-based patient record system in sub-Saharan Africa: The Mosoriot medical record system. J Am Med Inform Assoc 2003; 10: 295-303.
19 Bell DS, Daly DM, Robinson P. Is there a digital divide among physicians? A geographic analysis of information technology in Southern California physician offices. J Am Med Inform Assoc 2003; 10: 484-93.
20 Chang B, Bakken S, Brown SS, Houston TK, Kreps GL, Kukafka R. et al. Bridging the digital divide: reaching vulnerable populations. J Am Med Inform Assoc. 2004 (epublication ahead of print 6th August 2004)
21 Carney PA, Poor DA, Schifferdecker KE, Gephart DS, Brooks WB, Nierenberg DW. Computer use among community-based primary care physician preceptors. Acad Med 2004; 79: 580-90.
22 Morris L, Dumville J, Campbell LM, Sullivan F. A survey of computer use in Scottish primary care: general practitioners are no longer technophobic but other primary care staff need better computer access. Inform Prim Care 2003; 11: 5-11.
23 Theadom A, de Lusignan S, Wilson E, Chan T. Using three-channel video to evaluate the impact of the use of the computer on the patient-centredness of the general practice consultation. Inform Prim Care 2003; 11: 149-56.
24 Booth N, Robinson P, Kohannejad J. Identification of high-quality consultation practice in primary care: the effects of computer use on doctor-patient rapport. Inform Prim Care 2004; 12: 75-83.
25 Hamilton WT, Round AP, Sharp D, Peters TJ. The quality of record keeping in primary care: a comparison of computerised, paper and hybrid systems. Br J Gen Pract 2003; 53: 929-33.
26 Hippisley-Cox J, Pringle M, Cater R, Wynn A, Hammersley V, Coupland C. et al. The electronic patient record in primary care – regression or progression? A cross sectional study. BMJ 2003; 326: 1439-43.
27 Thiru K, de Lusignan S, Shaw N. Paperless practices: a report from a research network. Inform Prim Care 2002; 10: 89-94.
28 Carr-Bains S, de Lusignan S, commentaries by Hasman A, van der Lei J, Berg M. Moving to paperlessness: a case study from a large general practice. Inform Prim Care 2003; 11: 157-65.
29 Thiru K, Hassey A, Sullivan F. Systematic review of scope and quality of electronic patient record data in primary care. BMJ 2003; 326: 1070-5.
30 Jordan K, Porcheret M, Croft P. Quality of morbidity coding in general practice computerised medical records: a systematic review. Fam Pract 2004; 21: 396-412.
31 Williams JG. Measuring the completeness and currency of codified clinical information. Methods Inf Med 2003; 42: 482-8.
32 de Lusignan S, Stephens PN, Adal N, Majeed A. Does feedback improve the quality of computerized medical records in primary care?. J Am Med Inform Assoc 2002; 09: 395-401.
33 Horsfield P. Trends in data recording by general practice teams: an analysis of data extracted from clinical computer systems by the PRIMIS project. Inform Prim Care 2002; 10: 227-34.
34 Thiru K, de Lusignan S, Sullivan F, Brew S, Cooper A. Three steps to data quality. Inform Prim Care 2003; 11: 95-102.
35 Brown PJB, Warmington V, commentary by de Lusignan S, Teasdale S. Infotsunami: surviving the storm with data quality probes. Inform Prim Care 2003; 11: 229-37.
36 Bourke A, Dattani H, Robinson M. Feasibility study and methodology to create a quality-evaluated database of primary care data. Inform Prim Care 2004; 12: 171-7.
37 de Lusignan S, Valentin T, Chan T, Hague N, Wood O, van Vlymen J. et al. Problems with primary care data quality: osteoporosis as an exemplar. Inform Prim Care 2004; 12: 147-56.
38 de Lusignan S, Hague N, Brown A, Majeed A. An educational intervention to improve data recording in the management of ischaemic heart disease in primary care. J Public Health 2004; 26: 34-7.
39 Porcheret M, Hughes R, Evans D, Jordan K, Whitehurst R, Ogden H. et al. Data quality of general practice electronic health records: the impact of a program of assessments, feedback, and training. J Am Med Inform Assoc 2004; 11: 78-86.
40 Faulconer ER, de Lusignan S. An eightstep method for assessing diagnostic data quality in practice: chronic obstructive pulmonary disease (COPD) as an exemplar. Inform Prim Care. In press 2004
41 Bainbridge M. ‘There’s information in them there systems!’. Inform Prim Care 2002; 10: 71-2.
42 Bainbridge M. The ‘point of care’ vs ‘registers and datasets’ debate. Inform Prim Care 2002; 10: 123-4.
43 Davis E. Avoiding the ‘dataset mentality’. Inform Prim Care 2003; 11: 49-51.
44 Morris L, Taylor M, Campbell LM, Sullivan FM. How will practices cope with information for the new GMS contract? Coronary heart disease data recording in five Scottish practices. Inform Prim Care 2003; 11: 121-7.
45 Sullivan FM, McEwan N, Murphy G. Regional repositories, reintermediation and the new GMS contract: cardiovascular disease in Tayside. Inform Prim Care 2003; 11: 215-21.
46 Nylander O, Suominen T, Rintanen H, Nenonen M, Pelanteri S. What does information about referrals reveal about the service network?. Inform Prim Care 2003; 11: 21-6.
47 Jones D, Wilkin D. Do information systems meet the needs of primary care trusts?. Inform Prim Care 2003; 11: 53-9.
48 Sullivan FM, Pell JP, Sweetland M, Morris AD. How could primary care meet the informatics needs of UK Biobank? A Scottish proposal. Inform Prim Care 2003; 11: 129-35.
49 Miller RH, Sim I. Physicians’ use of electronic medical records: barriers and solutions. Health Aff 2004; 23: 116-26.
50 Morris L, Taylor MW, Hunter C, Campbell LM. Information management in primary care: delivering a strategy to improve patient care in Scotland. Inform Prim Care 2002; 10: 85-8.
51 Ellis B. Identification of the critical success factors involved in the implementation of clinical governance arrangements within primary care. Inform Prim Care 2002; 10: 19-23.
52 Cowley C, Daws L, Ellis B. Health informatics and modernisation: bridging the gap. Inform Prim Care 2003; 11: 207-14.
53 Mimnagh C, Cox S. Modelling the relationship of clinical governance and informatics: matching competencies to aid development. Inform Prim Care 2004; 12: 179-82.
54 Pringle M. Improving quality: bridging the health sector divide. Int J Qual Health Care 2003; 15: 457-62.
55 Casalino L, Gillies RR, Shortell SM, Schmittdiel JA, Bodenheimer T, Robinson JC. et al. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. JAMA 2003; 289: 434-41.
56 Onofrei M, Hunt J, Siemienczuk J, Touchette DR, Middleton B. A first step towards translating evidence into practice: heart failure in a community practicebased research network. Inform Prim Care 2004; 12: 139-45.
57 Simpson D, Nicholas J, Cooper K. The use of information technology in managing patients with coronary heart disease. Inform Prim Care 2002; 10: 15-8.
58 Horsfield P, Teasdale S. Generating information from electronic patient records in general practice: a description of clinical care and gender inequalities in coronary heart disease using data from over two million patient records. Inform Prim Care 2003; 11: 137-44.
59 Mitchell E, McConnahie A, Sullivan F. Consultation computer use to improve management of chronic disease in general practice: a before and after study. Inform Prim Care 2003; 11: 61-8.
60 Sanderson H, Adams T, Budden M, Hoare C. Lessons from the central Hampshire electronic health record pilot project: evaluation of the electronic health record for supporting patient care and secondary analysis. BMJ 2004; 328: 875-8.
61 Teasdale S. PRIMIS – information for clinical governance. Journal of Clinical Governance 2002; 10: 83-8.
62 Kuilboer MM, van Wijk MAM, Mosseveld M, van der Does E, Ponsioen BP, de Jongste JC. et al. Feasibility of AsthmaCritic, a decision-support system for asthma and COPD which generates patient-specific feedback on routinely recorded data in general practice. Fam Pract 2002; 19: 442-7.
63 Pepper D, Hamilton K, Caldwell A. Structured clinical decision making. Inform Prim Care 2002; 10: 11-3.
64 Deutsch T, Gergely T. An intelligent partner system for improving chronic illness care. Inform Prim Care 2003; 11: 13-9.
65 Rousseau N, McColl E, Newton J, Grimshaw J, Eccles M. Practice based, longitudinal, qualitative interview study of computerised evidence based guidelines in primary care. BMJ 2003; 326: 314-22.
66 Eccles M, McColl E, Steen N, Rousseau N, Grimshaw J, Parkin D. et al. Effect of computerised evidence based guidelines on management of asthma and angina in adults in primary care: cluster randomised controlled trial. BMJ 2002; 325: 941-7.
67 Maviglia SM, Zielstorff RD, Paterno M, Teich JM, Bates DW, Kuperman GJ. Automating complex guidelines for chronic disease: lessons learned. J Am Med Inform Assoc 2003; 10: 154-65.
68 Liaw S-T, Sulaiman N, Pearce C, Sims J, Hill K, Grain H. et al. Falls prevention within the Australian general practice data model: methodology, information model, and terminology issues. J Am Med Inform Assoc 2003; 10: 425-32.
69 Gadzhanova S, Stanek J, Warren J. Clinical user interfaces that learn from experience. Inform Prim Care 2002; 10: 217-20.
70 Hoch I, Heymann AD, Kurman I, Valinsky LJ, Chodick G, Shalev V. Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics. J Am Med Inform Assoc 2003; 10: 541-6.
71 Bindels R, Hasman A, Derickx M, van Wersch JWJ, Winkens RA. User satisfaction with a real-time automated feedback system for general practitioners: a quantitative and qualitative study. Int J Qual Health Care 2003; 15: 501-8.
72 Bindels R, Hasman A, Kester AD, Talmon JL, de Clercq PA, Winkens RAG. The efficacy of an automated feedback system for general practitioners. Inform Prim Care 2003; 11: 69-74.
73 Short D, Frischer M, Bashford J. The development and evaluation of a computerised decision support system for primary care based upon ‘patient profile decision analysis’. Inform Prim Care 2003; 11: 195-202.
74 Hall R, Jones N, Purves I. Acquiring, encoding, and re-using clinical knowledge in PRODIGY. Inform Prim Care 2002; 10: 211-6.
75 Demiris G, Patrick TB, Boren SA. Assessing patient safety awareness and needs in rural hospitals in one US state. Inform Prim Care 2004; 12: 157-62.
76 Bates DW, Evans RS, Murff H, Stetson P, Pizziferri L, Hripcsak G. Detecting adverse events using information technology. J Am Med Inform Assoc 2003; 10: 115-28.
77 Overhage JM, Middleton B, Miller RA, Zielstorff RD, Hersh WR. Does national regulatory mandate of provider order entry portend greater benefit than risk for health care delivery? The 2001 ACMI Debate. J Am Med Inform Assoc 2002; 09: 199-208.
78 Field TS, Gurwitz JH, Harrold LR, Rothschild JM, Debellis K, Seger AC. et al. Strategies for detecting adverse drug events among older persons in the ambulatory setting. J Am Med Inform Assoc. 2004 (epublication ahead of print 6th August 2004)
79 Fernando B, Savelyich BSP, Avery AJ, Sheikh A, Bainbridge M, Horsfield P. et al. Prescribing safety features of general practice computer systems: evaluation using simulated test cases. BMJ 2004; 328: 1171-3.
80 Avery AJ, Savelyich BSP, Teasdale S. Improving the safety features of general practice computer systems. Inform Prim Care 2003; 11: 203-6.
81 Goldstein MK, Hoffman BB, Coleman RW, Tu SW, Shankar RD, O’Connor M, Martins S. et al. Patient safety in guidelinebased decision support for hypertension management: ATHENA DSS. J Am Med Inform Assoc 2002; 09: S11-S16.
82 Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc 2004; 11: 104-12.
83 Mennerat F, Booth N. Concepts underlying continuity of care – the system of concepts described in ENV 13940a. Inform Prim Care 2002; 10: 31-8.
84 Brown PJB, Warmington V, Laurence M, Prevost AT. Randomised crossover trial comparing the performance of Clinical Terms Version 3 and Read Codes 5 byte set coding schemes in general practice. BMJ 2003; 326: 1127-31.
85 Brown PJB, Warmington V, Laurence M, Prevost AT. A methodology for the functional comparison of coding schemes in primary care. Inform Prim Care 2003; 11: 145-8.
86 Clark DH, Carter W, Sullivan FM. How often do GPs use rapid computer access to laboratory results? A description of 18 months’ use by 72 practices in Tayside. Inform Prim Care 2004; 12: 35-9.
87 Pillai A, Thomas S, Garg M. The electronic immediate discharge document: experience from the South West of Scotland. Inform Prim Care 2004; 12: 67-72.
88 Harrison J, Booth N. Applying new thinking from the linked and emerging fields of digital identity and privacy to information governance in health informatics. Inform Prim Care 2003; 11: 223-8.
89 Love T, Sullivan FM. Confidentiality, clinical governance and research in the community. Inform Prim Care 2004; 12: 1-2.
90 Cartwright CA, Korsen N, Urbach LE. Teaching the Teachers: helping faculty in a family practice residency improve their informatics skills. Acad Med 2002; 77: 385-91.
91 Teasdale S. Supporting change management with PRIMIS. Inform Prim Care 2002; 10: 221-5.
92 Yaghmaie F, Jayasuriya R. The roles of ‘subjective computer training’ and management support in the use of computers in community health centres. Inform Prim Care 2004; 12: 63-170.
93 Hayes G. Health informatics professionalism in primary care. Inform Prim Care 2003; 11: 1-3.
94 Pritchard P. Professional values and informatics: what is the connection?. Inform Prim Care 2004; 12: 91-6.
95 Winkelman J, Leonard KJ. Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework. J Am Med Inform Assoc 2004; 11: 151-61.
96 Shakeshaft AP, Framkish CJ. Using patient-driven computers to provide costeffective prevention in primary care: a conceptual framework. Health Promot Int 2003; 18: 67-77.
97 Pyper C, Amery J, Watson M, Crook C. Patients’ experiences when accessing their on-line electronic patient records in primary care. Br J Gen Pract 2004; 54: 38-43.
98 Ralston JD, Revere D, Robins LS, Goldberg HI. Patients’ experience with a diabetes support programme based on an interactive electronic medical record: qualitative study. BMJ 2004; 328: 1159-62.
99 Sciamanna CN, Marcus BH, Goldstein MG, Lawrence K, Swartz S, Bock B. et al. Feasibility of incorporating computertailored health behaviour communications in primary care settings. Inform Prim Care 2004; 12: 40-8.
100 Cox B. The impact of the Internet on the GP-patient relationship. Inform Prim Care 2002; 10: 95-8.
101 Umefjord G, Malker H, Olofsson N, Hensjö L-O, Petersson G. Primary care physicians’ experiences of carrying out consultations on the internet. Inform Prim Care 2004; 12: 85-90.
102 Kittler AF, Carlson GL, Harris C, Volk LA, Pizziferri L, Lippincott M. et al. Primary care physician attitudes towards using a secure web-based portal designed to facilitate electronic communication with patients. Inform Prim Care 2004; 12: 129-38.
103 Neville R, Marsden W, McCowan C, Pagliari C, Mullen H, Fannin A. A survey of GP attitudes to and experience of email consultations. Inform Prim Care. In press 2004
104 Neville R, Marsden W, McCowan C, Pagliari C, Mullen H, Fannin A. Email consultations in general practice. Inform Prim Care. In press 2004
105 Dickerson S, Reinhart AM, Feeley TH, Bidani R, Rich E, Garg VK. et al. Patient internet use for health information at three urban primary care clinics. J Am Med Inform Assoc. 2004 (epublication ahead of print 6th August 2004)
106 Roberts J, Copeland K. Stimulating convergence of clinical and lifestyle perspectives on the web: asthma as an example. Inform Prim Care 2002; 10: 201-4.
107 Madle G, Kostkova P, Mani-Saada J, Weinberg J, Williams P. Changing public attitudes to antibiotic prescribing: can the internet help?. Inform Prim Care 2004; 12: 19-26.
108 Huntington P, Williams P, Nicholas D. Age and gender user differences of a touchscreen kiosk: a study of kiosk transaction log files. Inform Prim Care 2002; 10: 3-9.
109 Nicholas D, Huntington P, Williams P, Monopolo M, Gunter B. The characteristics of users and non-users of a digital interactive television service – case study: the Living Health channel. Inform Prim Care 2002; 10: 73-84.
110 Huntington P, Nicholas D, Williams P, Gunter B. Comparing two digital consumer health television services using transaction log analysis. Inform Prim Care 2002; 10: 147-59.
111 Nicholas D, Huntington P, Gunter B, Williams P. Comparing the use of health information/advice in Birmingham and Hull: a case study of digital health information delivered via the television. Inform Prim Care 2003; 11: 75-87.
112 Nicholas D, Huntington P, Williams P, Gunter B. Pregnancy information and advice on Sky Television: an evaluation. Inform Prim Care. In press 2004
113 Houghton G, Singh S, Fraser J. Using email as a research tool in general practice: starting to implement the National Service Framework for Mental Health. Inform Prim Care 2003; 11: 27-31.
114 CMAJ Editorial. Repairing the foundation: the future of primary care. Can Med Assoc J 2004; 170: 1509.
115 www.infoway-inforoute.ca/
116 Mullins HC, Zapp JA. Funding an infrastructure to support primary care informatics. Inform Prim Care 2002; 10: 45-8.
117 Little DR, Zapp JA, Mullins HC, Zuckerman AE, Teasdale S, Johnson KB. Moving toward a United States strategic plan in primary care informatics: a White Paper of the Primary Care Informatics Working Group, American Medical Informatics Association. Inform Prim Care 2003; 11: 89-94.
118 Bates DW, Ebell M, Gotlieb E, Zapp J, Mullins HC. A proposal for electronic medical records in US primary care. J Am Med Inform Assoc 2003; 10: 1-10.
119 Bodenheimer T, Grumbach K. Electronic technology: a spark to revitalize primary care?. JAMA 2003; 290: 259-64.
120 Future of Family Medicine Project Leadership Committee. The future of family medicine: a collaborative project of the family medicine community. Ann Fam Med 2004; 02: S3-S32.
121 Yasnoff WA, Humphreys BL, Overhage JM, Detmer DE, Brennan PF, Morris RW. et al. A consensus action agenda for achieving the National Health Information Infrastructure. J Am Med Inform Assoc 2004; 11: 332-8.
122 Pritchard P. The ‘self-organising system’ as a model for primary health care – can local autonomy and centralisation co-exist?. Inform Prim Care 2002; 10: 125-34.
123 Chapman J. A systems perspective on computing in the NHS. Inform Prim Care 2002; 10: 197-9.
124 Martin M. Why is ICRS so hard?. Inform Prim Care 2003; 11: 37-8.
125 Majeed A, de Lusignan S, Teasdale S. Ten ways to improve information technology in the NHS. Commentary: improve the quality of the consultation. Commentary: Clinical focus might make it work. BMJ 2003; 326: 202-6.
126 Markwell D. Flights of fitness in Healthitia. Inform Prim Care 2004; 12: 65-6.
127 www.radcliffe-oxford.com/ipc