Assessing the impact of recording quality target data on the GP consultation using multi-channel video.
BACKGROUND
In the UK routinely collected computerized clinical data is used to assess progress towards financially incentivised quality targets for chronic disease management including hypertension.


OBJECTIVE
To develop a method for assessing the impact of recording quality target data in the clinical consultation.


METHODS
Raters were trained how to rate a multi-channel video of a simulated clinical consultation for interaction between actors, computer use, non-verbal communication.


RESULTS
25% of consultation time is computer use and a median of 4 to 5 items were coded per consultation mainly items related to the hypertension quality target. Intraclass correlation coefficient showed good inter-rater reliability (>0.9; p<0.001).


CONCLUSIONS
We have successfully piloted a novel technique for observing the influence of the computer on the consultation. Despite increasing computer use to record quality target data the overwhelming proportion of the consultation remains doctor patient interaction.
Moulene
Maigaelle V
MV
Primary Care Informatics, Division of Community Health Sciences, St. George'-University of London, United Kingdom.
de Lusignan
Simon
S
Freeman
George
G
van Vlymen
Jeremy
J
Sheeler
Ian
I
Singleton
Andrew
A
Kumarapeli
Pushpa
P
D002983:Clinical Competence; D005194:Family Practice; D006801:Humans; D006973:Hypertension / Q000628:therapy; D016347:Medical Records Systems, Computerized; D016544:Patient Simulation; D010865:Pilot Projects; D011320:Primary Health Care / Q000592:standards*; D015203:Reproducibility of Results; D013996:Time and Motion Studies; D014743:Videotape Recording / Q000295:instrumentation*