Achieving benefit for patients in primary care informatics: the report of a international consensus workshop at Medinfo 2007.
BACKGROUND
Landmark reports suggest that sharing health data between clinical computer systems should improve patient safety and the quality of care. Enhancing the use of informatics in primary care is usually a key part of these strategies.


OBJECTIVE
To synthesise the learning from the international use of informatics in primary care.


METHODS
The workshop was attended by 21 delegates drawn from all continents. There were presentations from USA, UK and the Netherlands, and informal updates from Australia, Argentina, and Sweden and the Nordic countries. These presentations were discussed in a workshop setting to identify common issues. Key principles were synthesised through a post-workshop analysis and then sorted into themes.


RESULTS
Themes emerged about the deployment of informatics which can be applied at health service, practice and individual clinical consultation level: 1 At the health service or provider level, success appeared proportional to the extent of collaboration between a broad range of stakeholders and identification of leaders. 2 Within the practice much is currently being achieved with legacy computer systems and apparently outdated coding systems. This includes prescribing safety alerts, clinical audit and promoting computer data recording and quality. 3 In the consultation the computer is a 'big player' and may make traditional models of the consultation redundant.


CONCLUSIONS
We should make more efforts to share learning; develop clear internationally acceptable definitions; highlight gaps between pockets of excellence and real-world practice, and most importantly suggest how they might be bridged. Knowledge synthesis from different health systems may provide a greater understanding of how the third actor (the computer) is best used in primary care.
de Lusignan
Simon
S
Division of Community Health Sciences, St George's - University of London, London, UK. slusigna@sgul.ac.uk
Teasdale
Sheila
S
D003695:Delivery of Health Care / Q000458:organization & administration; D006801:Humans; D048088:Informatics / Q000639:trends*; D007256:Information Systems / Q000458:organization & administration*; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D018511:Systems Integration