Expectations for the next generation of electronic patient records in primary care: a triangulated study.
BACKGROUND
Although primary care physicians are satisfied users of electronic patient records (EPRs) in Norway today, EPR systems may not have reached their full potential. We studied primary care physicians' needs and experiences in relation to EPRs and analysed potential improvements for today's EPR systems. RESPONDENTS AND METHODS: This is a triangulated study that compares qualitative and quantitative data from focus groups, observations of primary care encounters and a questionnaire survey.


RESULTS
General practioners (GPs) were not satisfied with the level of availability of information within EPR systems. They were especially concerned about follow-up for chronic disease and dealing with patients with multiple conditions. Many expressed a desire for reminders and easier access to clinical guidelines under normal working conditions, as well as the possibility of consultations with specialists from their EPR systems. GPs placed importance on the ability to communicate electronically with patients.


CONCLUSIONS
Progress toward a problem-oriented EPR system based on episodes of care that includes decision support is necessary to satisfy the needs expressed by GPs. Further research could solve the problem of integration of functionality for consultation with specialists and integration with patient held records. Results from this study could contribute to further development of the next generation of EPRs in primary care, as well as inspire the application of EPRs in other parts of the health sector.
Department of Community Medicine and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Medisinsk Teknisk Forskningssenter (MTFS), N-7489 Trondheim, Norway. tom.christensen@ntnu.no
Tom
T
Christensen
Anders
A
Grimsmo
D003658:Decision Making, Computer-Assisted; D004059:Diffusion of Innovation; D034742:Electronic Mail; D006801:Humans; D016247:Information Storage and Retrieval; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D009664:Norway; D011320:Primary Health Care / Q000458:organization & administration*; D013997:Time Factors