Embedding electronic decision-support tools for suspected cancer in primary care: a qualitative study of GPs' experiences.
OBJECTIVE
The purpose of this evaluation was to obtain views from general practitioners (GPs) who piloted the electronic risk assessment tools (eRATs) for suspected lung or colorectal cancer. We wanted to find out whether GPs were able to integrate these tools into their everyday practice. We were also keen to identify facilitators and barriers to their more widespread use.


BACKGROUND
Cancer remains one of UK's biggest health problems, in terms of morbidity and mortality. Comparative European data show that five-year survival figures for many cancers are lower in the United Kingdom than in comparable European countries. eRATs are intended to aid recognition of symptoms of lung and colorectal cancers in patients aged 40 years and over.


METHODS
This was a qualitative study; telephone interviews were conducted with 23 GPs who piloted the eRATs. A systematic qualitative analysis was applied to the data. The normalisation process model was used after data collection. This theory-driven conceptual framework was used to examine the operationalisation of this intervention in Primary Care.


RESULTS
Electronic decision-support tools appear to be useful additions to the resources available to GPs in order to assist them with recognizing potential cancer symptoms. However, the tools need to be refined in order to integrate them into GP practice. The tools raised GPs' awareness about cancer because of the prompt facility of the software, although this also raised the potential of 'prompt fatigue'. GPs constantly receive alerts via their clinical system, particularly related to the Quality and Outcomes Framework. The integration of eRATs into routine practice could be engendered by improvement to the training packages that accompany them, and by its delivery via a platform compatible with all GP clinical systems.
1Lecturer in Social Research,School of Social Sciences,University of Hull,HU6 7RX,UK.
Lisa
L
Dikomitis
2Research Fellow,Hull York Medical School,University of Hull,HU6 7RX,UK.
Trish
T
Green
3Professor of Primary Care Medicine,Hull York Medical School,University of Hull,HU6 7RX,UK.
Una
U
Macleod
D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003661:Decision Support Techniques; D005194:Family Practice; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D036301:Qualitative Research; D018570:Risk Assessment; D012984:Software; D006113:United Kingdom
cancer; decision support; early diagnosis; risk assessment