Challenges to implementing electronic trial data collection in primary care: a qualitative study

BMC Family Practice

Nicholas Turner¹  Jodi Taylor¹  Kathryn Curtis²  Alastair D. Hay²  Jeremy Horwood²  Christie Cabral²  Brendan Delaney³  Anne Schilder⁴  Michael Moore⁵  Paul Little⁵  Scott Wilkes⁶  Vibhore Prasad⁷  Vasa Curcin⁷  Jesús Domínguez⁷  Sarah Gallagher⁸ 

[1] Bristol Randomised Trial Collaboration (BRTC), Part of the Bristol Trial Centre, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS82PS, Bristol, UK;Centre for Academic Primary Care, Bristol Medical School: Population Health Sciences, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK;Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, South Kensington Campus, SW7 2AZ, London, UK;NIHR University College London Hospitals Biomedical Research Centre and evidENT, UCL Ear Institute, 91 Gower Street, WC1E 6AB, London, UK;Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University Of Southampton, SO17 1BJ, Southampton, UK;School of Medicine, Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, City Campus, Chester Road, SR1 3SD, Sunderland, UK;School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King’s College London, Addison House 3.07, Guy’s Campus, SE1 1UL, London, UK;The Portland Practice, St Pauls Medical Centre, 121 Swindon Road, GL50 4DP, Cheltenham, Gloucestershire, UK;

关键词: Primary health care;    Electronic health records;    Information technology;   

DOI  :  10.1186/s12875-021-01498-6

来源: Springer

【 摘 要 】

BackgroundWithin-consultation recruitment to primary care trials is challenging. Ensuring procedures are efficient and self-explanatory is the key to optimising recruitment. Trial recruitment software that integrates with the electronic health record to support and partially automate procedures is becoming more common. If it works well, such software can support greater participation and more efficient trial designs. An innovative electronic trial recruitment and outcomes software was designed to support recruitment to the Runny Ear randomised controlled trial, comparing topical, oral and delayed antibiotic treatment for acute otitis media with discharge in children. A qualitative evaluation investigated the views and experiences of primary care staff using this trial software.MethodsStaff were purposively sampled in relation to site, role and whether the practice successfully recruited patients. In-depth interviews were conducted using a flexible topic guide, audio recorded and transcribed. Data were analysed thematically.ResultsSixteen staff were interviewed, including GPs, practice managers, information technology (IT) leads and research staff. GPs wanted trial software that automatically captures patient data. However, the experience of getting the software to work within the limited and complex IT infrastructure of primary care was frustrating and time consuming. Installation was reliant on practice level IT expertise, which varied between practices. Although most had external IT support, this rarely included supported for research IT. Arrangements for approving new software varied across practices and often, but not always, required authorisation from Clinical Commissioning Groups.ConclusionsPrimary care IT systems are not solely under the control of individual practices or CCGs or the National Health Service. Rather they are part of a complex system that spans all three and is influenced by semi-autonomous stakeholders operating at different levels. This led to time consuming and sometimes insurmountable barriers to installation at the practice level. These need to be addressed if software supporting efficient research in primary care is to become a reality.

【 授权许可】

CC BY