Embedding electronic decision-support tools for suspected cancer in primary care: a qualitative study of GPs' experiences.

Lisa Dikomitis,Trish Green,Una Macleod

doi:10.1017/s1463423615000109

Lisa Dikomitis, Trish Green + Show 1 more

Open Access

https://doi.org/10.1017/s1463423615000109

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Abstract

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. 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. 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. 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.

Highlights

In terms of morbidity and mortality, cancer remains one of UK’s biggest health problems
This finding is not new and should, not be surprising (May, 2006; May et al, 2007a, 2007b). This is the first time that an attempt has been made to incorporate electronic risk assessment tools (eRATs) for cancer diagnosis into general practitioners (GPs)’ electronic systems
GPs reported learning about new aspects of cancer symptom presentation as a result of using the eRATs, and the tools in themselves were

Summary

Introduction

In terms of morbidity and mortality, cancer remains one of UK’s biggest health problems This has led to increased interest in how patients and professionals recognize cancer symptoms. This is because European data show that one-year survival figures for many cancers are poorer in the United Kingdom than in comparable European countries In the UK healthcare system, this pathway involves primary care, and most commonly general practitioners (GPs) Owing to their traditional gate-keeping role within the UK healthcare system, there is an emerging body of work on the role of GPs in the process to cancer diagnosis (Richards, 2009; Hippisley‐Cox and Coupland, 2011; Mansell et al, 2011; Hamilton et al, 2013; Mitchell et al, 2013)

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