Integrating asthma tools and clinical guidelines into primary care EMRs across Canada: A mixed-methods approach

Abstract

<b>Background:</b> Electronic medical records (EMRs) offer opportunities to integrate guidelines into the process of care, provide real-time feedback on performance enable surveillance, and benchmarking. <b>Objectives:</b> To determine how best to integrate electronic asthma tools (eTools) and clinical guidelines into primary care EMRs across Canada, measure and provide feedback on performance within an EMR, and design and scale an asthma surveillance system that supports quality improvement. <b>Methods:</b> A focus group of 8 experts (6 physicians, 2 allied health professionals) in primary care, asthma, and EMRs, and one patient discussed methods for integrating asthma eTools and clinical guidelines into EMRs and completed 2 questionnaires on the utility of asthma performance indicators and eTools. <b>Results:</b> 7 themes were identified from qualitative analysis: (1) prioritize end-user, (2) gain stakeholder trust; (3) open communication; (4) system adaptability; (5) develop for existing workflows; (6) outcome-oriented design; and (7) system efficiency (Figure 1). The 3 asthma indicators perceived most useful in primary care were: smoking cessation support, monitoring asthma by objective measures, and number of ED visits/hospitalizations for asthma. <b>Conclusion:</b> Primary care experts see value in integrating asthma eTools into primary care EMRs. Themes identified highlight strategies for successful eTool integration into EMRs.