Abstract
The National Health Service in England has given increasing priority to improving inter-professional communication, enabling better management of patients with chronic conditions and reducing medical errors through effective use of information. Despite considerable efforts to reduce patient harm through better information usage, medical errors continue to occur, posing a serious threat to patient safety. This study explores the range, quality and sophistication of existing information systems in primary care with the aim to capture what information practitioners need to provide a safe service and identify barriers to its effective use in care pathways. Data were collected through semi-structured interviews with general practitioners from surgeries in North West London and a survey evaluating their experience with information systems in care pathways. Important information is still missing, specifically discharge summaries detailing medication changes and changes in the diagnosis and management of patients, blood results ordered by hospital specialists and findings from clinical investigations. Participants identified numerous barriers, including the communication gap between primary and secondary care, the variable quality and consistency of clinical correspondence and the inadequate technological integration. Despite attempts to improve integration and information flow in care pathways, existing systems provide practitioners with only partial access to information, hindering their ability to take informed decisions. This study offers a framework for understanding what tools should be in place to enable effective use of information in primary care.
Highlights
The Department of Health in England has invested heavily in the implementation of information systems with the aim to reform the use of information in the National Health Service (NHS), enhance inter-professional communication across care levels and improve service quality and patient safety.[1]
Despite the expectation that integrated care would improve communication between providers,[20] the results show that general practitioners (GPs) remain dissatisfied with the quality and timeliness of information in care pathways at this early stage of the pilot and often have to make clinical decisions based on missing or limited information, potentially exposing patients to safety risks
Despite attempts to improve integration and information flow across care levels, our findings confirm that the communication gap between primary and secondary care has yet to be bridged
Summary
The Department of Health in England has invested heavily in the implementation of information systems with the aim to reform the use of information in the National Health Service (NHS), enhance inter-professional communication across care levels and improve service quality and patient safety.[1] Despite the huge investments in information technology (IT) over the last decade, patients still experience avoidable harm. The National Health Service in England has given increasing priority to improving inter-professional communication, enabling better management of patients with chronic conditions and reducing medical errors through effective use of information. Objectives This study explores the range, quality and sophistication of existing information systems in primary care with the aim to capture what information practitioners need to provide a safe service and identify barriers to its effective use in care pathways. This study offers a framework for understanding what tools should be in place to enable effective use of information in primary care
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