BMC Med Inform Decis Mak - A qualitative evaluation of general practitioners' views on protocol-driven eReferral in Scotland.

Tópicos

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Resumo

CKGROUND: The ever increasing volume of referrals from primary care to specialist services is putting considerable pressure on resource-constrained health services while effective communication across fragmented services remains a substantial challenge. Previous studies have suggested that electronic referrals (eReferral) can bear important benefits for cross-organisational processes and patient care management.METHODS: We conducted 25 semi-structured interviews and 1 focus group with primary care providers to elucidate General Practitioners' (GPs) perspectives on information management processes in the patient pathway in NHSScotland, 1 focus group with members of the Scottish Electronic Patient Record programme and one interview with a senior architect of the Scottish Care Information national eReferral System (SCI Gateway). Using Normalisation Process Theory, we performed a qualitative analysis to elucidate GPs' perspectives on eReferral to identify the factors which they felt either facilitated or hindered referral processes.RESULTS: The majority of GPs interviewed felt that eReferral substantially streamlined communication processes, with the immediate transfer of referral documents and the availability of an electronic audit trail perceived as two substantial improvements over paper-based referrals. Most GPs felt that the SCI Gateway system was reasonably straightforward to use. Referral protocols and templates could be perceived as useful by some GPs while others considered them to be cumbersome at times.CONCLUSION: Our study suggests that the deployment and adoption of eReferral across the NHS in Scotland has been achieved by a combination of factors: (i) a policy context - including national mandatory targets for eReferral - which all NHS health-boards were bound to operationalise through their Local Delivery Plans and also (ii) the fact that primary care doctors considered that the overall benefits brought by the deployment of eReferral throughout the patient pathway significantly outweigh any potential disbenefits.

Resumo Limpo

ckground ever increas volum referr primari care specialist servic put consider pressur resourceconstrain health servic effect communic across fragment servic remain substanti challeng previous studi suggest electron referr ereferr can bear import benefit crossorganis process patient care managementmethod conduct semistructur interview focus group primari care provid elucid general practition gps perspect inform manag process patient pathway nhsscotland focus group member scottish electron patient record programm one interview senior architect scottish care inform nation ereferr system sci gateway use normalis process theori perform qualit analysi elucid gps perspect ereferr identifi factor felt either facilit hinder referr processesresult major gps interview felt ereferr substanti streamlin communic process immedi transfer referr document avail electron audit trail perceiv two substanti improv paperbas referr gps felt sci gateway system reason straightforward use referr protocol templat perceiv use gps other consid cumbersom timesconclus studi suggest deploy adopt ereferr across nhs scotland achiev combin factor polici context includ nation mandatori target ereferr nhs healthboard bound operationalis local deliveri plan also ii fact primari care doctor consid overal benefit brought deploy ereferr throughout patient pathway signific outweigh potenti disbenefit

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