A qualitative evaluation of general practitioners' views on protocol-driven eReferral in Scotland

Bouamrane, M.-M. and Mair, F. S. (2014) A qualitative evaluation of general practitioners' views on protocol-driven eReferral in Scotland. BMC Medical Informatics and Decision Making, 14(30), (doi:10.1186/1472-6947-14-30)

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Publisher's URL: http://dx.doi.org/10.1186/1472-6947-14-30

Abstract

Background 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 eRefferal - 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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mair, Professor Frances and Bouamrane, Dr Matt-Mouley
Authors: Bouamrane, M.-M., and Mair, F. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:BMC Medical Informatics and Decision Making
Publisher:BioMed Central
ISSN:1472-6947
ISSN (Online):1472-6947

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