Title
The electronic locum record for general practitioners: Outcome of an evaluation study in the Netherlands
Author
Dumay, A.C.M.
Haaker, T.I.
TNO Kwaliteit van Leven
Publication year
2010
Abstract
Background: A locum practitioner is an out-of-hours general practitioner who needs access to the electronic health record of visiting patients. The electronic locum record is a summary of the electronic health record available to the locum practitioner and includes the most significant health problems, the most recent records of the patient's visits to the practice, current medication data and information on allergies and intolerances. The locum practitioner returns a locum medical note to the electronic health record at the general practitioner with his or her diagnosis, treatment or referral of the visiting patient. A pilot project of the electronic locum record was implemented in the Twente region of the Netherlands. Objective: To obtain policy information for the nationwide implementation of the electronic locum record as a first component of the electronic health record in the Netherlands. Methods: First, evaluation aspects were collected from parties involved in the pilot implementation process. Aspects were taken from the work flow to operationalise the electronic health record. Secondly, indicator questions were formulated and normative levels agreed for each indicator by a panel with experts from the medical and information technology domain. Third, the actual values were rated either by measurement (technical indicators) or by structured interviews (process indicators) with the general practitioners who joined the pilot study. Finally, a cross case analysis was performed by checking for (in-)consistencies among the respondents. Results: Eight out of the 15 key indicators scored positive, three failed and four remained inconclusive. The indicators that failed the norms related to the guideline for electronic registration of patient information, the process of acquiring the healthcare professional identification card and card-related services. Indicators that remained inconclusive referred to storing and archiving of identification cards and codes, the use of the identification repository at the general practice post and the usefulness and ease-of-use of the electronic locum record. Conclusions: The study demonstrates that many processes, systems, services and practices for nation-wide implementation of the electronic locum record for general practitioners in the Netherlands are in place. However, significant improvements are required on a number of aspects. For example general practitioners need to be trained more in applying the guideline for electronic registration of patient data. Also the process for general practitioners to acquire their unique healthcare professional identification cards should require less effort. We also recommend that a strong regional information technology support group should be in operation during roll-out. © 2010.
Subject
Health
Zorginnovatie
Communication
Electronic health record
Electronic locum record
General practitioner
Implementation
IT consistency
Patient safety
Case analysis
Data and information
Ease-of-use
Electronic health record
Evaluation study
General practitioner
General practitioners
Health care professionals
Identification cards
Key indicator
Netherlands
Patient data
Patient information
Patient safety
Pilot implementation
Pilot projects
Pilot studies
Process indicators
Regional information
Technical indicator
Work-flows
Health
Hospital data processing
Records management
Information technology
article
electronic locum record
electronic medical record
general practitioner
health care policy
interview
medical information
Netherlands
patient information
priority journal
Access to Information
After-Hours Care
Electronic Health Records
Health Policy
Humans
Netherlands
Outcome and Process Assessment (Health Care)
Physicians, Family
To reference this document use:
http://resolver.tudelft.nl/uuid:26de0a51-251b-4e38-91bf-de297ec869b9
TNO identifier
409264
ISSN
1386-5056
Source
International Journal of Medical Informatics, 79 (9), 623-636
Document type
article