General practitioner and nurse practitioner attitudes towards electronic reminders in primary care: A qualitative analysis
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Author(s)
Cecil, Elizabeth
Dewa, Lindsay
Ma, Richard
Majeed, Farrukh
Aylin, Paul
Type
Journal Article
Abstract
Objectives Reminders in primary care administrative systems aim to help clinicians provide evidence-based care, prescribe safely and save money. However, increased use of reminders can lead to alert fatigue. Our study aimed to assess general practitioners’ (GPs) and nurse practitioners’ (NPs) views on electronic reminders in primary care.
Design A qualitative analysis using semistructured interviews.
Setting and participants Fifteen GPs and NP based in general practices located in North-West London and Yorkshire, England.
Methods We collected data on participants’ views on: (1) perceptions of the value of information provided; (2) reminder-related behaviours and (3) how to improve reminders. We carried out a thematic analysis.
Results Participants were familiar with reminders in their clinical systems and felt many were important to support their clinical work. However, participants reported, on average, 70% of reminders were ignored. Four major themes emerged: (1) reaction to a reminder, which was mixed and varied by situation. (2) Factors influencing the decision to act on reminders, often related to experience, consultation styles and interests of participants. Time constraints, alert design, inappropriate presentation and litigation were also factors. (3) Negative consequences of using reminders were increased workload or costs and compromising GP and NPs behaviour. (4) Factors relating to improving users’ engagement with reminders were prevention of unnecessary reminders through data linkage across healthcare administrative systems or the development of more intelligent algorithms. Participants felt training was vital to effectively manage reminders.
Conclusions GPs and NPs believe reminders are useful in supporting the provision of good quality patient care. Improving GPs and NPs’ engagement with reminders centres on further developing their relevance to their clinical practice, which is personalised, considers cognitive workflow and suppresses inappropriate presentation.
Design A qualitative analysis using semistructured interviews.
Setting and participants Fifteen GPs and NP based in general practices located in North-West London and Yorkshire, England.
Methods We collected data on participants’ views on: (1) perceptions of the value of information provided; (2) reminder-related behaviours and (3) how to improve reminders. We carried out a thematic analysis.
Results Participants were familiar with reminders in their clinical systems and felt many were important to support their clinical work. However, participants reported, on average, 70% of reminders were ignored. Four major themes emerged: (1) reaction to a reminder, which was mixed and varied by situation. (2) Factors influencing the decision to act on reminders, often related to experience, consultation styles and interests of participants. Time constraints, alert design, inappropriate presentation and litigation were also factors. (3) Negative consequences of using reminders were increased workload or costs and compromising GP and NPs behaviour. (4) Factors relating to improving users’ engagement with reminders were prevention of unnecessary reminders through data linkage across healthcare administrative systems or the development of more intelligent algorithms. Participants felt training was vital to effectively manage reminders.
Conclusions GPs and NPs believe reminders are useful in supporting the provision of good quality patient care. Improving GPs and NPs’ engagement with reminders centres on further developing their relevance to their clinical practice, which is personalised, considers cognitive workflow and suppresses inappropriate presentation.
Date Issued
2021-07-12
Date Acceptance
2021-06-17
Citation
BMJ Open, 2021, 11
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
11
Copyright Statement
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY (http://creativecommons.org/licenses/by/4.0/). Published by BMJ.
License URL
Sponsor
National Institute for Health Research
Grant Number
DRF-2017-10-181
Subjects
information technology
primary care
quality in health care
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Article Number
e045050.
Date Publish Online
2021-07-12