This study examines the socio-technical factors that have influenced the adoption of electronic medical records systems within primary care practices in NHSScotland in order to inform future implementations in this sphere. As part of a study on information management processes in the patient surgical pathway in NHSScotland, we carried out 25 in-depth semi-structured interviews with primary care doctors between February 2012 and January 2013. Our previous experience suggests that eliciting user views may serve an important feedback agenda on the part of the users. ![]() The latter may include views of appropriateness relative to the kind of data that technology might produce or transmit. Technology arrives with a set of assumptions about users’ needs, and these may not match user views and expectations. The introduction of new systems and technology is often seen to be disruptive in relation to existing practice. The procurement of primary care EMRs has since been delegated to the 14 territorial NHS boards of Scotland and the migration from GPASS to alternative accredited commercial systems had to be completed nationally by March 2012. The Scottish Health executive eHealth strategy (2008-2011) paved the way for the modernisation of the primary care electronic landscape in Scotland. GPASS was initially developed in the mid-80’s and the system was provided to GPs free of charge by the NHS National Services Scotland. In Scotland, a majority of primary care practices used until recently, an Electronic Medical Records (EMR) system called GPASS (General Practice Administration System for Scotland). GPs routinely use computerised systems within their practices. The majority of healthcare encounters in the UK take place in a primary care setting, with a family doctor, commonly known as a General Practitioner (GP). Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors. Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation. The majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. ![]() We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework. We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years.
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