Email updates

Keep up to date with the latest news and content from BMC Medical Informatics and Decision Making and BioMed Central.

Open Access Research article

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

Matt-Mouley Bouamrane1* and Frances S Mair2

Author Affiliations

1 University of Aberdeen, Institute of Applied Health Sciences, Aberdeen, Scotland, UK

2 College of Medical, Veterinary and Life Sciences, Institute of Health & Well-Being, Glasgow, Scotland, UK

For all author emails, please log on.

BMC Medical Informatics and Decision Making 2014, 14:30  doi:10.1186/1472-6947-14-30

Published: 9 April 2014

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 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.

Keywords:
(Mesh); Perioperative nursing; Medical informatics applications; Information systems