Petrova Mila, Barclay Matthew, Barclay Sam S, Barclay Stephen I G
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Int J Med Inform. 2017 Aug;104:74-83. doi: 10.1016/j.ijmedinf.2017.05.009. Epub 2017 May 17.
In the UK, General Practitioners and Practice Managers are key to enabling health information exchange (typically referred to as 'data sharing'). This study aimed to survey GPs and PMs for familiarity, engagement with and perceptions of patient data sharing.
Cross-sectional survey. All 107 general practices in England's second largest Clinical Commissioning Group, Cambridgeshire & Peterborough CCG. Descriptive statistics; hierarchical logistic regression; thematic analysis.
405 (64%) responses were received - from 338 (62%) GPs and 67 (71%) PMs. Familiarity and engagement were highest for local frail elderly and end of life care projects (>76% had used). The greatest difference in use concerned the now suspended national care.data initiative: PMs had odds of reporting use 75 times higher than GP partners (95% CI 27-211). Patient confusion was the most pronounced challenge and improved coordination the most pronounced expected benefit. Frequency of discussions with patients varied with IT competence (OR 4.2 for most competent users relative to least, 95% CI 1.7-10.7) and clinical system (OR 0.3, 95% CI 0.1-0.5). Patient reservations were reported more frequently by respondents who rated their IT competence as highest (OR 3.3, 95% CI 1.5-7.6), perceived more data sharing challenges (OR for a 1-point increase in challenges perception score 3.4, 95% CI 2.1-5.6) and by PMs (relative to GP partners, OR 18.0, 95% CI 7.9-41.3).
Familiarity with and use of data sharing projects was high among GPs and PMs. Both their individual and organisational characteristics were associated with the reported frequency of discussions and patients' responses. Improved awareness of the impact of provider characteristics and attitudes on patients' decisions about data sharing may enhance the equity and autonomy of those decisions.
在英国，全科医生和诊所管理人员是实现健康信息交换（通常称为“数据共享”）的关键。本研究旨在调查全科医生和诊所管理人员对患者数据共享的熟悉程度、参与情况及看法。
横断面调查。对英格兰第二大临床委托集团剑桥郡及彼得伯勒临床委托集团的所有107家全科诊所进行调查。采用描述性统计、分层逻辑回归和主题分析。
共收到405份（64%）回复，其中338份（62%）来自全科医生，67份（71%）来自诊所管理人员。对当地体弱老年人和临终关怀项目的熟悉程度和参与度最高（超过76%的人使用过）。使用情况差异最大的是现已暂停的国家care.data计划：诊所管理人员报告使用该计划的几率比全科医生合伙人高75倍（95%置信区间27 - 211）。患者困惑是最突出的挑战，而改善协调是最突出的预期益处。与患者讨论的频率因信息技术能力（最有能力的用户相对于能力最差的用户的比值比为4.2，95%置信区间1.7 - 10.7）和临床系统（比值比为0.3，95%置信区间0.1 - 0.5）而异。将自己的信息技术能力评为最高的受访者（比值比为3.3，95%置信区间1.5 - 7.6）、认为数据共享挑战更多的受访者（挑战感知得分每增加1分的比值比为3.4，95%置信区间2.1 - 5.6）以及诊所管理人员（相对于全科医生合伙人，比值比为18.
