Understanding implementation and usefulness of electronic clinical decision support (eCDS) for melanoma in English primary care: a qualitative investigation.
Royal College of General Practitioners
MetadataShow full item record
Pannebakker, M., Mills, K., Johnson, M., Emery, J. D., & Walter, F. (2019). Understanding implementation and usefulness of electronic clinical decision support (eCDS) for melanoma in English primary care: a qualitative investigation.. BJGP open, 3 (1), bjgpopen18X101635. https://doi.org/10.3399/bjgpopen18x101635
Background: Timely diagnosis of the serious skin cancer melanoma can improve patient outcomes. Clinical guidelines suggest that GPs use checklists, and the 7-point checklist has been disseminated by EMIS as an electronic clinical decision support tool (eCDS). Aim: To understand GP and patient perspectives on the implementation and usefulness of the eCDS. Design and Setting: Semi-structured interviews with GPs and patients set in four South East of England general practices following consultations using the eCDS for suspicious pigmented lesions. Method: Interviews were recorded and transcribed verbatim. The Consolidated Framework for Implementation Research underpinned analysis using thematic approaches. Results: 14 interviews with GPs and 14 with patients were undertaken. Most GPs reported that, as the eCDS was embedded in the medical record, it was useful, easy to use, time efficient, and could facilitate patient-GP communication. They were less clear that it could meet policy or patient needs to improve early diagnosis, and some felt that it could lead to unnecessary referrals. Few felt that it had been sufficiently implemented at practice level. More felt confident with their own management of moles, and that the eCDS could be most useful for borderline decision-making. No patients were aware that the eCDS had been used during their consultation. Conclusions: Successful implementation of a new tool such as eCDS for melanoma requires GPs to perceive its value and understand how it can best be integrated into clinical practice. Disseminating a tool without such explanations is unlikely to promote its adoption into routine practice.
National Institute for Health Research (NIHR-CS-012-030)
Embargo Lift Date
External DOI: https://doi.org/10.3399/bjgpopen18x101635
This record's URL: https://www.repository.cam.ac.uk/handle/1810/288201