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Improving general practice computer systems for patient safety: qualitative study of key stakeholders
  1. Anthony J Avery1,
  2. Boki S P Savelyich1,
  3. Aziz Sheikh2,
  4. Caroline J Morris3,
  5. Isobel Bowler1,
  6. Sheila Teasdale4
  1. 1Division of Primary Care, University of Nottingham, Queen’s Medical Centre, Nottingham, UK
  2. 2Division of Community Health Sciences: GP Section, University of Edinburgh, Edinburgh, UK
  3. 3School of Pharmacy & Pharmaceutical Sciences, University of Manchester, Manchester, UK
  4. 4Primary Care Information Services (PRIMIS+), Division of Primary Care, University of Nottingham, Nottingham, UK
  1. Correspondence to:
 Professor A J Avery
 Division of Primary Care, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK; tony.avery{at}


Objective: The authors sought to identify ways in which the use of general practice computer systems could be improved to enhance safety in primary care.

Design: Qualitative study using semistructured interviews.

Participants: Thirty one participants, representing a broad range of relevant disciplines and interest groups. Participants included clinicians, computer system and drug database suppliers, academics with interests in health informatics and members of governmental, professional and patient representative bodies.

Setting: UK.

Results: Participants identified deficiencies in current systems that pose serious threats to patient safety. To bring about improvements, providers need to supply clinicians with safe, accurate and accessible information for decision support; be aware of the importance of human ergonomics in the design of hazard alerts; consider the value of audit trails and develop mechanisms to allow for the accurate transfer of information between clinical computer systems. These improvements in computer systems will be most likely to occur if mandated through regulations. Individual practices are in need of improved education and training which focuses, in particular, on providing support with recording data accurately and using call, recall and reminders effectively.

Conclusion: There are significant opportunities for improving the safety of general practice computer systems. Priorities include improving the knowledge base for clinical decision support, paying greater attention to human ergonomics in system design, improved staff training and the introduction of new regulations mandating system suppliers to satisfy essential safety requirements.

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  • All of the authors on this paper are independent of the National Patient Safety Agency.

  • Competing interests: None declared.

  • Ethics approval: Approval was granted from Nottingham Research Ethics Committee 2 for interviewing GPs involved in this study.

    Contributors: All authors were involved in planning the study, analysing the transcripts and writing the paper. AA and BS conducted the interviews, did the initial and final analyses and wrote the first drafts of the paper. AA conceived of the study and obtained the funding. AA is the guarantor for this study.

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