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This paper reports on selected findings from a Danish national survey of citizens' perception and use of information and communication technology (ICT) for their health care [1]. Focus is on citizens' use of ICT and on communication with their General Practitioner (GP). It also focuses on citizens' experience of their GPs' ICT use and no use during medical consultations. The responsibility for medical service in Denmark is to a large extent handed over to the primary sector where the GP is the gatekeeper. Our data display that 65% of the adult citizens or their relatives have been using ICT to communicate with their GP. Twenty-two percent have experienced their GP use a computer screen to actively show them something while they have a consultation. Further, our data supports the assumption that the higher the education people have, the more likely they are to use ICT for their health care. The understanding of the use of ICT in communication with the GP is central to monitoring and developing an ICT that supports all citizens and considers new ways in which to enhance quality of care. [ABSTRACT FROM AUTHOR]

The objective of this research is to explore the nature of the interplay among various institutional influences within public sector institutional fields in circumstances where radical institutional change originating from financial and non-financial concerns is present. The paper uses insights from the institutional logics theory in the context of hospital commissioning in the English National Health Service (NHS). It argues that multiple institutional logics coexist, conflict, and compete with one another in the newly-reformed healthcare field in England. These logics are: the medical/professional logic, the neo-liberal business logic, and the governance logic, among others. New legislative structures, inspired by the political logic, have exacerbated the tensions among logics, while bringing opportunities for competing and conflicting logics to complement one another in harmony in the persona of the new GP-commissioner hero. [ABSTRACT FROM AUTHOR]

Electronic Health Records (EHRs) can be used for research but this raises the problem of data quality. Objective: To evaluate the quality of the information recorded in an EHR by a general practitioner (GP) during a regular office consultation. Method: 191 dialogs between the GP and patient were recorded and translated into the International Classification of Primary Care Second edition (ICPC-2) codes. Written information of the corresponding EHR was extracted and coded for comparison. Results: The primary reason for the consultation was recorded in the EHR in 41.2% of the cases and the diagnosis in 44.1% of the cases. Diagnoses noted in the EHR were less often communicated to the patients than the primary reasons (p<0.0001). Conclusion: There is a loss of information between the dialog during a consultation and what is reported in the EHR. Consequences in terms of continuity and safety of care can be expected. [ABSTRACT FROM AUTHOR]

In Australia, general practice (GP) acts as the gatekeeper to the rest of the healthcare system, and therefore the vast majority of the population have an electronic medical record. It follows that the largest database of the population is therefore on the distributed GP computers. Informed by a comprehensive system-wide data strategy, the Population Level Analysis and Reporting program extracts data from the GP electronic medical records and repurposes it for multiple uses. The program requires the data to be coded and then structured for multiple uses clinical care, clinical governance, research, and policy. [ABSTRACT FROM AUTHOR]

We designed, constructed, and evaluated a mobile medical care vehicle called "Rollende Arztpraxis" (rolling medical practice, RMP) that delivers the full medical care of a general practitioner to increase medical care supply in rural areas. Six communities have been identified, where the RMP has been visited 501 times in 14 months. Two different schedules of stops and treatment times have been tested. We show that the RMP treated mainly elderly and multimorbid patients. An accompanying study showed high acceptance and satisfaction of treated patients and treating doctors. An economic evaluation of three different utilization models with three treatment modes each showed no financial sustainability. We show that ambulatory care in rural areas can be complemented by a mobile care unit, if legal and financial barriers can be overcome. [ABSTRACT FROM AUTHOR]