Does Informatics Enable or Inhibit the Delivery of Patient-centred, Coordinated, and Quality-assured Care: a Delphi Study

Journal: IMIA Yearbook
ISSN: 0943-4747

Patient-Centered Care Coordination

Issue: 2015: IMIA Yearbook 2015
Pages: 22-29
Ahead of Print: 2015-06-30

Does Informatics Enable or Inhibit the Delivery of Patient-centred, Coordinated, and Quality-assured Care: a Delphi Study

A Contribution of the IMIA Primary Health Care Informatics Working Group

Special Section: Patient-centered Care Coordination

Working Group Contributions

H. Liyanage (1), A. Correa (1), S-T. Liaw (2), C. Kuziemsky (3), A. L. Terry (4), S. de Lusignan (1)

(1) Department of Health Care Management & Policy, University of Surrey, Guildford, Surrey, UK; (2) School of Public Health & Community Medicine, UNSW Medicine, Australia; (3) Telfer School of Management, University of Ottawa, Ontario, Canada; (4) Centre for Studies in Family Medicine, Western University, London, Ontario, Canada


Clinical informatics, patient-centred care, patient participation, healthcare quality assurance, computerised medical records


Background: Primary care delivers patient-centred and coordinated care, which should be quality-assured. Much of family practice now routinely uses computerised medical record (CMR) systems, these systems being linked at varying levels to laboratories and other care providers. CMR systems have the potential to support care. Objective: To achieve a consensus among an international panel of health care professionals and informatics experts about the role of informatics in the delivery of patient-centred, coordinated, and quality-assured care. Method: The consensus building exercise involved 20 individuals, five general practitioners and 15 informatics academics, members of the International Medical Informatics Association Primary Care Informatics Working Group. A thematic analysis of the literature was carried out according to the defined themes. Results:The first round of the analysis developed 27 statements on how the CMR, or any other information system, including paper-based medical records, supports care delivery. Round 2 aimed at achieving a consensus about the statements of round one. Round 3 stated that there was an agreement on informatics principles and structures that should be put in place. However, there was a disagreement about the processes involved in the implementation, and about the clinical interaction with the systems after the implementation. Conclusions: The panel had a strong agreement about the core concepts and structures that should be put in place to support high quality care. However, this agreement evaporated over statements related to implementation. These findings reflect literature and personal experiences: whilst there is consensus about how informatics structures and processes support good quality care, implementation is difficult.

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