Supplementary table 1 Example of reviewing - Church GP01 P02 (EMIS) | ||||||
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Display | Cursor selecting P02 from front desk | Consultation History displayed (15-July_2010) highlighted | Recent problem (18-June-2010) highlighted; Details of examination on 18-June_2010 displayed | Current Prescribing displayed | Medical Record - Problem Management details displayed | Scrolling through Consultation History |
Time | 00:00 | 00:02 | 00:12 | 00:31 | 00:35 | 00:37 |
Finding the patient led immediately to a fleeting display of quality outcome framework (QOF) indicators, indicative of long-term conditions; a particular consultation is displayed (perused) for 10 seconds then a recent problem is highlighted and explored for 19 seconds. A brief look at current prescribing (4 seconds) took place with a return to the medical record and a (6 second) scroll through history. |
Supplementary table 2 Example of reviewing - Seaside GP01 P16 (INPS Vision) | ||||||
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Display | EHR opens on Problems tab; Examination findings highlighted in filter | Move to history page and scrolling through history | Cursor on log for problem (21/01/11) and entry highlighted (00:25) | Document Viewer - Clinical letter from 17-May-10 highlighted:- 'CHOOSE & BOOK'; read letters (18-Nov-09 @ 0:46); (02-Nov-09 @ 0:55), | Cursor on close (1:05) Journal - Therapy (list of drugs prescribed repeats) (1:08) | Displaying Journal (21/02/11 problem highlighted until 06:20 |
Time | 00:04 | 00:07 | 00:17 | 00:35 | 01:04 | 01:12 |
When letters and results were reviewed in preparing for the patient-consultation, they may be used to create the narrative in taking history. Interruptions to this reviewing process (e.g. a telephone call about a different patient) resulted in the GP repeating much of the review. The GP was able to switch to the review of the clinical letter at 06:23 in the patient consultation before reviewing a therapy at 06:35.. |