[Qualitative approach to the attitudes and expectations of doctors during the process of computerising primary care]

Abstract

Objective: To find the attitudes and expectations of doctors during the process of computerising primary care (PC).

Design: Qualitative investigation through discussion groups.

Participants: Thirty-one doctors from the two PC regions of Gipuzkoa.

Method: Intentional stratified sampling by regions and by experience in using a computer in the consulting-room. Five discussion groups with recording and transcription of the contents with prior authorisation and guarantee of confidentiality. Qualitative analysis of the notes and transcriptions with the help of computer back-up. Validation through sending of results to participants and discussion between the authors.

Results: Introducing computers into PC consulting-rooms had repercussions both on the ordering and contents of the information recorded. The effort <<to know what is being done>> was not accompanied by subsequent evaluation. Notable deficiencies in management of the computerising process were perceived. Computer use created additional symbolic effects for both patients and doctors.

Conclusions: Computerising PC is a process whose repercussions on medical care are far from neutral and so require rigorous discussion and evaluation. Defining step-by-step and measurable objectives, transparency in management and the promotion of evaluative research would all favour the effective development of projects to computerise PC.