Faculty Opinions recommendation of Artificial intelligence and the future of primary care: exploratory qualitative study of UK general practitioners' views.

BACKGROUND In recent decades, virtual care has emerged as a promising option to support primary care delivery. However, despite the potential, adoption rates remained low. With the outbreak of COVID-19, it has suddenly been pushed to the forefront of care delivery. As we progress into the second year of the COVID-19 pandemic, there is a need and opportunity to review the impact remote care had in primary care settings and reassess its potential future role. OBJECTIVE This study aims to explore the perspectives of General Practitioners / Family Doctors (GPs/FDs) on a.) use of virtual care during the COVID-19 pandemic; b.) perceived impact on quality and safety of care; c.) essential factors for high-quality and sustainable use of virtual care in the future. METHODS Online cross-sectional questionnaire of GPs/FDs, distributed across 20 countries. The survey was hosted in Qualtrics and distributed using email, social media, and the researchers’ personal contact networks. General Practitioners were eligible for the survey if they were working mainly in primary care during the period of the COVID-19 pandemic. Descriptive statistical analysis will be performed for quantitative variables, and subgroup analyses will be conducted to explore the relationships between the use of virtual care and perceptions on impact on quality and safety of care, and participants’ characteristics. Qualitative data (free-text responses) will be analysed using framework analysis. RESULTS N/A CONCLUSIONS The study will provide a comprehensive overview of the availability of virtual care technologies, perceived impact on quality and safety of care and essential factors for high-quality future use. In addition, a description of the underlying factors that influence this adoption and perceptions, in both individual GP/FD characteristics, and the context in which they work, will be provided. While the COVID-19 pandemic may prove the first great stress test of the capabilities, capacity, and robustness of digital systems currently in use, remote care will likely remain an increasingly common approach in the future. There is an imperative to identify the main lessons from this unexpected transformation and use them to inform policy decisions and health service design.

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Views of general practitioners on the use of STOPP&START in primary care: a qualitative study

Acta Clinica Belgica ◽

10.1179/2295333714y.0000000036 ◽

2014 ◽

Vol 69 (4) ◽

pp. 251-261 ◽

Cited By ~ 15

Author(s):

O. Dalleur ◽

J-M. Feron ◽

A. Spinewine

Keyword(s):

Primary Care ◽

Qualitative Study ◽

General Practitioners

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Envisioning an artificial intelligence documentation assistant for future primary care consultations: A co-design study with general practitioners

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocaa131 ◽

2020 ◽

Vol 27 (11) ◽

pp. 1695-1704

Author(s):

A Baki Kocaballi ◽

Kiran Ijaz ◽

Liliana Laranjo ◽

Juan C Quiroz ◽

Dana Rezazadegan ◽

...

Keyword(s):

Artificial Intelligence ◽

Primary Care ◽

General Practitioners ◽

Legal Aspects ◽

Models Of Care ◽

Professional Autonomy ◽

Existing Problems ◽

Ensure Patient Safety ◽

Inductive Thematic Analysis

Abstract Objective The study sought to understand the potential roles of a future artificial intelligence (AI) documentation assistant in primary care consultations and to identify implications for doctors, patients, healthcare system, and technology design from the perspective of general practitioners. Materials and Methods Co-design workshops with general practitioners were conducted. The workshops focused on (1) understanding the current consultation context and identifying existing problems, (2) ideating future solutions to these problems, and (3) discussing future roles for AI in primary care. The workshop activities included affinity diagramming, brainwriting, and video prototyping methods. The workshops were audio-recorded and transcribed verbatim. Inductive thematic analysis of the transcripts of conversations was performed. Results Two researchers facilitated 3 co-design workshops with 16 general practitioners. Three main themes emerged: professional autonomy, human-AI collaboration, and new models of care. Major implications identified within these themes included (1) concerns with medico-legal aspects arising from constant recording and accessibility of full consultation records, (2) future consultations taking place out of the exam rooms in a distributed system involving empowered patients, (3) human conversation and empathy remaining the core tasks of doctors in any future AI-enabled consultations, and (4) questioning the current focus of AI initiatives on improved efficiency as opposed to patient care. Conclusions AI documentation assistants will likely to be integral to the future primary care consultations. However, these technologies will still need to be supervised by a human until strong evidence for reliable autonomous performance is available. Therefore, different human-AI collaboration models will need to be designed and evaluated to ensure patient safety, quality of care, doctor safety, and doctor autonomy.

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A preliminary qualitative study of general practitioners’ views on malnutrition management and oral nutritional supplementation prescription in the community

Proceedings of The Nutrition Society ◽

10.1017/s0029665120002803 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Patricia Domínguez Castro ◽

Sharon Kennelly ◽

Barbara Clyne ◽

Gerard Bury ◽

Catriona Bradley ◽

...

Keyword(s):

Primary Care ◽

At Risk ◽

Qualitative Study ◽

General Practitioners ◽

Health Care Professionals ◽

Inappropriate Prescribing ◽

Community Setting ◽

Community Dwelling ◽

Care Community ◽

Oral Nutritional Supplements

AbstractMalnutrition, arising from a deficiency of energy and protein intake, occurs commonly among community-dwelling individuals. Oral nutritional supplements (ONS) are an effective method of managing malnutrition if prescribed for patients who are malnourished or at risk of malnutrition. However, previous research indicates that inappropriate prescribing of ONS occurs frequently in the community setting (30–70% prevalence). Moreover, it has been previously shown that the management of patients ‘at risk’ of malnutrition in the primary care/community setting in Ireland is sub-optimal, with low awareness of the condition and its management among non-dietetic health care professionals (HCPs). In Ireland, general practitioners (GPs) are the main prescribers of ONS in primary care. They are also on many occasions the first point of contact for individuals in the community who are malnourished or at risk of malnutrition. Therefore, exploring their experiences and perceptions can provide insight into the complexities of managing malnutrition and ONS prescribing in the community. The aim of this qualitative study was to explore GPs’ experiences and opinions on the management of malnutrition and the prescription of ONS in the primary care/community setting in Ireland. Semi-structured interviews were conducted with nine GPs. The interview explored among others the following domains; Barriers and facilitators in the management of malnutrition, ONS prescribing in the primary care/community setting, and future directions in the management of malnutrition and ONS prescribing. Recorded interviews were transcribed and analysed using inductive thematic analysis. Three main themes were identified; i) Malnutrition a secondary concern, encapsulating the idea that malnutrition is not something that GPs screen for in isolation ii) Resources and support for managing malnutrition are needed in the community iii) Reluctance to prescribe ONS. GPs reported not screening for malnutrition, but viewed it as a consequence of other conditions and social factors. According to the GPs, they should not have sole responsibility for malnutrition management and more dietitians and trained community nurses would be desirable to support them to deal with malnutrition in the community. A preference to avoid supplementation and implement dietary changes first was expressed by GPs. As main prescribers, GPs thought that they should receive further independent trainingon the different ONS available in the market as currently they did not feel confident prescribing a range of them. Awareness of ONS cost and its misuse by certain patients were reported as reasons that made GPs reluctant to prescribe them, potentially leading to under prescribing.

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