Fokus on ICPC-coding i General Practics

Student thesis: Master programme thesis

  • Bente Wengler
3 year, Master of Health Informatics (Continuing education) (Continuing Education Programme (Master))
This project has studied the barriers and uncertainties that are in relation to using ICPC classification among general practitioners (AL) and the activities of new users and existing users demand. The study was performed by 3 focus group interviews(FG) with a total of 16 GP from 3 physician practices in RM. Participants were selected from questionnaire on ICPC coding from mid 2008 (SPU 2008), based on criteria of GP using ICPC codes or not and whether they want advice or not. The data were analyzed from DeLones and McLean IS Success Model and a model derived from Knud Illeris (KI) 3 learning dimensions. It appeared, there was a discrepancy between the expected grouping in relation to ICPC coding and guidance, and the answers that were given in SPU 2008. Based on that there are no FG with GP, who don´t want guidance. This group is instead associated with per-sonal expressions of SPU 2008 and the comments that have justified refusal of participa-tion. The result showed that there are barriers and uncertainties in the group that didn’t use coding and the group that did. The informers who doesn’t use coding, has no coincident positions of barriers and uncertainties. It appeared that there were barriers to the EPR sys-tem handling the ICPC code tool, how ICPC coding was used and how it fit into the workflow of the practice with the time pressure in the consultation and that it was difficult to make it become a habit. There is uncertainty to how the coding could be exploited politically. It appears that a benefit could promote engagement. In the group of informants who uses ICPC coding the barriers and uncertainties were expressed as to if the EPR system could handle the ICPC coding better and if the ICPC classification should be more specific. There is a difference between the need for guidance for doctors coding and the doctors not coding, both in relation to form of guidance, content, and compared to the need for practical training. The results obtained were discussed in relation to the KI didactic model and theory on the 3 dimensions, contents, driver (motivation) and interaction. A socio-technical approach was involved in discussions in relation to the organizational influ-ence. The conclusion of the study indicates that there is a need for different learning services to the doctors who uses coding and the doctors who dont and that the doctors who certainly do not want guidance will not be supported with training ICPC coding. The conclusion is also that the EPR systems lack of maturity can be an obstacle to the ICPC coding. A response must be established in which, as a starting point a strong vision for the ICPC coding is created, and a response where focus is on a context which ICPC coding is a part of, all of that in relation to patient care and workflow in practice. The project provides an education for activities to promote and support the ICPC coding in the GP supported by the results of this project.
Publication date2009
Number of pages121
Publishing institutionÅlborg Universitet
ID: 17589627