Violence

November 2011

Research

Web based diabetes care planning

Sociotechnical barriers to implementation in general practice

Volume 40, No.11, November 2011 Pages 915-917

Akuh Adaji

Peter Schattner

Leon Piterman

Background

This research explored the sociotechnical barriers in the implementation of web based diabetes care plans in general practice from the perspective of implementing stakeholders.

Methods

A qualitative case study design was use to explore the sociotechnical barriers. Twenty-one stakeholders were purposely recruited and interviewed.

Results

Technological barriers included rudimentary IT applications in general practice; standardisation and interoperability issues; and ‘bugs’ in the system. The role of practice managers as gatekeepers influenced the uptake of the technology. General practitioners were noted to be time poor, while practice nurses preferred to stick with paper based ways of doing care plans. The relationship between allied health professionals and GPs also influenced the adoption process.

Discussion

Implementers had significant insight into the sociotechnical barriers to diabetes web based care planning in general practice. Future research should examine the roles of the stakeholders involved in determining standards and the interoperability of systems.

The use of care plans in the management of patients with chronic disease is a common practice within primary care. A care plan is 'a written, comprehensive, and longitudinal plan of action that sets out the healthcare needs of a patient and the types of services and supports needed to meet those needs'.1 In Australia, the care planning process is initiated by the general practitioner in consultation with the patient, and sometimes with the assistance of the practice nurse. Two types of care plans (Table 1) are funded by Medicare: a General Practice Management Plan (GPMP) and a Team Care Arrangement (TCA).

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Correspondence afp@racgp.org.au

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For more information see Wikipedia: Comparison of reference management software
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Research