Essential requirements of information technology for primary care.

Policy, economics and technology are driving primary care with unprecedented speed. Responding to this rapidly changing environment is essential for maintaining state-of-the-art care delivery. Although Health Information Technology (HIT) offers much promise to primary care, electronic health records (EHRs) have produced only modest improvements in quality. To understand how HIT could better meet the needs of primary care, the North American Primary Care Research Group (NAPCRG) gathered a select group of Family Medicine physicians from across North America and Europe with a broad range of informatics expertise. Over several months, the group discussed existing standards, classifications, modelling, communications, data structures, coding systems and how each of these enabled or hindered primary care delivery. During the discussions, a broad consensus emerged on HIT requirements essential to the primary care domain. This summary provides the author’s interpretation of the identified technical challenges in ontology, terminology, continuity and portability in terms more familiar to most Family Physicians. Although standardized EHR capabilities are described by Health Level Seven International [(www.hl7.org) a global standards development organization for health information], little is known about specific capabilities important to primary care. The committee characterized information services in terms of the capacity to support Family Medicine core values. Enhancement of continuing, comprehensive, compassionate and personal care provided an indication of responsiveness to primary care. The recommendations below reflect the most important challenges identified and provide a qualitative measure to discriminate HIT support for essential primary care services. The committee focussed on areas with known problems in order to guide providers, promote research and spur development by vendors.