Information flows in the new primary care organisations: Rhetoric versus reality

Background: Primary care organisations (PCOs) are required to collect, collate and analyse information from primary, secondary and community care services, in order to assess the health status of populations, to develop and monitor health improvement plans and to implement clinical governance. Objective: To examine the current state of information management among PCOs in west London. Methods: A semi-structured interview administered to a purposive sample of 20 clinicians and managers from PCOs and health authorities in west London and the regional office. Interview transcripts were analysed using the technique of constant comparison. Results: The potential value of information derived from primary care and the necessity of moving towards electronic data capture were perceived by all those interviewed. Wide variation across organisations was observed in computerisation and clinical system use, which could explain differences in the completeness and quality of electronic data capture across west London, and the degree to which data are used to develop services. Data from secondary care and community trusts were judged inadequate to monitor quality of care. Respondents reported that their organisations lacked resources to collate and analyse data, but were interested in collaboration with outside agencies. Ethical issues causing concern included patient consent to the use of data by organisations outside the primary care group, data confidentiality and security. Conclusions: PCOs will not be able to monitor the health status of their populations or the progress of initiatives such as control of hypertension in the diabetic population until they develop reliable electronic data capture and have the resources to collate and analyse data.