Requires clear strategies | |
Potential problems and work flow issues were discussed when considering mechanisms. An important aspect was that staff felt that there needed to be clarity about what would happen once a text prompt had been sent to the patient. In particular, there was concern about what should be done if patients did not re-attend. It was suggested that enabling patients to reply to the text prompt would avoid this scenario. | ‘For the prompt I think you would need a good text messaging service so we have got something called Mjog which allows patients to text back so maybe if when they have got a prompt they could maybe text back you know, 1. No symptoms any more so then you still have that feedback if it has completely resolved itself and it hasn’t just gone out into the ether and you haven’t got any feedback.’ (Practice 2) |
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System implications | |
Staff referred to mechanisms already in place when considering whether the intervention would work. It was felt that current mechanisms would support the intervention being embedded into existing electronic templates, providing patient copies, the generation of a text message prompt, and patients being able to reply to the text prompt. However, staff also highlighted potential technical difficulties if practices had different IT systems, necessitating the need for different versions of the intervention. There was discussion about how IT may act as a barrier to the uptake of the intervention and that issues around IT were a major consideration for embedding new practices in primary care. Staff emphasised the importance of working with system developers to successfully implement the intervention in practice. | ‘We frequently give patients regular information don’t we?’ (Practice 1) ‘… it is just time and IT isn’t it? And again what might work well in SystmOne which where a system on practice might not work well in an EMIS practice. I think you would have to have several different versions based on the clinical system and the ability and again text messaging services it depends what practices have signed up for and are willing to pay for as to how it would work.’ (Practice 2) |