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CC BY-NC-ND 4.0 · Yearb Med Inform 2021; 30(01): 044-055
DOI: 10.1055/s-0041-1726489
Special Section: Managing Pandemics with Health Informatics
Working Group Contributions

Primary Care Informatics Response to Covid-19 Pandemic: Adaptation, Progress, and Lessons from Four Countries with High ICT Development

Authors

  • Siaw-Teng Liaw

    1   WHO Collaborating Centre on eHealth, UNSW Sydney, Australia

  • Craig Kuziemsky

    2   MacEwan University, Edmonton, Alberta, Canada

  • Richard Schreiber

    3   Penn State Health Holy Spirit Medical Center, Camp Hill, Pennsylvania, USA

  • Jitendra Jonnagaddala

    1   WHO Collaborating Centre on eHealth, UNSW Sydney, Australia

  • Harshana Liyanage

    4   Nuffield Department of Primary Care Health Sciences, University of Oxford, UK

  • Aliasgar Chittalia

    5   Family Practice Center, Mountaintop, Pennsylvania, USA

  • Ravninder Bahniwal

    6   Schulich Interfaculty Program in Public Health, Western University, London, Canada

  • Jennifer W. He

    7   Graduate Program in Epidemiology and Biostatistics, Western University, London, Canada

  • Bridget L. Ryan

    8   Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Canada

  • Daniel J. Lizotte

    9   Department of Computer Science, Western University, London, Canada

  • Jacqueline K. Kueper

    7   Graduate Program in Epidemiology and Biostatistics, Western University, London, Canada

  • Amanda L. Terry

    8   Centre for Studies in Family Medicine, Department of Family Medicine, Western University, London, Canada

  • Simon de Lusignan

    4   Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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Summary

Objective: Internationally, primary care practice had to transform in response to the COVID pandemic. Informatics issues included access, privacy, and security, as well as patient concerns of equity, safety, quality, and trust. This paper describes progress and lessons learned.

Methods: IMIA Primary Care Informatics Working Group members from Australia, Canada, United Kingdom and United States developed a standardised template for collection of information. The template guided a rapid literature review. We also included experiential learning from primary care and public health perspectives.

Results: All countries responded rapidly. Common themes included rapid reductions then transformation to virtual visits, pausing of non-COVID related informatics projects, all against a background of non-standardized digital development and disparate territory or state regulations and guidance. Common barriers in these four and in less-resourced countries included disparities in internet access and availability including bandwidth limitations when internet access was available, initial lack of coding standards, and fears of primary care clinicians that patients were delaying care despite the availability of televisits.

Conclusions: Primary care clinicians were able to respond to the COVID crisis through telehealth and electronic record enabled change. However, the lack of coordinated national strategies and regulation, assurance of financial viability, and working in silos remained limitations. The potential for primary care informatics to transform current practice was highlighted. More research is needed to confirm preliminary observations and trends noted.

Keywords

Telemedicine - Primary Health Care - health policy - public health - severe acute respiratory syndrome coronavirus 2


Publication History

Article published online:
21 April 2021

© 2021. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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