Article Figures & Data
Figures
- Figure 1. Screenshots of EMIS software to show electronic clinical decision support for melanoma. eCDS = electronic clinical decision support.
- Figure 2. Overview of the Consolidated Framework for Implementation Research as applied to eCDS tools. eCDS = electronic clinical decision support.
Tables
n (%) Age Mean age, years (range) 44 (27–60) ≤40 years 5 (36) 41–50 years 4 (29) ≥51 years 5 (36) Sex Female 9 (64) Male 5 (36) Ethnicity White British 11 (79) Asian British 1 (7) Mixed 1 (7) Other ethnic group 1 (7) Years since qualification Mean number of years (range) 17 (0–33) ≤5 years 5 (36) 6–25 years 5 (36) ≥26 years 4 (29) n (%) Age Mean age, years (range) 63 (36–80) <60 years 5 (36) 60–69 years 4 (29) ≥70 years 5 (36) Sex Female 11 (79) Male 3 (21) Ethnicity White British 14 (100) Highest qualification None 2 (14) GCSE equivalent 7 (50) A-level 1 (7) Undergraduate degree 2 (14) Postgraduate 1 (7) PhD 1 (7) Employment status Retired 9 (64) Working 4 (29) Homemaker 1 (7) Consultation outcome Referral to a specialist 6 (43) No further action 8 (57) - Table 2. Illustrative quotations from each patient about their consultation, including whether they were examined, whether a checklist or computer tool was used, and whether they were referred.
Patient
ID, sex, ageExamination Checklist use Computer use Referral
Yes/No01, F,
<60 years'A junior doctor, she took some notes and she thought it was probably one of those keratosey things … she’d had a look through one of those little glass things that they put up, and she thought it was probably okay … Dr A came in to check what she’d said to me, he couldn’t look through one of those things and, because of my history, that’s why he sent me up' 'I don’t remember that, no' 'Yeah, she looked at it, asked me questions, I don’t remember them being questions on computer, it was more why was I worried about it…' Y 02, F,
60–69 years'She measured the dark brown marks and she looked at the others and said, “Yes, it had cleared up”' 'No' 'No, only to look up because she wasn’t the one who started the tablets off, to see how long I’d been taking them and no, not really' Y 03, M,
60–69 years'Yeah, she did … as I recall she looked at it, and then I think she just stretched the skin a little bit by it, you know, put her finger either side of it and just pulled it like that and looked at it again and … well I don’t think she asked me if I’d got any problems anywhere else, she just sort of felt my arms and then she said, “Well I think the best thing is to… get a specialist to look at it”' 'No, I didn’t [notice]' n/a Y 04, F,
≥70 years'He took a photo and he looked at it, you know, with a sort of glass and he said "Well I think it's a small growth" and … I can't think what happened then… "We'll have to keep an eye on it", I think that's what he said' 'No, no.' 'Sometimes you can go there and see one and he never looks at you at all and he just types, but this one, he did sit and look at it, and then type it in, you know' Y 05, F,
≥70 years'She just recommended that I saw a dermatologist.' 'No' n/a Y 06, F,
≥70 years'I obviously explained why I was there and that I’d been before and when, and he … tracked it down on a computer and found his notes from the previous consultation. And then he looked at it with a magnifying glass and he measured it and he … asked me if it was painful and if it was itchy and I’d already told him that I wasn’t sure but I thought it might have changed colour a bit and got a bit bigger' 'Right, well, I’m not aware of him using a specific tool, if … you’re really looking at the effectiveness of this tool' 'Yeah, he did use the computer during the consultation but they always do, don’t they? It didn’t seem that he used it any more or any less than normal' Y 07, F,
<60 years'She had look at it and I think, I explained my history because I hadn’t seen this lady with my previous back thing, so she read the notes' 'No, I don’t remember that, no, we just talked about it and she read my notes' 'No' N 08, F
<60 years'I asked her just to check them, so she had a look and she said they look absolutely fine, they do just naturally grow but she didn’t have any concerns with them at all … I think, yeah, just with her own eyes. I was going to say did she measure them but I don’t think she did. No, 'cos I really don’t think she was concerned about it.' 'No' 'No' N 09, M
<60 years'Well, I just took my top off and she checked it, and then got, I know she looked through whatever it is they look through with their light or whatever, I don’t know what it’s called' 'Not really, no I don’t think so … to be honest I can’t remember, but I don’t think so.' 'No' N 10, M,
<60 years'She looked at it by rubbing some funny gel on it and putting like a spy glass on it, I’m sure you’re familiar with that, I suspect it just aids the visibility. She informed me at that time that it was nothing problematic but offered to whip it off with some freezy spray next time I was in …' 'I don’t recall her looking at any, she didn’t give me any check sheets or computer stuff, no' 'I really can’t remember but I don’t think so' N 11, F,
60–69 years'He looked at it with a magnifying light and he did study it, yes, and I think he probably asked me how long I'd looked at it' 'No I don't think [so]' 'I don't think so' N 12, F,
60–69 years'I showed her and she had a look at it, she measured it with a little tool thing and she said she really couldn’t see anything wrong with it … I think she just measured it. It was a sort of a measuring device' 'No, no. I don’t think there was any need because it’s so unsinister' n/a N 13, F,
≥70 years'I just explained the background, I said something about what was there and she had a look at it, and we spent enough time I felt with it, I was quite satisfied and I'm not sure what instrument she looked at it through, it was just a little black handheld thing that, you know, she looked at it very closely' 'No, no, because that wasn't the main thing I was really going there about so I guess she was running out of time too, but she did a good job, I was satisfied' n/a N 14, F,
≥70 years'She had a look at them, she said there was only one that might possibly be and so the point of taking a photograph was to see if it got bigger because … that would be a sign that there might be something to worry about … We’ve done two further checks when I’ve been there for something else and both times she thought it hadn’t got bigger, this particular one that she’s keeping her eye on and photographing' 'No I’m quite sure she didn’t' n/a N
In this issue
Understanding implementation and usefulness of electronic clinical decision support (eCDS) for melanoma in English primary care: a qualitative investigation
Jump to section
Keywords
More in this TOC Section
Related Articles
Cited By...
Advertisement
