Are problem-oriented medial records (POMR) suitable for use in GPs' daily practice?

Problem-oriented functions have been implemented in almost all Belgian GPs' software systems since 2003. We therefore investigated whether some of them - especially the explicit linking procedure between treatments or referrals and the relevant problems - can be used by GPs in their current daily practice. In 2005, within the Belgian ResoPrim project, we organized data collection, mainly around the theme of "hypertension and cardiovascular risk factors", by 26 volunteer GPs' practices using three different software systems. Data were collected prospectively over six weeks in early 2005, and retrospectively for 2004. In this paper we report only on the part of the study that aimed to assess the linking procedure. For all patients and hypertensive patients alike, the key indicators used were the percentage of (problem-) linked drugs among the drugs extracted, the percentage of anti-hypertensive (problem-) linked drugs among anti-hypertensive drugs extracted, and the percentage of (problem-) linked referrals among the number of referrals extracted. For all patients, the data collected relate to 10,914 contacts (7,831 patients) in 2005, and to 74,878 contacts (16,813 patients) in 2004. Large variations were observed per software system and GP, and also over time. The percentage of linked drugs rose from 2% (2004, two GPs) to 36% (2005, fourteen GPs). For linked referrals the percentage was 65% in 2004 vs. 75% in 2005. Our study shows that some functions related to the problem-oriented patient record were spontaneously used by GPs in daily practice. This use increased during collaboration with the primary care research network. This increase was not restricted to the theme of data collection (i.e. not restricted to hypertensive patients, to anti-hypertensive drugs or to links with cardiovascular problems).