Our role in EFMI
EFMI WG PCI Primary Care Informatics
last update : April 2011
The Primary Care Informatics Working Group (PCI WG) aims to promote the further development of this emerging scientific discipline [1,2]. We are always keen to welcome new members and to encourage international debate and discussion. We have managed to publish papers based on our workshops over the last three years and intend to continue this.
The objectives of the working group are congruent with those of EFMI, but focussed on a primary care perspective:
- To advance international cooperation and the dissemination of information about primary health care informatics, as a scientific discipline based on empirical research and part of clinical practice.
- To promote high standards in the application and practice of primary health care informatics
- To promote research and development to develop a core generaliseable theory for primary care informatics
- To encourage high standards in education in health informatics, especially for primary health care
Primary Care Informatics is the scientific study of data, information and knowledge, and how they can be modelled, processed or harnessed to promote health and develop patient-centred primary medical care. Its methods reflect the biopsychosocial model of primary healthcare and the longitudinal relationships between patients and professionals. Its context is one in which patients present with unstructured problems to specially trained primary care professionals who adopt a heuristic approach to decision making within the consultation. 
To help achieve its objectives the activities of the working group are to be focussed around defined themes. The list is not exhaustive and other themes can be added or removed depending on the wishes of the group. However its aim is to maintain focus, and make it more likely that the group will achieve some useful outcomes.
- Data quality:
Exploring the barriers to the coding of structured information in Primary Care and how these may be overcome. This work includes (1) Data quality initiatives; (2) To ensure that research based on routinely collected data reflects how these clinical concepts are represented in clinical records; (3) To explore the extent to which we can interpret health data without access to the free-text record (generally the free-text record is not included in studies based on routinely collected primary care data). 
- The use of computers in patient-centred consultations:
Primary care is delivered through consultations. Usually these are one-to-one encounters between the patient and the healthcare professional. Use of the computer tends to interfere with the patient centred tone of the consultation. The challenge is to develop technology that supports patient centred consulting. We have developed a taxonomy of how evaluation in this domain should be reported, which has been submitted to the 2011 IMIA Yearbook.
- e-Health initiatives:
Telemedicine and telemonitoring of patients in their own homes has been demonstrated in a wide range of clinical settings. They are slowly being integrated into mainstream practice. The working group will wish to explore the characteristics of the scalable e-health initiative, and how it can be implemented in primary care.
- Knowledge management for primary care:
Information overload is a real phenomenon in clinical practice. Primary care professionals need to know where to look for information rather than hold it themselves: we need to develop an appropriate knowledge management strategy for primary care.
Highlights for the PCI WG 2008/2011
• Workshop at the EFMI STC 2008 London, UK, launching the ALFA toolkit. This is a multi-channel video method of precisely observing the impact of the computer on the clinical consultation (www.jmir.org/2008/4/e27/ ).
• We have further developed our international collaboration about video evaluation of the use of ICT in the clinical setting, and have contributed a position paper recommending a standard taxonomy for the standardized reporting of video studies.
• Involvement in the TRANSFoRm project – an FP7 EU funded project, which is setting out to develop a template for an electronic primary care research network across Europe and improved decision support. Our working group workshops at EFMI meetings will focus on understanding the barriers to sharing health data. (http://www.clininf.eu/projects/transform.html )
• Development of the TIRRE – TRANSFoRm International Research Readiness Instrument – to assess the readiness of data repositories to participate in research. (http://www.clininf.eu/projects/tirre.html )
• A combined workshop with IMIA and other regional informatics associations at MEDINFO 2010.
• The outputs from our workshop at IMIA have led to: (1) A workshop at the EFMI STC in Slovenia 2011; and (2) A second contribution to the IMIA Year book
Highlights for the PCI WG 2004/2007
- Pre-MEDINFO 2004 Consensus conference.
This conference was a great success, attracting 53 delegates to a full day event prior to MEDINFO 2004. Europe was the best represented continent after the USA; with The Netherlands the best represented European country.
There was consensus about what the core elements of primary care were – considering the vast range of health systems primary care physicians work in. There was also agreement that the unique nature of primary care means that it requires its own health informatics sub-specialty: primary care informatics (PCI). Much of the conference examined why primary care informatics had been successful in Europe and the lessons for the USA as this country looks to computerise primary care .
- Feeding back routinely collected computer data in an educational context to improve the quality of care: a workshop at the STC Athens.
The PCI WG held a successful workshop on how to learn from your own computer data to improve the quality of care. So called: "Audit-based education" .
- MIE2006 – Workshop + practice visits
The working group has had an excellent year, with an excellent workshop at MIE2006. This was organised with primary care colleagues in Maastricht and explored how routinely collected primary care computer data are “Goldmines form Research.” This was followed by a visit to a Netherlands general practice to see a primary care clinical system in action. A paper based on the workshop has been published in Informatics in Primary Care .
- Three members of the Working group were invited to talk about the role of primary care informatics in patient safety (http://www.patientsafetycongress.org/?sayfa=home). We presented material about the role of the primary care computer system in making prescribing safer; as well as how integrated health information systems enable critical information about a patient to be potentially shared across a health service.
- STC2007 – Brijuni, Croatia
A primary care half-day formed a key component of this conference. The primary care papers and posters describe how widely computerisation has been adopted in primary care across an enlarged Europe . The best papers will be published in a special section of Informatics in Primary Care. 
- MEDINFO2007 – Brisbane, Australia
The joint AMIA (American Informatics Association); EFMI, and IMIA (International Medical Informatics Association) joint Primary Care Informatics Working Groups plan to hold another consensus conference. Our intention is to repeat the format of the full day event held prior to MEDINDFO2004 in San Francisco . The date of the conference has been set for Friday 17th August, just before the start of MEDINFO. Primary care informaticians are urged to put this date in their diary.
New members and Journal (Informatics in Primary Care):
- Increasing the working group membership
We wish to increase the membership of the primary care working group, and encourage representation form all EFMI member countries. The working group has been expanded to 27 over the last year, but needs to develop its membership further. Council members are urged to encourage primary care professionals to join the working group – so that the group contains a pan-European sample of primary care informaticians.
Special offer to members of the PCI WG – Reduced subscription to Informatics in Primary Care:
Reduced subscription to the Journal of informatics in Primary Care Members of the working group are able to obtain a reduced subscription. Please see the working group part of the EFMI website (www.efmi.org) for details; new subscribers are also entitled to a free book.
The primary care informatics working group is active working with a dynamic membership. We always welcome new members to the group and ideas for conferences and debate. We are very happy to contribute to future EFMI MIE and STC meetings.
-  de Lusignan S. What is primary care informatics? J Am Med Inform Assoc. 2003;10(4):304-9.
-  de Lusignan S. Introduction to the Primary Care Informatics Working Group of the European Federation for Medical Informatics (EFMI). Informatics in Primary Care. 2003;11(3):175-6.
-  de Lusignan S, van Weel C. The use of routinely collected computer data for research in primary care: opportunities and challenges. Fam Pract. 2006 Apr;23(2):253-63.
-  de Lusignan S. An educational intervention, involving feedback of routinely collected computer data, to improve cardiovascular disease management in UK primary care. Methods Inf Med. 2007;46(1):57-62.
-  de Lusignan S, Metsemakers JF, Houwink , Gunnarsdottir V, van der Lei J. A report of the European Federation for Medical Informatics Primary Care Informatics Working Group (EFMI PCIWG) from MIE2006, Maastricht, The Netherlands. Inform Prim Care. 2006;14(3):203-9.
-  Eds. Bryden J, de Lusignan S, Blobel B, Petroveki M. Medical Informatics in an Enlarged Europe. Proceedings of the European Federation for Medical Informatics Special Topic Conference. Berlin; Akademische Verlagsgesellschaft Aka (Aka-Verlag), 2007.
-  de Lusignan S, Teasdale S, Little D, Zapp J, Zuckerman A, Bates D, Steele A. Comprehensive computerised primary care records are an essential component of any national health information strategy: report from an international consensus conference. Informatics in Primary Care 2004:13(4):255-64.
Chair and contact:
Department of Health Care Management and Policy, University of Surrey, GUILDFORD, GU2 7XH, UK