Therapists' experiences with implementing new documentation practices for low back pain in electronic health care records: an interview study.

OBJECTIVE: Clinical practice is constantly changing with new guidelines being published, changes in patients' preferences but also by new qualitative requirements for therapists and institutional surveys on delivered care. Electronic health records (EHR) are used for all these purposes. We involved physiotherapists and occupational therapists in an intervention to change documentation practice in their electronic health record for low back pain (LBP) and later evaluated the feasibility of the new health records. The aim of the present study was to explore therapists' experiences working with the new EHR. RESULTS: Three themes were identified thru interviews: (I) Facilitators and motivators towards implementation, (II) Changing routines as a group and (III) Obstacles against successful implementation. This study identifies a need for involving therapists and management for successful change of electronic health care records usage in municipalities. However, difficulties were encountered in meeting documentation of practice requirements and obtaining sufficient data quality in the EHR for data to be used for daily use, quality assessment and research. In this small descriptive study, developing an EHR that simultaneously serves treatment plans, quality assessment, and research purposes was not expressed being feasible. Further research in this area is needed.

Perspectives on the treatment of sequelae after cancer: protocol of an interview study of primary care physiotherapists.

INTRODUCTION: An increasing number of patients are living with fatigue, pain and other sequelae after cancer. About 30% of these patients express a need for physical rehabilitation and patients prefer to be involved in medical decision-making. This includes being offered individualised treatment with patient-defined goals and education during all aspects of treatment by physiotherapists with empathic skills. However, physiotherapists are often unaware of the relationship between cancer and its presenting symptoms. This can lead to inappropriate care and unrealistic goalsetting for rehabilitation. This calls for greater attention towards physiotherapist's treatment and their current perspectives on how treatment can be improved in physiotherapy clinics. The aim of this study is to explore physiotherapists perspectives on barriers, facilitators and potential solutions to improve the care of sequelae after cancer in physiotherapy clinics. METHODS AND ANALYSIS: This is a qualitative interview study using individual semistructured interviews with physiotherapists using a phenomenological approach to explore their lifeworld at work. We will recruit physiotherapists working in private clinics based on a variation in gender and years of working experience in private clinics. We will conduct between 10 and 16 interviews online via Microsoft Teams and thematically analyse data supported by NVivo software. Interviewing is scheduled to take place from April 2022. ETHICS AND DISSEMINATION: This is a non-intervention and qualitative study, and the local Ethics Committee in the North Denmark Region has stated that their approval is not needed. Informants will provide a written informed consent. Study information will be sent to the informant at least 3 days prior to the interview session and information will be summarised by the interviewer before the interview.Aside from publication, results will be disseminated by two teaching institutions, a regional health care provider and DEFACTUM (a public Danish research institution focusing on increasing social equality in health).

Collect Once - Use Many Times: The Research Potential of Low Back Pain Patients' Municipal Electronic Healthcare Records.

Collect Once - Use Many Times can possibly increase the research potential of clinical data from electronic healthcare records (EHR). The objective of this study was to achieve an increased understanding of the research potential of low back pain patients' municipal EHR by assessing the data quality. This explanatory sequentially mixed-methods case study consists of descriptive- and content analysis. The descriptive analysis was based on data extracted from the municipal EHR. The indicators chosen were pain and physical function. Included subjects were low back pain patients in the Northern Denmark. For the content analysis, clinical notes from the municipal EHR was used. The descriptive analysis (n=172) showed that the outcome measure for pain was documented in 50% of the municipal EHR and the outcome measure for physical function was documented in 48% of the municipal EHR. The content analysis (n=5) revealed imprecise, inconsistent, and nonsystematic use of outcome measures. In conclusion, the poor data quality observed is a potential barrier for introducing the Collect Once - Use Many Times paradigm, which is a prerequisite for reusing clinical data for quality assessment and research purposes.