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
