ArticleBMJ open2025
Clinician perspectives on linked electronic health records for preventing type 2 diabetes after gestational diabetes in primary care-an Australian qualitative study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe objective of this study was to understand primary care clinician perspectives on a novel linked health data system to facilitate diabetes prevention for individuals with a history of gestational diabetes mellitus (GDM). We used the conceptual example of linking the National Gestational Diabetes Register with primary care electronic health records to understand clinicians' views on potential implementation.
designA qualitative study of semistructured interviews with primary care clinicians.
settingAustralian primary care.
participantsPrimary care clinicians (n=14). Inclusion criteria were: general practitioners (GPs), practice nurses and/or diabetes educators working in primary care in Australia, and seeing individuals with a history of GDM; aged 18 years and over; and willing to voluntarily contribute to the project. There were no exclusion criteria.
resultsClinicians' views on acceptability, feasibility and utility were characterised by realistic optimism for a linked data system to improve GP workflow and patient outcomes. Clinicians noted existing pressures on primary care and patient concerns regarding confidentiality and privacy, and that these factors should be considered in the development process. Clinicians envisaged three functions for their clinical management systems: (1) automatically updating a patient's past history; (2) generating actionable alerts and (3) generating recall lists. DISCUSSION: Primary care clinicians were unanimously supportive of a linked health data system to facilitate diabetes prevention. Consistent with previous studies, we identified the key clinician-related enabler as the integration into existing GP workflows to facilitate pro-active clinical care. Point-of-care tools and preventative care consultations could increase the uptake of screening and provide opportunities for patient education post partum.
conclusionIn combination with effective prevention programmes, and health policy and system supports, linked health data systems could be part of the equation for type 2 diabetes prevention for individuals with a history of GDM. Larger acceptability, feasibility, co-design and implementation studies are recommended.
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