COAC: Using health information systems to address patient concerns in GP consultations: a feasibility study


National Institute for Health (NIHR) Research for Patient Benefit (RfPB) Ref. PB-PG-1217-20012

What is the research question?

Can we develop and test a complex intervention designed to more comprehensively address patients’ concerns in general practice?

What is the problem?

Problems are missed in up to 50% of primary care consultations. This might be because of insufficient time for patients to discuss all their problems, or they could be interrupted by the GP when they start to explain. Sometimes, patients are unclear after the consultation about advice given, or what to do if their problem worsens. This can be distressing for patients, can lead to health problems, or increased NHS costs, as patients might re-consult to get their concerns addressed. Reducing consultation rates by just 1% could save the NHS over £100million. Widespread use of smartphones and GP SMS-technology provides an opportunity to address this problem through more efficient information-sharing.

What is the aim of the research?

The aim of this study is to develop and test a method to more comprehensively address patients’ concerns in general practice. This will involve patients completing an electronic questionnaire about their concerns before a GP consultation, which is shared with the GP, and receiving a printable summary of advice at the end. If successful, the research will improve care for patients receiving the new consultation method and reduce rates of re-consultation for the same problem.

How will this be achieved?

We will carry out two studies.

In study 1 we will develop two technologies and processes. First, we will design a questionnaire for patients to complete on smartphone/computer before their consultation. This questionnaire, which will identify their reasons for consulting and other health issues, will be shared with the GP before the consultation. This may include problems troubling the patient that would otherwise not have been raised. The second technology will be a report to be printed for the patient at the end of the consultation, including problems raised, advice given and follow-up required. This will provide a joint understanding between the patient and GP and help the patient remember advice given.

In study 2, we will test these technologies in consultations with 72 patients. GPs will be asked to read the questionnaire information before the consultation and provide the printed report at the end of the consultation. To assess the new method, we will collect information about how well the consultation worked for these 72 patients. We will collect the same information from 36 patients who had a consultation without the new method, so that we can compare the two groups. If this works successfully, we will seek funding to test it in a larger sample.

Who is leading the research?

Dr Mairead Murphy, Research Fellow, Population Health Sciences, Centre for Academic Primary Care, University of Bristol.

Further information:

COAC Study

For more information or to get involved in this project, please contact

The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.