Exploitation of electronic medical records data in primary health care. Resistances and solutions. Study in eight Walloon health care centres.

INTRODUCTION: The Electronic Medical Records (EMR), used every day for primary health care may constitute an instrument for gathering locally usable data to improve the quality of care and, on a larger scale, be a basis of epidemiological data. In spite of a policy of promotion of the EMR made by the Federation of French-speaking Belgian "Medical Houses", its use remains very marginal. METHODS: Eight Medical Houses, motivated by computerization of medical records have been met. Quantitative indicators of use of the EMR have been assessed. A qualitative assessment of the resistances to computerization, and solutions which can be brought, has been realized through the technique of the nominal group. RESULTS: The use of the EMR remains slight, allowing for exceptions. The proposed solutions could be put together in 5 categories : ethics, training, search for sense, practice and interdisciplinarity. DISCUSSION: The practitioners are willing to computerize if they get immediate advantages (knowledge of their patients and their team operating). They expressed the need of having a tool easy to use, that doesn't make them lose time and that has respect for their specificity of work and organization (interdisciplinary and self-managed teams). They expressed the need of an external support, under the form of adapted training and supervision for the data management. Ethical concerns (security, data transfer, place of the computer in the relationship with the patient) are surprisingly not present enough.