A mixed methods evaluation of a shared electronic health record between general practice and community pharmacy.

Abstract

Introduction: Integrating community pharmacies into primary care via digital infrastructure is crucial to enhancing continuity, coordination, and safety of care. Historically, community pharmacies have not had full access to general practice electronic health records (EHRs), limiting their ability to provide informed interventions. The introduction of shared, interoperable EHRs has the potential to address this limitation and redefine the clinical role of community pharmacists.

Aim: This study aimed to evaluate the feasibility, acceptability, and impact of granting community pharmacies read-and-write access to a shared EHR system (SystmOne) across selected sites in the East of England.

Method: A 12-month mixed-methods pilot (Jan-Dec 2023) was conducted using an explanatory sequential and convergent approach. Data were collected from 35 community pharmacies and 31 general practices via activity logs, surveys, and semi-structured interviews. Descriptive statistics was used to analyse quantitative data and thematic coding used for analysing qualitative data. Data was then integrated to evaluate service delivery, communication, and user experience.

Results: Thirteen community pharmacies actively used the EHR, documenting over 19,000 appointments and 16,000 clinical entries. Usage varied, with barriers including workload, technical complexity, and duplicated documentation requirements. However, users reported improvements in patient safety, interprofessional communication, and service efficiency. Appointment booking and task-sharing functions fostered collaborative working, while access to real-time clinical information supported clinical decision-making. Training support, trust between sectors, and policy alignment were identified as critical enablers for system uptake.

Conclusion: Providing community pharmacies with read-and-write access to a shared EHR is feasible and contributes to safer, more integrated patient care. Improved communication, clinical documentation, and task delegation between pharmacists and general practice staff represent a major shift in digital collaboration. However, successful scale-up requires investment in interoperability, national IT infrastructure alignment, and streamlined reimbursement processes to prevent duplication of effort. These findings support the evolving clinical role of community pharmacists and suggest that integrated digital systems are essential to realising the full potential of community pharmacy in the modern NHS to improve patient care.