ArticleBMJ open2018
Spatial distribution of clinical computer systems in primary care in England in 2016 and implications for primary care electronic medical record databases: a cross-sectional population study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 1 of them a synthesis that pooled it.
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Who cites it
76 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of drug safety advisories on drug utilisation: an international interrupted time series and meta-analysis.BMJ quality & safety · 2022Pooled it
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- Multi-faceted intervention to improve management of antibiotics for children presenting to primary care with acute cough and respiratory tract infection (CHICO): efficient cluster randomised controlled trial.BMJ (Clinical research ed.) · 2023Trial
- Incidence and prevalence of obstructive sleep apnoea and narcolepsy in the UK: a population-based descriptive study.Thorax · 2026Article
- Comparative Effectiveness and Safety of Once-Weekly Injectable Semaglutide Versus Dulaglutide in Individuals with Type 2 Diabetes Managed in UK Primary Care: A Population-Based Cohort Study.The Lancet regional health. Europe · 2026Article
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- Scale, Skill-Mix, and Access Implications of the Production of Appointments by Primary Care Practices in England.Health economics · 2026Article
- Consultations with locum doctors in UK general practice: longitudinal analysis of electronic health records.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Patient characteristics associated with clinically coded long COVID: an OpenSAFELY study using electronic health records.BJGP open · 2025Article
- Prescribing practices for proton pump inhibitors among primary care physicians in England: an evaluation.BJGP open · 2025Article
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- Impact of long COVID on health-related quality-of-life: an OpenSAFELY population cohort study using patient-reported outcome measures (OpenPROMPT).The Lancet regional health. Europe · 2024Article
- Comparing the clinical practice and prescribing safety of locum and permanent doctors: observational study of primary care consultations in England.BMC medicine · 2024Observational
- Implementation and external validation of the Cambridge Multimorbidity Score in the UK Biobank cohort.BMC medical research methodology · 2024Article
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- Seasonal trends in antidepressant prescribing, depression, anxiety and self-harm in adolescents and young adults: an open cohort study using English primary care data.BMJ mental health · 2023Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors.
Funding
Abstract
objectivesUK primary care databases (PCDs) are used by researchers worldwide to inform clinical practice. These databases have been primarily tied to single clinical computer systems, but little is known about the adoption of these systems by primary care practices or their geographical representativeness. We explore the spatial distribution of clinical computing systems and discuss the implications for the longevity and regional representativeness of these resources.
designCross-sectional study.
settingEnglish primary care clinical computer systems.
participants7526 general practices in August 2016.
methodsSpatial mapping of family practices in England in 2016 by clinical computer system at two geographical levels, the lower Clinical Commissioning Group (CCG, 209 units) and the higher National Health Service regions (14 units). Data for practices included numbers of doctors, nurses and patients, and area deprivation.
resultsOf 7526 practices, Egton Medical Information Systems (EMIS) was used in 4199 (56%), SystmOne in 2552 (34%) and Vision in 636 (9%). Great regional variability was observed for all systems, with EMIS having a stronger presence in the West of England, London and the South; SystmOne in the East and some regions in the South; and Vision in London, the South, Greater Manchester and Birmingham.
conclusionsPCDs based on single clinical computer systems are geographically clustered in England. For example, Clinical Practice Research Datalink and The Health Improvement Network, the most popular primary care databases in terms of research outputs, are based on the Vision clinical computer system, used by <10% of practices and heavily concentrated in three major conurbations and the South. Researchers need to be aware of the analytical challenges posed by clustering, and barriers to accessing alternative PCDs need to be removed.
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