JMIR Publications

ABSTRACT

The management of diagnostic uncertainty is part of every primary care physician’s role. Electronic safety netting (e-safety-netting) tools are designed to assist healthcare professionals in managing diagnostic uncertainty either within or separate to the electronic healthcare record. Using software in addition to verbal and/or paper based safety-netting methods could make the process more rigorous, robust, traceable and auditable. There is no consistent definition or approach to e-safety-netting despite an increasing number of software products identifying as such and being offered to clinical teams, particularly since the COVID-19 pandemic. E-safety-netting tools have developed to perform a variety of functions including clinician alerts, administrative tasking, decision support and triggering reminder text messages to patients. However, these tools have not been evaluated using robust research designs for patient safety interventions. We present a framework of criteria for effective e-safety netting tools, to improve patient safety through more targeted development of software. The framework is based on similar criteria from electronic health record development and principles of patient safety. There are currently no tools available that meet all of the criteria in the framework. When new tools have been developed and validated through robust research, the framework will enable national and local audit and analysis, highlighting differences in performance and presenting potential solutions for improvement. We outline key areas for future research, both in primary care and within integrated care systems. E-safety-netting tools that align with the individual, social and technical aspects of primary care working are more likely to succeed.