Table 4 Thematic analysis: KS features sub themes (primary, secondary, tertiary) and indicative quotes

1º Theme

KS Features

2º Themes

Inputs

Outputs

3º Themes

Existing Patient Data

“Any system that will just you click on a link, like the sign one and it brings everything in, and it will tell you in in seconds”

AB Rx Summary & Information

‘No but that IS useful… it would be very good to have all this data on one page without having to move between screens.’

‘Susceptibility to severe infection (e.g. diabetes), previous hospitalisation for similar infection, last antibiotics given (name and date), antibiotics allergies’

Search Tools

“If a list of appropriate medication is presented after diagnosis, I would click to view a range of options of meds to prescribe for a choice of agent.”

Recommended Actions

‘What abx for that indication could be prescribed. Then, choosing from a list with a link to current medications that the patient is already on e.g. not a macrolide if on anti-psychotics QT interval or patient pregnant avoid X drug at term—linking in with how many weeks pregnant pt. is

‘…we ended up spending a load of time speaking to the ENT registrar for advice about further possible AB to give … and it would have been very helpful … get advice about you've tried this you've tried this, now, this is the next step.’

Templates

‘you click the bring up the… hearing template the QRisk scoring templates and this recently is a COVID review template that is been coming up so similar things similar on those lines would be that helpful.’

Credibility

‘The information about CCG endorsement, research and trials would help.’

KS Opening

‘So in the diagnosis I’d fill in a read code … so I would put it in at ‘Diagnosis’ and then use the use the tool at that point, and then at the bottom put the plan from the tool, or you know, using the support of the tool.’

[Avoid] Popup Notifications

‘The pop-ups can get a bit tedious sometimes you end up closing them.’

Reception Triage

‘I get it, it will help… in some instances they might be able to get it, but I don't know I think it's a lot of responsibility.’

Patient Communication

‘Ability to text pt. [patient]. If they have mobile; Text or phone call—remote consultation (EMIS user); AccuRx text is most useful. You can send links for leaflets, other info and option for them to text back too’

‘and to help them understand their personal relationship to the antibiotics, so perhaps any risks that they've got from the antibiotic or maybe the fact that they've already had [an antibiotic]’