Teasdale, SheilaBates, DavidKmetik, KarenSuzewits, JeffBainbridge, Mike2021-08-302007-09-01Teasdale, Sheila, David Bates, Karen Kmetik, Jeff Suzewits, and Mike Bainbridge. “Secondary Uses of Clinical Data in Primary Care.” Informatics in Primary Care 15, no. 3 (September 1, 2007): 157–66. https://doi.org/10.14236/jhi.v15i3.654.1476-03201475-9985https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37369182This paper, presented as a panel at the American Medical Informatics Association (AMIA) Fall Symposium 2006, explores a number of secondary uses of primary care clinical data derived from point-of-care systems, and the issues arising from those uses. The authors (from the USA and the UK) describe, compare and contrast some secondary uses: pay-for-performance, public disclosure, clinical audit, health resource planning, and clinical system usage; in various environments: national health system, network of small family practice offices, and university teaching centres. In the UK, such data are now being used in pay-for-performance for GPs, and approximately 35% of their salary has been put at risk, which has resulted in close scrutiny. In the USA, pay-for-performance is at an earlier stage but is increasingly prevalent and continues to be hotly debated. Some of the issues that arise from these uses of clinical data - data quality including accuracy, comparability, perverse incentives, effect of secondary uses on care provision, and security and confidentiality among others - were discussed. Finally, options and opportunities for improving secondary uses of data in the light of the issues covered earlier were considered.en-USJournal Article2021-08-3010.14236/jhi.v15i3.654