Primary care health professionals' approach to clinical coding: a qualitative interview study.

This study demonstrates the complexity of clinical coding in primary care. Clinical and non-clinical staff spoke of systems that lacked intuitiveness, and the challenges of multi-morbidity and time pressures when coding in clinical situations. These challenges are likely to be exacerbated in socio-economically deprived areas, leading to under-reporting of disease in these areas. Challenges of clinical coding may lead to implications for data quality, particularly the validity of research findings generated from studies reliant on clinical coding from primary care. There are also consequences for patient care. Participants cared about coding quality and wanted a better way of using coding. There is a need to explore technological and non-technological solutions, such as artificial intelligence, training and education, to unburden people using clinical coding in primary care.