## 4 Discussion  
This research provides experiential knowledge on the PMS attributes required by physiotherapists in order to facilitate workflows on both clinical and administrative activities and to overcome the inefficiencies perceived on current software programs. A total of five themes were identified (data entry and issuance of reports on patient clinical care, clinical-care electronic communication with patients and other health professionals, management of administrative documents and marketing communications, billing and accounting of payments and supplies, and access to PMS). In total, 43 specific attributes (categories) emerged and were classified into 12 subthemes. In general, many issues identified during the focus groups were reflected in the different professional physiotherapy associations' guides published to counsel their members on assessing and choosing software solutions [1; 2]. Some disparities arise due to differences in the national standard requirements to register, the professional duties and responsibilities, or the national regulations (e.g., general data protection regulation). However, these guides were based on a literature review, the experience in other health professions, and informal discussions with members and consultations with leading physiotherapists and health information technology experts [1; 2]. To the best of our knowledge, this is the first study to globally explore the perceptions of physiotherapists in relation to the practical use of PMS in their clinics using focus groups. [PERSON] and [PERSON] [19] conducted a qualitative study performing interviews with physiotherapists and experts to learn the specific requirements of physiotherapists on the practical use of software in the therapeutic process, and many themes coincide with our research. However, the themes in that study were quite general, involved only the clinical care, and the sample size for the interview (n = 13) was small. [PERSON] et al. (2021), in their qualitative study, focused on developing survey instruments to collect the physiotherapists' and patients' perceptions on the uptake and acceptance of digital health interventions in physiotherapy [21]. [PERSON] et al. (2017) evaluated the perspectives of physiotherapists and patients on needs, requirements, and barriers for EHR adoption for physiotherapy [9]. All in all, little research has been performed on the specific attributes required by physiotherapists on the practical use of practice management software, which covers not only clinical aspects but all the non-clinical aspects relevant to run a physiotherapy center. Our study used the grounded theory approach to build an understanding and knowledge of the theoretical framework of physiotherapy PMS. Six focus groups with experienced physiotherapists were carried out, and a thematic analysis was undertaken to code and classify the comments. Measures were adopted to maintain consistency and enhance credibility. As a consequence of all of these methods, our study identified a wide conceptual framework to describe the areas, themes, and subthemes relevant to physiotherapy management software. In our opinion, this framework makes it easy to break and understand a multidimensional and complicated subject. Moreover, our approach appears to be more comprehensive than previous approaches to learn the needs of the physiotherapy collective regarding PMS. During the development of the focus groups, clinical-care issues took most of the discussion time and coded statements, giving us a good idea of the inadequacy and inefficiencies of the current PMS for physiotherapy. The rest of the time and issues dealt with administrative tasks, security and confidentiality, communication, economic issues, legal and regulatory requirements, or technical aspects, which concerned physiotherapists'work. These were finally gathered into one broad area called \"Administrative tasks\" to avoid separating or overlapping issues.