An analysis of a novel Canadian pilot health information exchange to improve transitions between hospital and long-term care/skilled nursing facility

Abstract

Purpose -The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report. Design/methodology/approach -Utilization statistics of the data integration solution were captured at onemonth post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group. Findings -The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts. Practical implications -A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.

Good Practice in the Implementation of Digital Social Care Records: A Rapid Scoping Review (Preprint)

“…Five were undertaken in the United States [9,[14][15][16]18]. Three were carried out in Finland [51][52][53], two in Australia [11,13] , two in Canada [19,54] , and two in Sweden [12,55]. The remaining were undertaken in Switzerland [8], Japan [56], Austria [17], Italy [57], or involved multiple countries [6].…”

“…Over one-third of studies from other countries were conducted in nursing homes/facilities (n=7) [6,8,9,14,15,17,18]. Other settings included home care (n=5) [12,[54][55][56][57], care homes (n=1) [13] long-term care facilities (n=1) [11] and an acute care hospital and its neighbouring long-term care home (n=1) [19], assisted living communities (n=1) [16], health centres in Finland (n=2) [51,52], and social care services (n=1) [53].…”

“…Some were specific systems commissioned by/developed for local authorities or regions, such as the Aged Care Ecosystem [13], the Edotto regional information system [57], CareFirst [10], the PASSsystem [50] or CareCentric [3], among others. Four studies focused on interoperability [10,19,20,56]. Studies can be grouped into those which aimed to: (i) identify barriers and/or facilitators to the implementation of DSCRs and/or information exchange systems (n=9) [3,10,13,19,20,[47][48][49]52]; (ii) assess the proportion/prevalence of services using DSCRs and/or information exchange systems, and/or how these are being used (n=7) [14-18, 45, 55]; (iii) investigate how digital systems affect the work of care professionals or care providers (n=4) [7,11,50,53]; (iv) assess care professionals' perceptions about the use of digital systems (n=4) [6,8,51,54]; (v) map services' readiness/maturity and/or care professionals' capability to adopt DSCRs and/or information exchange systems (n=3) [9,12,42]; (vi) assess potential strategies to improving existing DSCRs or information exchange systems (n=1) [57]; and (vii) assess the impact of use of information communication technology (ICT) on health outcomes (n=1) [56].…”

“…To achieve these aims, most studies used a qualitative design (n=14) [3, 6, 7, 11-13, 17, 47-49, 51, 52, 55, 57]. Eight studies used mixed methods [9,10,19,20,45,50,53,54] and seven, a quantitative design [8, 14-16, 18, 43, 56]. None of the studies which aimed to identify barriers and/or facilitators, to investigate how digital systems affect work routines, or to assess potential strategies to improve digital systems used quantitative methods.…”

“…Across the UK, a common term is Digital Social Care Records (DSCRs). In North America, parts of Europe, and Australia the terms Electronic Health Records (EHRs) [16][17][18][19][20], Electronic Patient Records (EPRs) [6] or Electronic Medical Records (EMRs) [9,19] are often used in social care settings. Digital care records can be part of initiatives frequently referred to as Health Information Exchange (HIE), which aim to facilitate data sharing across health and social care and improve care continuity and efficiency [16][17][18][19][20].…”