Health Information Use in Home Care: Brainstorming Barriers, Facilitators, and Recommendations

Abstract

There is growing recognition of the importance of sharing health information in home care; however, limited research exists to identify appropriate strategies, especially with home care providers. We engaged home care stakeholders from three locations in Ontario to determine facilitators, barriers, and recommendations for using health information in home care. The results suggest that health professionals recognize the potential of these systems to enhance communication through several emergent themes; however, there was a lack of agreement on the current facilitators, barriers, and recommendations for future interventions. More research is needed to achieve consensus before strategies for improvement can be initiated.

Data sharing between home care professionals: a feasibility study using the RAI Home Care instrument

“…It was evident from the focus groups that these participants feel increasing pressures on their time, which is supported from previous research in home care in Ontario [9,13]. This workload issue is not surprising given that there has been a dramatic increase in the number of individuals receiving home care in Canada within the last 10 years [31].…”

“…The falls checklist was created based on feedback from the Clinical Advisory Group that they needed a simple one-page summary of the information provided in the falls Clinical Assessment Protocol (CAP) and based on earlier work that showed the importance of summary reports that are simple and highlight key pieces of information from the RAI-HC [9]. Although the focus group participants were not asked to comment on this tool specifically, there is the potential for something like this to be shared between care coordinators and service providers to improve communication and to quickly summarize their perspectives of the same client and highlight the key areas where they feel the client is at risk (e.g., environmental hazards, medications, unsteady gait).…”

“…It was clear that our one-day education session was inadequate preparation and that ongoing follow-up was needed to ensure that all participants had a certain comfort level and understanding of how to interpret the information. Stolee et al [9] also found that a key barrier to using health information in home care was inconsistent sharing of data from the RAI-HC between care coordinators and therapy providers and that the service providers did not have an adequate understanding of the RAI-HC and its outputs. If RAI-HC data are to be shared between professionals, there is a need for education and regular feedback and support as they become more familiar with the assessment.…”

“…The RAI-HC was developed by interRAI (http://www.interrai.org), a non-profit research consortium [4,5], and has documented reliability and validity [3,6-8]. A key benefit of the RAI-HC is that it captures data at the level of the individual client in a way that is consistent and standardized, which has been cited as a key facilitator for using health information in home care [9]. Implementation and ongoing use of this system represents a substantial investment, yet some early evidence suggests that this information is not currently being utilized in Ontario to its fullest potential [10].…”

Adding Home Health Care to the Discussion on Health Information Technology Policy

“…However, existing legislation excludes home health agencies from HIT incentive programs (Wolf et al, 2012) and there is limited knowledge (Stolee et al, 2010) and dialogue on the need, potential benefits, and logistics of integrating HIT for meaningful use into the nation's home health care industry. We argue that home health care should be included in larger initiatives that establish HIT for meaningful use.…”