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Studying intersection points - An analysis of information needs for shared homecare of elderly patients

Objectives: Elderly patients are increasingly receiving care in their own homes but this process is not well supported by existing systems which suffer from limited integration of health and social care services. The result is fragmentation of care, lack of coordination between services, duplication of services, and limited participation of patients and informal carers in the care process. In this study we attempt to identify the key intersection points, i.e. where different actors involved in the homecare of elderly patients interact, and to analyse their individual information requirements. How these requirements can be met using information and communication technology (ICT) is discussed. Methods: The study involved 13 participants representing professional health and social care workers, patients and relatives. Their interactions and information needs were obtained using a variety of methods including multi-disciplinary thematic seminars, participatory observations, interviews, inventory of current information systems, scenarios, sketching and prototyping. Results: The key intersection points where information exchange between different actors is needed are (i) Initiation of patient specific changes in homecare provision, (ii) Consultations, (iii) Delegation of duties, (iv) Referrals, (v) Important health events and general care (vi) Coordination of planned activities. Shared information objects which would be beneficial include (i) Contact information of all parties, (ii) Patient care plan, (iii) Patient’s medication list, (iv) Risk factors, (v) Updates to medical records, (vi) Patient medical summaries, (vii) Patient centred calendar (viii) Assessment of their homecare needs. An ICT solution implemented to meet these requirements must be integrated with existing systems to minimise any additional work that staff will have to do and also address major issues such as security, design of mobile applications (including both interface design and synchronisation issues), interoperability and ethical and legal aspects. Conclusion: This study has identified the information that needs to be shared at key intersection points between different actors involved in providing homecare for the elderly. It has also indicated how this information can be made available through ICT and highlighted the challenges that will have to be overcome in order to support patient centred care.

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Journal on Information Technology in Healthcare
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Scopus scopus - exported 1/8/16
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