Views of patient, healthcare professionals and administrative staff on flow of information and collaboration in a regional health information exchange: a qualitative study

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Increasingly, customers can be involved in developing healthcare services with their healthcare professionals. Patient participation fosters better recognition of different needs in the patient service chain. Patient‐centred care gives patients the opportunity to take an active role in their care management 1. For example, the care of patients with multiple conditions, such as cancer or diabetes, is complex and cross‐sectional and needs the involvement of different care professionals in patient care and collaboration across multiple organisations. Furthermore, healthcare delivery is fragmented, and there are still some noninteroperable clinical information systems that pose an obstacle to the effective coordination of care in disease management and continuity of care 1. For example, chronic disease patients with multiple conditions often have many caregivers and different healthcare providers located within various institutions, requiring collaboration within an integrated health environment. The care of patients with such diseases involves multiple medical tests like laboratory tests, follow‐up tests, as well as a lot of medication and other ancillary services 4. Functional healthcare services require digital and timely communication between healthcare providers to improve the flow of information for healthcare professionals, participating in patient care 3.
However, physicians and other healthcare professionals often do not have comprehensive information about the patient when and where it is needed most, namely at the point of care. Problems in achieving better health outcomes still occur, and effective care management for patient‐specific data access and disease‐specific knowledge presented by key components foster clinical decision support and patient activation 2. Effective integrated care requires effective flow of information and regional collaboration between healthcare professionals and access to patient health information to all those who deliver care across organisational boundaries for the better care coordination of the patient health service package 1.
According to the results of previous studies, health information exchange (HIE) is a significant component of healthcare transformation strategies at both regional and national levels (1). HIE systems give providers electronic access to patient information from several different healthcare organisations. Better access to patient information from multiple sources at the point of care has the potential to improve health care. HIE could provide better opportunities for facilitating collaboration among healthcare professionals, processing HIE electronically to transfer patient‐level information between different organisations and professional groups to improve co‐operation and flow of information regarding patient‐centred care (1). The quality and safety of treatment will also be improved when healthcare professionals gain access to up‐to‐date information on their patients and have information on the care delivery process readily available for better chronic care management, care coordination and consumer activation 7. Many EU countries and the United States (US) are developing HIE programmes, either regionally or nationally 11.
Little previous empirical research was found on patient experiences and views of healthcare professionals concerning regional HIE and collaboration across organisational boundaries. According to the results of previous studies, patients benefited from the use of HIE regionally between healthcare professionals and organisations 17. It was found that patients supported physicians the use of HIE among healthcare providers 23, with the capability to improve the quality of care 23. HIE usage improved data availability from other institutions and better communication between healthcare professionals 19, who thought it improved care quality and safety of healthcare delivery 20. Patients were interested in accessing their patient information in an HIE system 27. All respondents emphasised privacy and security issues 22. In this study, the aim was to get a deeper understanding of the flow of information and collaboration in one hospital district area from the viewpoint of patients, healthcare professionals and administrative staff.
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