Bridging the Gap – Electronic Messaging between Home Health Care and General Practitioners

Abstract

Communication between health care providers is essential for the safe delivery of care to patients. The health care service is fragmented and the tools designed to support communication between health care providers has been unsatisfactory, in particular between home health care nurses and general practitioners (GPs). Three sub-studies were conducted to; 1) describe the experiences of home health care nurses with an e-messaging system and to determine how e-messaging influenced their communication with GPs; 2) describe the home health care nurses’ assessments of using an e-messaging system in their communication with GPs and to identify which factors predict e-messaging as an efficient tool for communication with GPs; 3) explore how the use of an e-messaging system influences patient safety in the medication information process from the perspective of both home health care nurses and GPs. The study employed several methods such as; 1) focus group interviews and semi-structured interviews with home health care nurses GPs; and 2) a questionnaire sent to home health care nurses in 12 municipalities which had implemented an e-messaging system, and for comparison, in 16 municipalities that had not. The findings of this study indicated that the introduction of an e-messaging system had an assembling effect on home health care nurses, GPs and their communication. The e-messaging system promoted the formalisation of work routines between them with the establishment of communication procedures. It also supported informal communication between the home health care nurses and the GPs, which was an important requisite for collaboration and building knowledge about their common patients. With regard to medication information, the e-messaging system resulted in both increases and decreases in patient safety. Finally, both social and technical factors had an impact on the work system of the home health care nurses and GPs when implementing and using and e-messaging system.