Health information dissemination from hospital to community care: current state and next steps in Ontario

Abstract

Introduction: The transition of patients from hospitals back to community care is often poorly managed and lacks organized communication between care providers in each setting.

Objective: The purpose of this paper is to analyze the current state of health information systems used in community based healthcare, and whether they have the functionality to disseminate patient information from the hospital to their community care providers when they go home. This paper aims to evaluate the progress made in this area thus far, and compare existing innovations in technology with the current state in Ontario healthcare. Literature Review: A literature review was conducted using OvidSP to search the databases Embase 1974 to 2014 April 04, Ovid Healthstar 1966 to February 2014, and Ovid MEDLINE® In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946 to Present. A search using terms related to health information technology, hospital discharge, and community health care yielded 42 relevant results.

Findings: The most frequently occurring topic areas in the literature were: the use of discharge summaries and how their quality may be enhanced, and various medication reconciliation tools and methods. Care provider types considered in the literature were predominantly primary care physicians; followed by pharmacists, nurses, with some focus on family member care providers at home. All articles discussed some form of electronic method for sharing information across sectors and facilities in healthcare. Current Ontario initiatives relevant to these topics are Health Links, ClinicalConnect, Hospital Report Manager, and the Canadian Health Outcomes for Better Information and Care project.

Discussion: The four projects described are reliable, sustainable health information technology tools. They should be regarded as innovations, and success of each will likely be realized with additional work in the near future.

Conclusions: Ideally, the system that disseminates vital hospital information to community care providers is electronic, reliable, timely, and complete. The presence of literature on various enhancements to quality of discharge summaries and medication reconciliation tools indicate their significance. Ontario initiatives are underway to strengthen methods for disseminating hospital information to community care providers.