Table 1
Participants in the focus group and individual interviews.
| Title, profession | Organisation | Focus group | Interview |
|---|---|---|---|
| Physician | Hospital | X | |
| Pharmacist | Hospital | X | |
| Head of department, RN | Hospital | X | |
| RN | Hospital | X | X |
| Quality developer | Hospital | X | |
| Quality developer and RN | Hospital | X | X |
| Administrator | Hospital | X | |
| Occupational therapist | Home care | X | X |
| Social worker | Municipality | X | |
| RN | Primary care | X | |
| RN | Hospital | X | |
| Assistant nurse | Hospital | X |
[i] * RN = Registered nurse.
Figure 1
Information flow for a fictitious older patient with chronic illnesses and complex needs.
Figure 2
Map of the information flow through different information channels along a fictitious patient’s care trajectory through the healthcare system.
Table 2
Example of the analysis procedure.
| Theme | Coherent information flow is challenged by a lack of interoperability of information systems across the organisation | ||
|---|---|---|---|
| Category | Isolated EHR systems | Complex health care systems lacking collaboration | Lost information despite major efforts |
| Condensed meaning unit | Calling several numbers for information | Patient referred to several parts of the health care system | Patient makes contact when things do not go as planned. |
| Meaning unit | I get a number or three numbers to some nurse there and then I have to call until I get the right person…you have to make the rounds | Your blood sugar is high – you should talk to the diabetes nurse – and I’m having trouble breathing – you should call the heart failure nurse | They call; the home care staff hasn’t shown up, have they got the wrong address, when were the tests supposed to be taken? |
Table 3
Themes and categories.
| Theme | Coherent information flow is challenged by a lack of interoperability of information systems across the organisation | Expected to be an active partner but excluded from the information flow |
|---|---|---|
| Category | Isolated EHR systems | Home alone |
| Complex health care systems lacking collaboration | Determination of diagnose | |
| Lost information despite major efforts | Negative consequences |