tailieunhanh - báo cáo khoa học: "Towards successful coordination of electronic health record based-referrals: a qualitative analysis"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Towards successful coordination of electronic health record based-referrals: a qualitative analysis | Hysong et al. Implementation Science 2011 6 84 http content 6 1 84 Implementation Science IMPLEMENTATION SCIENCE RESEARCH Open Access Towards successful coordination of electronic health record based-referrals a qualitative analysis Q I I2 I I l crinn 1 2AHml Fc Ii ii ol3 r lcorì F Qiỳỳiri4 I inHcox Ạ Dcii I5 lAr if if iT c1 2 Qimran Qinnh6 fiiH Sylvia J Hysong Adol Esquivel Dean F Sittig Lindsey A raul Duiiiid Espadas Simian Singn and Hardeep Singh1 2 Abstract Background Successful subspecidlty referrals require considerable coordination and interactive communication among the primary care provider PCP the subspecialist and the patient which may be challenging in the outpatient setting. Even when referrals are facilitated by electronic health records EHRs . e-referrals lapses in patient follow-up might occur. Although compelling reasons exist why referral coordination should be improved little is known about which elements of the complex referral coordination process should be targeted for improvement. Using Okhuysen Bechky s coordination framework this paper aims to understand the barriers facilitators and suggestions for improving communication and coordination of EHR-based referrals in an integrated healthcare system. Methods We conducted a qualitative study to understand coordination breakdowns related to e-referrals in an integrated healthcare system and examined work-system factors that affect the timely receipt of subspecialty care. We conducted interviews with seven subject matter experts and six focus groups with a total of 30 PCPs and subspecialists at two tertiary care Department of Veterans Affairs VA medical centers. Using techniques from grounded theory and content analysis we identified organizational themes that affected the referral process. Results Four themes emerged lack of an institutional referral policy lack of standardization in certain referral procedures ambiguity in roles and responsibilities and .