出版社：Utrecht University, Maastricht University, Groningen University
摘要：Intramural care is provided by different teams of day- and night care workers. It can be a challenge to provide the necessary care and support, in particular whenever decisions need to be based on care plans and reports made by someone else. Clear communication and coordination between day- and night care professionals seems to be a prerequisite for guaranteeing 24-hour personalized care and support. Increasingly, this coordination between professionals takes place through information systems such as the Electronic Health Record EHR and digital surveillance technologies, of which the latter are mostly used during the night. These systems can provide professionals a better awareness of the client's care and support needs. However, automatic information exchange between the EHR and the surveillance technology is lacking. Thereby, these systems are used separately, forcing care professionals to manually transfer client data from one system to another. Meanwhile, both systems contain a great amount of possibly relevant data that can reinforce each other. Yet, it is unclear which minimum dataset is relevant to exchange and how the exchange of data can contribute to 24/7 care. Furthermore, care providers struggle with the balance between privacy legislations and the safety of their clients. Therefore, an explorative study was performed with the central question: How can it be ensured that care professionals have a good picture of the client's healthcare needs 24 hours a day, regardless of the different systems that are supporting them? Semi-structured interviews and focus groups were performed with day- and night care professionals of six care organizations and developers of six EHR suppliers and six surveillance technology suppliers. The interviews and focus groups were held to gather an insight in their perceptions in respect to the research question. From the study it appeared that standardization is lacking to enable the exchange of information between systems and that a vendor lock-in is quite common among care organizations. Care professionals and organizations have the need to be provided with relevant information at the right time through one central system, or as few solutions as possible. The communication and coordination between day- and night care professionals can – according to care professionals - be accomplished by: having and sharing a clear vision on the use of night care technology among all relevant stakeholders; active support for this vision by the board of directors; assigning key-users to support and promote exchange; and night care integration in EHR. The integrated use of data from various sources is an important condition for exploiting the predictive value of data and more proactively responding to potential risks and needs of clients. Information exchange and the optimal use of this information not only involves the integration of technology, but also the integration of services and work procedures. This requires a cultural change within healthcare organizations with support of all stakeholders. Thus, integrated care must be addressed both at the human and system level.
关键词：ehr ; surveillance technology ; intramural care ; day care ; night care
