Crooks Valorie A, Agarwal Gina
Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada.
BMC Fam Pract. 2008 Dec 9;9:65. doi: 10.1186/1471-2296-9-65.
Central to establishing continuity of care is the development of a relationship between doctor and patient/caregiver. Transfer of information between these parties facilitates the development of continuity in general; and specifically informational continuity of care. We conducted a systematic review of published literature to gain a better understanding of the roles that different parties - specifically doctors, patients, family caregivers, and technology - play in establishing and maintaining informational continuity of care within family practice.
Relevant published articles were sought from five databases. Accepted articles were reviewed and appraised in a consistent way. Fifty-six articles were retained following title and abstract reviews. Of these, 28 were accepted for this review.
No articles focused explicitly on the roles involved in establishing or maintaining informational continuity of care within family practice. Most informational continuity of care literature focused on the transfer of information between settings and not at the first point of contact. Numerous roles were, however, were interpreted using the data extracted from reviewed articles. Doctors are responsible for record keeping, knowing patients' histories, recalling accumulated knowledge, and maintaining confidentiality. Patients are responsible for disclosing personal and health details, transferring information to other practitioners (including new family doctors), and establishing trust. Both are responsible for developing a relationship of trust. Technology is an important tool of informational continuity of care through holding important information, providing search functions, and providing a space for recorded information. There is a significant gap in our knowledge about the roles that family caregivers play.
The number of roles identified and the interrelationships between them indicates that establishing and maintaining informational continuity of care within family practice is a complex and multifaceted process. This synthesis of roles provided serves as an important resource for continuity of care researchers in general, for the development of continuity of care quality indicators, and for the practice of family medicine.
建立连续性医疗服务的核心是医生与患者/护理者之间关系的发展。这些各方之间的信息传递总体上促进了连续性的发展；特别是医疗服务的信息连续性。我们对已发表的文献进行了系统综述，以更好地了解不同各方——特别是医生、患者、家庭护理者和技术——在家庭医疗中建立和维持医疗服务信息连续性方面所起的作用。
从五个数据库中查找相关的已发表文章。以一致的方式对被接受的文章进行审查和评估。经过标题和摘要审查后保留了56篇文章。其中，28篇被接受用于本综述。
没有文章明确关注家庭医疗中建立或维持医疗服务信息连续性所涉及的角色。大多数医疗服务信息连续性文献关注的是不同医疗场景之间的信息传递，而非首次接触时的情况。然而，通过从审查文章中提取的数据对众多角色进行了阐释。医生负责记录保存、了解患者病史、回忆积累的知识以及保密。患者负责披露个人和健康细节、将信息传递给其他从业者（包括新的家庭医生）以及建立信任。双方都负责建立信任关系。技术是医疗服务信息连续性的重要工具，通过保存重要信息、提供搜索功能以及为记录信息提供空间。我们对家庭护理者所起的作用的了解存在重大差距。
所确定的角色数量及其相互关系表明，在家庭医疗中建立和维持医疗服务信息连续性是一个复杂且多方面的过程。这种角色综合对于一般的连续性医疗服务研究人员、连续性医疗服务质量指标的制定以及家庭医学实践而言，都是一项重要资源。
