Baudendistel I, Winkler E C, Kamradt M, Brophy S, Längst G, Eckrich F, Heinze O, Bergh B, Szecsenyi J, Ose D
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
Ethics and Patient-Oriented Care, National Centre for Tumor Diseases (NCT), Heidelberg, Germany.
Eur J Cancer Care (Engl). 2017 Mar;26(2). doi: 10.1111/ecc.12429. Epub 2016 Feb 3.
Cross-sectoral cancer care is complex and involves collaboration from health care professionals (HCPs) across multiple sectors. However, when health information exchange (HIE) is not adequate, it results in impeded coordination and continuity of care. A web-based personal electronic health record (PEPA) under patients' control, providing access to personal health data across sectors, is being developed. Aim of this study was to explore perceived benefits and concerns. Using a qualitative approach, 10 focus groups were performed collecting views of three prospective user groups: patients with colorectal cancer (n = 12), physicians (n = 17) and other HCPs (n = 16). Representatives from different health sectors across the Rhine-Neckar region (Germany) participated. Data were audio- and videotaped, transcribed verbatim and thematically analysed. Our study shows that patients and HCPs expected a PEPA to enhance cross-sectoral availability of information, cross-sectoral cooperation and facilitate data management. Quality of cancer care was expected to be improved. Concerns were expressed in terms of data protection and data security. Concepts like a PEPA offer the chance to support HIE and avoid gaps of information in cross-sectoral cancer care. This may lead to improvements in coordination and continuity of care. Issues concerning data security and protection have to be addressed.
跨部门癌症护理很复杂,需要多个部门的医疗保健专业人员(HCPs)进行协作。然而,当健康信息交换(HIE)不充分时,就会导致护理协调和连续性受阻。目前正在开发一种基于网络的个人电子健康记录(PEPA),由患者控制,可跨部门访问个人健康数据。本研究的目的是探讨其感知到的益处和担忧。采用定性方法,进行了10个焦点小组讨论,收集了三个潜在用户群体的意见:结直肠癌患者(n = 12)、医生(n = 17)和其他HCPs(n = 16)。来自莱茵-内卡地区(德国)不同卫生部门的代表参与了讨论。数据进行了音频和视频录制,逐字转录并进行了主题分析。我们的研究表明,患者和HCPs期望PEPA能提高信息的跨部门可用性、促进跨部门合作并便于数据管理。预计癌症护理质量会得到改善。在数据保护和数据安全方面也表达了担忧。像PEPA这样的概念为支持HIE和避免跨部门癌症护理中的信息缺口提供了机会。这可能会改善护理的协调性和连续性。必须解决数据安全和保护方面的问题。