Department of Clinical Research, Sørlandet Hospital Trust, Post Box 416, Kristiansand N-4604, Norway.
Department of Information and Communication Technology, University of Agder, Post Box 422, Kristiansand N-4604, Norway.
J Healthc Eng. 2020 Sep 15;2020:8824882. doi: 10.1155/2020/8824882. eCollection 2020.
Health care service provision of individualised treatment to an ageing population prone to chronic conditions and multimorbidities is threatened. There is a need for digitally supported care, that is, (1) person-centred, (2) integrated, and (3) proactive. The research project , , aimed to validate and verify the prerequisites for health care systems run with patient-centred service models. This paper presents an explorative study of the digital support of a cross-organisational health care team in Norway, providing services to elderly frail people with multimorbidities in hospital discharge transition. Qualitative research methods were employed, with interviews and observations to map and evaluate the information flow and the digital support of collaborative work across organisations. The evaluation showed a lacking interoperability between the digital systems and a limited support for cross-organisational teamwork, causing raised manual efforts to maintain the information flow. Tools for coordination and planning across organisations were lacking. To enhance the situation, principles for a cloud-based health portal are proposed with a shared workspace, teamwork functionality for cross-organisational health care teams, and automatic back-end synchronisation of stored information. The main implications of this paper lie in the proposed principles which are transferable to a multitude of clinical contexts, where ad-hoc based access to shared medical information is of importance for decision-making and life-saving treatment.
医疗保健服务为易患慢性病和多种疾病的老龄化人口提供个体化治疗，这一服务正受到威胁。数字化支持的医疗保健服务变得尤为必要，即（1）以患者为中心，（2）整合，（3）主动。研究项目，旨在验证和验证以患者为中心的服务模式运行的医疗保健系统的前提条件。本文介绍了挪威跨组织医疗保健团队的数字化支持的探索性研究，该团队为处于出院过渡阶段的患有多种疾病的体弱老年人提供服务。采用定性研究方法，通过访谈和观察来映射和评估信息流动以及跨组织协作的数字化支持。评估结果表明，数字系统之间缺乏互操作性，对跨组织团队合作的支持有限，导致需要大量的人工努力来维持信息流。跨组织协调和规划工具也有所欠缺。为了改善这种情况，提出了基于云的健康门户的原则，其中包括共享工作区、跨组织医疗保健团队的团队协作功能以及存储信息的自动后端同步。本文的主要意义在于提出的原则可以应用于多种临床环境，在这些环境中，临时访问共享医疗信息对于决策和挽救生命的治疗至关重要。
