JMIR Publications

ABSTRACT

Background:

Hospitalized patients with complex care needs require an interprofessional team of health professionals working together to support their care in hospital and during discharge planning. However, interprofessional communication and collaboration in the inpatient setting is often fragmented and inefficient, leading to poor patient outcomes and provider frustration. Health information technology can potentially help improve team communication and collaboration, but to date, evidence of their effectiveness is lacking. There are also concerns that current implementations further fragment and increase clinician burden without proven benefits.

Objective:

To generate transferrable lessons for future designers of health information technology tools to facilitate team communication and collaboration.

Methods:

A secondary analysis of the qualitative component of a mixed methods evaluation was carried out. The electronic communication and collaboration platform was implemented on two general internal medicine wards in a large community teaching hospital in Mississauga, Ontario, Canada. Fifteen inpatient clinicians on those wards, including nurses, physicians, and allied healthcare providers, were recruited to participate in semi-structured interviews about their experience with a co-designed electronic communication and collaboration tool. Data was analyzed using the Technology Acceptance Model (TAM), and themes relating to the constructs of Perceived Ease Of Use (PEOU) and Perceived Usefulness (PU) were identified.

Results:

: A secondary analysis guided by the TAM highlighted the following. Intuitive design removed training as a barrier for use, but lack of training may hinder participants’ PEOU if features designed for efficiency are not discovered by users. Organized information was found to be useful for creating a comprehensive clinical picture of each patient and facilitating improved handovers. However, information needs to be both comprehensive and succinct at the same time, or else information overload may negatively impact PEOU. The mixed paper and electronic practice environment also negatively impacted PEOU due to unavoidable double documentation and need for printing. Participants perceived the tool to be useful as it improved efficiency in information retrieval and documentation, improved the handovers process, afforded another mode of communication when face-to-face communication was impractical, and improved share awareness. The PU of this tool is dependent on its utilization, and is optimized when all team members use it.

Conclusions:

Electronic tools can support communication and collaboration for interprofessional teams caring for complex patients. There are transferable lessons learned that can improve PU and PEOU of future systems.