JMIR Publications

ABSTRACT

Background:

Discharge planning (DP) is crucial for care continuity after a hospital stay but remains complex due to organizational constraints, interprofessional coordination, and administrative demands. Despite ongoing digitalization efforts, many health technologies overlook the sociotechnical nature of discharge processes, limiting acceptance and integration into clinical workflows.

Objective:

To examine real-world DP practices in two German university hospitals, identify user-centered needs, and derive design implications for responsibly integrating AI-based systems into DP.

Methods:

A mixed-methods field study was conducted combining qualitative and quantitative approaches. In the qualitative phase, DP employees participated in workshops (n = 33). Additionally, expert interviews were conducted with 2 physicians and 3 nurses (n = 5). Activities explored understanding of AI, challenges in DP workflows, and best-case process scenarios; existing processes were collaboratively modeled to identify potential intervention points for technological support. Transcripts were analyzed inductively following Mayring’s qualitative content analysis. Quantitative data were collected through a standardized questionnaire (n = 23), focusing on workload distribution, process inefficiencies and openness to using AI in the DP context. Descriptive statistics were used to identify high-burden segments. Findings were integrated through methodological triangulation.

Results:

Persistent challenges emerged in interdisciplinary communication, documentation practices, and information continuity. Participants expressed uncertainty about the value of AI in DP, emphasizing the need for transparency, explainability, and role alignment. Questionnaire data confirmed bottlenecks in information transfer and high administrative workload. Design requirements for future systems include process transparency, support for coordination tasks, and adaptability to clinical roles.

Conclusions:

DP is a sociotechnical process in which human expertise and organizational context must guide system design. Participatory, context-aware design approaches are essential for integrating AI into clinical practice. Aligning technology with everyday workflows can increase acceptance and yield more effective digital interventions.