Information Technology Reference
In-Depth Information
applications in Austria. The main target is the
creation of a national health-information-system
for people and health service providers. The proj-
ect Smart Open Services for European Patients
(epSOS) was started in July 2008 by 12 members
of the European Union. The goal of epSOS is to
enable access to patient data over national bor-
ders. It aims at building and evaluating a service
infrastructure for demonstrating cross-border
interoperability between European Electronic
Health Record Systems.
Due to the use of different care models, it is
difficult to build a mutual basis of care-relevant
information. As semantic interoperability is neces-
sary for the technical interoperability, therefore dif-
ferent care documentation systems were analyzed
to define common definitions and categorizations
of care-relevant data. The analysis showed that
no standardized vocabulary has been used, and
that the interpretation of certain terms spans a
wide range of meaning. A delegation of caretak-
ers was consulted to develop an electronic care
summary (Franz, Lehner, Mayr, & Mayr, 2009)
which meets the varying needs of the recipients.
As there is no established electronic connection to
transfer mobile nursing documents, nursing home
documentation, and hospital care documentation,
the exchange of documents is frequently solely
paper-based. When a patient is admitted to a hos-
pital, the written nursing care summary is printed
and given to the patient to take with her or him.
Such notes are structured in different ways and
generally cover between 2 and 20 pages. In one
survey, 40% of the nursing staff in nursing homes
(n=265) confirmed that nursing care summaries
are sometimes lost on the way (Mayr & Lehner,
2008b). Knowing this background, it is obvious
why a steady transfer of care-relevant informa-
tion for nursing is virtually impossible. If the
relevant data arrive at the correct station, it has
to be retrieved. The same process is necessary at
the return from the hospital to the long-term care
facility. Likewise, all care-relevant data of users of
short-term care or day care have to be registered
anew on the basis of the handwritten comments
of mobile nursing services.
This inadequate process affects the quality
of nursing care, and therefore the quality of liv-
ing of elderly people (Ament-Rambow, 2003).
Repeated data entry leads to an administrative
overhead for the nursing staff and is an unnecessary
cost driver in the welfare and health system. As
long as mobile nursing services use paper-based
documentation and healthcare facilities work (at
least partially) using IT-supported systems, com-
e-Care: Efficient Exchange
of Patient Care Data
The project
e-Care
(Patient-oriented Care Infor-
mation) was started in 2008 by the Upper Austria
University of Applied Sciences in cooperation
with the IT company x-tention IT GmbH and
several hospitals, mobile nursing services, and
nursing homes. The development process lasted
two years, in which the findings of national as well
as international projects and initiatives (ELGA,
EpSOS, and IHE) were considered. The goal of
e-Care was to make all patient care-relevant data
electronically accessible and readily available.
When a patient is acutely referred to the hospital
from a nursing home, the nursing care summary
is sent with the patient via the transport service
to the reception ward and finally to the stationary
ward in the hospital. On its way, it passes up to
nine interfaces and is therefore easily lost before
it arrives at its intended destination (Mayr &
Lehner, 2008b). In mobile nursing and homecare,
information exchange is even more difficult. When
an acute problem occurs, there is often no care-
giver present who can arrange that an up-to-date
nursing care summary accompanies the patient
(Mayr M., 2008c). If the nursing care summary is
lost or there is no one involved in the transferring
process or referral, care-relevant data for nursing
care may be transferred too late or not transferred
at all, meaning that the data is not accessible for
all intended recipients when it is needed.
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