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Home Healthcare, Hospice, and Information Technology Innovations Conference

Innovations in Home Healthcare, Hospice, and Information Technology

A forum towards achieving evidence-based diffusion and implementation of innovations

Fri, Nov 3, 2017
Friday, Nov 3, 2017, Washington - D.C.
H3IT: Home Healthcare, Hospice, and Information Technology Conference Washington D.C., 2014
Information Practices and Information Systems in
Home Health Care: A Field-Study
Ragnhild Hellesø
, Merete Lyngstad
n line with the general development in health care an increasing number of people receive health care in their
homes. Caring for patients in their homes requires that providers have systems that collaborate with other
providers, with access to relevant, accurate, up-dated and situation specic information. To enhance quality
of care and eciency in collaboration of services, the use of appropriate health information technologies (HIT)
is frequently suggested as a solution.
In addition dierent types of collaborative processes must be supported by dierent
technologies in order to provide proper support to the work. Most studies which have investigated health care informa-
tion practices have been conducted in hospitals.
We have not identied studies exploring home care nurses’ information
practices in-depth. The aim of this presentation is to report from an ongoing study aimed to explore home care nurses’
information practices including their collaborators in the dierent situations and available information.
Methods: A eld study using observations, individual and group interviews were conducted. The entire material contains
totally 97 observations and 23 interviews with nurses in two Norwegian municipalities. A conceptual framework building on
a practice typology guided the overall study design. The typology describes that nursing care could be separated within four
dierent practice situations; acute situations, problematic situations, non-problematic situations, and problem identifying
situations. Each of the practice situations has their own distinct characteristics, though they are not mutually exclusive
An integrative analytical approach was used to analyze the collected data.
Results: The analysis revealed that practice situations in home health care are characterized along two dierent but inter-
dependent axes regarding the nurses’ information needs. Firstly, patient related axes representing a continuum from acute to
long term care situations. The second axes concerns organizational factors representing a continuum from where the nurses
collaborated with other providers in a particular situation in a limited time and space, to practice situations which required
long-time interdisciplinary and inter-organizational coordination and information. The home care nurses did not always have
access to relevant situation specic information in the dierent practice situations. This was partly due to lack in their HIT
system and partly due to gaps between providers in dierent levels of the health care system. The two dierent municipalities
had dierent HIT systems. Both systems had their advantages but also shortcomings for covering the nurses’ information
and collaboration situations.
Discussion: The ndings illustrate that home care nurses need to manage dierent information situations. They are not
guaranteed accurate information at point of care in every situation. Their HIT systems are not developed at a level of meeting
the plurality and complexity of practice and information situations. However, the ndings from the current study may be
helpful towards a more systematized development of feasible and appropriate HIT.
Conclusion: The study highlights the need for developing more appropriate and accurate HIT-systems for ensuring quality
and safe health care for patients at home.
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Institute of Health and Society, University of Oslo, Norway
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