A qualitative analysis of communication workflows between adult day service centers and primary care providers
- PMID: 34964467
- PMCID: PMC9006686
- DOI: 10.1093/jamia/ocab284
A qualitative analysis of communication workflows between adult day service centers and primary care providers
Abstract
Objectives: Our study documented communication workflows across adult day care centers (ADCs) and primary care providers (PCPs) around complex needs of persons living with dementia (PLWD). We also identified barriers and facilitators to productive communication in clinical decision support and clinical information systems.
Materials and methods: We conducted 6 focus groups with ADC staff (N = 33) and individual semistructured interviews with PCPs (N = 22) in California. The eHealth Enhanced Chronic Care Model was used to frame the directed qualitative content analysis.
Results: Our results captured cumbersome and ineffective workflows currently used to exchange information across PCPs and ADCs. Stakeholders characterized current communication as (1) infrequent, (2) delayed, (3) incomplete, (4) unreliable, (5) irrelevant, and (6) generic. Conversely, communication that was bidirectional, relevant, succinct, and interdisciplinary was needed to elevate the standard of care for PLWD.
Discussion and conclusion: ADCs possess a wealth of information that can support clinical decision-making across community-based providers involved in the care of PLWD, especially PCPs. However, effective information exchange is mired by complicated workflows that rely on antiquated technologies (eg, facsimile) and standard templates. Current information exchange largely focuses on satisfying regulatory guidelines rather than supporting clinical decision-making. Integrating community-based services into the health care continuum is a necessary step in elevating the standard of care for PLWD. In the absence of interoperable electronic health records, which may not be financially viable for ADCs, other options, such as mobile health, should be explored to facilitate productive information exchange of personalized relevant information.
Keywords: adult day services; dementia; electronic health records; health communication; primary health care.
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Figures
References
-
- Aging in Place. Adult day care; 2021. https://aginginplace.org/adult-day-care/. Accessed June 30, 2021.
-
- Sadarangani T, Zagorski W, Parker L, et al. Identifying research priorities in adult day centers to support evidence-based care of vulnerable older adults. Prog Community Health Partnersh 2021; 15 (1): 127–31. - PubMed
-
- Caffrey C, Lendon JP. Service provision, hospitalizations, and chronic conditions in adult day services centers: findings from the 2016 National Study of Long-Term care providers. Natl Health Stat Rep 2019; 124: 1–9. - PubMed
-
- Rothwell CJ, Madans JH, Lau DT, et al. Long-term care providers and services users in the United States, 2015–2016: data from the 2016 National Study of Long-Term Care Providers. Vital Health Stat 2019; 43: 1–78. - PubMed