Are general practitioners satisfied with electronic discharge summaries?

Balmain Hospital, Balmain NSW 2041.
The HIM journal (Impact Factor: 1.15). 02/2007; 36(1):7-12.
Source: PubMed


The aim of this study was to assess general practitioners' (GPs') satisfaction with the quality of information in electronic discharge summaries and the timeliness of their receipt of the summaries. The study was conducted in a 75-bed Australian public metropolitan hospital which uses an electronic discharge summary which is mailed to the patients' nominated GP. Eighty-five GPs were surveyed regarding their satisfaction with the content of the electronic discharge summary and the timeliness of receipt. the majority of respondents indicated that they had received the electronic discharge summary within two weeks of the patients' discharge from hospital. The majority also indicated that they were satisfied with all eight documentation data elements. Some GPs indicated that they would prefer to receive the electronic discharge summary electronically by email rather than by conventional mail, and that they would like more information in the "follow-up and recommendations" content areas of the summary. It was concluded that the majority of GPs agreed that the electronic discharge summary was an improvement over the manual discharge summary. Further developments in the safe and secure electronic transfer of discharge summary information needs to be addressed to meet the information needs of GPs.

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Available from: Joanne Callen, Mar 16, 2015
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    • "electronic/analogical dictation) [2]. Those studies focus on four types of impact indicators: the satisfaction of the users [3], the performance of the process: delivery time to the recipient [4] [5], process quality: errors in identifying patients/physicians, missing letters, the quality of the letter's content [5] [6]: its completeness [6] [7] [8], presence of errors in the within the letter [7] [8]. "
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    ABSTRACT: Studies on the impact of a Health Information Technology seldom consider socio-technical characteristics of the work system in which the technology is implemented. Yet those dimensions may act as hidden variables that could explain the inconsistency of impact studies' results in terms of performance, quality and satisfaction. This paper reports on the identification of those variables in the discharge letter (DL) process. Human Factors experts performed an analysis of the work system of the DL process in 17 medical units. The DL process is composed of three sub-processes running with work system differing according to the distribution of tasks, the technology implemented and the work organization. Hidden variables identified are: verification by the physician, technology's integration, number of editing cycles, physicians' preferences etc. Those variables can be collected automatically or by questionnaire. Statistical analyses will have to be performed to know which variable explain impact indicators.
    Studies in health technology and informatics 08/2015; 218:145-50.
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    • "Evaluation studies of electronic discharge summaries conducted in Australia have shown mixed results (Alderton & Callen 2007; Callen, Alderton & McIntosh 2008; Callen, McIntosh & Li 2010). One study found that up to 93% of GPs found electronic discharge summaries were an overall improvement on the paper discharge summary in terms of quality of information and its timeliness (Alderton & Callen 2007). However, neither of the studies comparing paper and electronic discharge summaries found a significant difference in the quality of medication documentation (Callen, Alderton & McIntosh 2008; Callen, McIntosh & Li 2010). "
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    ABSTRACT: Complete, accurate and timely hospital discharge summaries are important for continuity of care. The aim of this study was to evaluate the effectiveness of an electronic discharge summary system in improving the medication information provided compared to the information in paper discharge summaries. We conducted a retrospective audit of 199 paper and 200 electronic discharge summaries from a 350-bed teaching hospital in Sydney, Australia. The completeness of medication information, and whether medication changes during the admission were explained, were assessed. Further, the likelihood of any incomplete information having an impact on continuity of care was assessed. There were 1352 and 1771 medication orders assessed in paper and electronic discharge summaries, respectively. Of these, 90.9% and 93.4% were complete in paper and electronic discharge summaries, respectively. The dose (OR 25.24, 95% CI: 3.41-186.9) and route (OR 8.65, 95% CI: 3.46-21.59) fields of medication orders, were more likely to be complete in electronic as compared with paper discharge summaries. There was no difference for drug frequency (OR 1.09, 95% CI: 0.77-1.55). There was no significant improvement in the proportion of incomplete medication orders rated as unclear and likely to impede continuity of care in paper compared with electronic discharge summaries (7.3% vs. 6.5%). Of changes to medication regimen, only medication additions were more likely to be explained in the electronic (n=253, 37.2%) compared to paper (n=104, 14.3%) discharge summaries (OR 3.14; 95% CI: 2.20-4.18). In summary, electronic discharge summaries offer some improvements over paper discharge summaries in terms of the quality of medication information documented. However, explanations of changes to medication regimens remained low, despite this being crucial information. Future efforts should focus on including the rationale for changes to medication regimens in discharge summaries.
    The HIM journal 07/2014; 43(3). DOI:10.12826/18333575.2014.0009.Lehnbom · 1.15 Impact Factor
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    • "The increasing use of electronic patient management systems in hospitals which facilitate computer-generated summaries in standardized formats has addressed many of the problems with handwritten summaries. Structured electronic discharge summaries created with input from senior doctors may be much more effective for accurately communicating discharge information to GPs [6] [7]. Nevertheless highly structured and accurate discharge summaries are of limited use if they do not reach the primary physician in a timely manner. "
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    ABSTRACT: To examine the effectiveness of delivering of computer-generated discharge summaries to general practice by email, fax, post and patient hand delivery. Blinded, randomized controlled trial. A pre-study audit ascertaining baseline statistics and a follow-up survey were conducted with general practice to determine preferred medium for receiving discharge communication. 196 geriatric patients who were admitted to the aged care ward of a 300-bed metropolitan teaching hospital. Twenty-eight patients were lost to follow-up and 52 general practices participated in the final survey. The pre-study audit followed 63 discharges from the same ward. 168 eligible patients were randomly assigned to have their electronic discharge summary sent by email (n=40), fax (n=48), post (n=40) or patient hand delivery (n=40). Receipt of discharge summary by the general practice clinic within 7 days of patient discharge from hospital. The receipt rates for email (73.9%, n=17) and fax were comparable (69.4%, n=25; chi(2)=0.137, df=1, P=0.712), and significantly higher (chi(2)=19.86, df=3, P<0.0002) than post (43.8%, n=14) and patient hand delivery (24.2%, n=8). General practices indicated that fax was the most preferred method (82.7%) for communication of discharge summaries. The majority of general practices (75.0%) utilized an electronic system for storage of patient information while 88.5% of practices reported using medical prescribing software. Transmission of computer-generated discharge summaries by fax or email offers the most effective method of communicating with primary care physicians, as long as accurate contact information is available. Although fax is still the most preferred, email has many advantages that could potentially allow it to replace fax as a standard mode for delivery of discharge communication.
    International Journal of Medical Informatics 03/2010; 79(3):167-72. DOI:10.1016/j.ijmedinf.2009.12.006 · 2.00 Impact Factor
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