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Experiences of Health Care Providers with Patient-Held Personal Health Records for Asylum Seekers

This study examines the experiences of health care providers in reception centers with a patient-held personal health record for asylum seekers in Germany. The study explores the access to medical history, benefits, limitations, and implementation of the patient-held personal health records.

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Experiences of Health Care Providers with Patient-Held Personal Health Records for Asylum Seekers

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  1. Experiences of health care providers in reception centers with a patient-held personal health record for asylum seekers – a multi-sited qualitative study in a German federal state Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr Department of General Practice and Health Services Research University Hospital Heidelberg rosa.jahn@med.uni-heidelberg.de

  2. Background - When in Germany…. Hospital A Private practitioner A Private practitioner B Private practitioner B Reception center Walk-in clinic Transfer Hospital A Continuity of care across in-country trajectory? Private practitioner C District-level accomodation Hospital B Private practitioner ^C Walk-in clinic Private practitioner A Hospital B Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  3. Background – When in Germany… • Walk-in clinics in house • Nostandards, variousmodels • Professions • Medical fields • Staffsize • Health informationsystem • Paper-based, electronic records Reception center Walk-in clinic Continuity of care withinfacilities? Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  4. Personal Health Record – The Solution? Patient-held PHR Start: Feb 2016 Content: • Name, ID • Explanations for patients / doctors • Chronicdiseases • Medication Plan • Consultations • Medical appointments Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  5. Evaluatingthe PHR - Methods • Research question: • Availabilityofmedicalhistorybefore/after, localpractices, perceivedbenefits & limitations • Data collection: • Semi-structuredinterviews • 17 health care providers (11 doctors, 6 nurses) from 6 receptioncenters in Baden-Wuerttemberg • Analysis: • Coding in MAXQDA, thematicanalysis to identifykeyissues Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  6. Results – Access to historybefore • Particularlyimportantbecausecommunicationwiththepatientscanbechallenging, puzzle work • Particularlydifficult in facilitieswith multiple health informationsystems, large staffsize (~ 40 doctors), lack ofcommunicationwith external doctors • And – All is lost after transfer  Generally positive attitudestowardsthe PHR Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  7. Results – Access to history after • Collecting all medical documents in one place – „folder“ • Reading colleagues‘ notes, improving care • Information about external consultations • Information about consultations prior to transfer • Communicating tasks to nurses – eg blood pressure, prescription • However: • „Most of the time, I see only my own handwriting“ (D5) • „There is a point in the booklet if it is properly kept“ (D4) Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  8. Results – Implementation Implementation successaffectedby… • …workingenvironment • …physicianinformation, inclusion and compliance • …patientinformation, patientcompliance • …integrationof PHR withexistinghealth informationsystems - no „double documentation“ • …perceivedbenefitsof PHR in respective individual worksetting Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  9. Take Home Message • Patient-held PHR considered to improvecontinuityof care • Things to consider in implementation: • The contextneeds to betakenintoaccount! (staffsize, health informationsystem, workingconditions,…) • The providershave to beincluded in theimplementationprocess • Provideguidelinesregardingpatientinformation Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

  10. Time for questions! Heidelberg University Hospital | MERH 2018 | Rosa Jahn, Sandra Ziegler, Stefan Nöst, Sandra Claudia Gewalt, Cornelia Straßner, Kayvan Bozorgmehr

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