Barriers and facilitators to a health information exchange system between general practitioners and hospitals: a qualitative study in Southern Switzerland.

Abstract

Health information exchange (HIE) systems are computer tools that healthcare providers use to share patients' medical information electronically. Our study aimed to identify barriers and facilitators perceived by general practitioners (GPs) when using an HIE system in the Canton of Ticino, a region in southern Switzerland. We performed a qualitative study using semi-structured interviews. Ten GPs participated in the study. We analysed transcripts using thematic content analysis and following an abductive approach (a mix of deductive and inductive approaches). Our findings indicate the following main facilitators of the HIE system: (a) the perception of having to do with a secure system; (b) the possibility of delegating its management to secretaries and healthcare assistants; (c) technical support and training; (d) high quality of the information exchanged; (e) positive impact on clinical practice; and (f) regional context. However, major challenges still persist, and GPs reported the following main barriers to using an HIE system: (a) a frequent lack of all the patient documentation they needed; (b) no effective workflow improvements; and (c) lack of some technical features. The results of our study provide a qualitative perspective of opinions and experiences of GPs that can inform improvements of the current HIE system and future federal and cantonal HIE initiatives in Switzerland and elsewhere.