Challenges for IT-supported shared care: a qualitative analyses of two shared care initiatives for diabetes treatment in Denmark

Maren Fich Granlien,Jesper Simonsen

doi:10.5334/ijic.187

Abstract

To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of Denmark throughout 2005. The study comprises 21 interviews and 35 hours of observations. The data were analysed through a coding process that led to the emergence of three main challenges impeding the organisational implementation of IT-supported shared care. The two cases faced the same challenges that led to the same problem: The secondary care sector quickly adopted the system while the primary sector was far more sceptical towards using it. In both cases, we observe a discrepancy of needs satisfied, especially with regard to the primary care sector and its general practitioners which hinder bridging the primary sector (general practitioners) and the secondary sector (hospitals and outpatient clinics). Especially the needs associated with the primary sector were not being satisfied. We discovered three main challenges related to bridging the gap between the two sectors: (1) Poor integration with the general practitioners' existing IT systems; (2) low compatibility with general practitioners' work ethic; (3) and discrepancy between the number of diabetes patients and the related need for shared care. We conclude that development of IT-supported shared care must recognise the underlying and significant differences between the primary and secondary care sectors: If IT-supported shared care does not meet the needs of the general practitioners as well as the needs of the secondary care sector the initiative will fail.

Highlights

During the past decade in Denmark, electronic information technologies (IT), representing infrastructures that support integrated and long-term medical care across hospitals and professional boundaries, have been the subject of extensive investments and multiple implementation efforts
Short et al w2x have conducted a qualitative study of the general practitioners’ barriers to the adoption of an IT system that supports decisions made during their consultations. They identify challenges that correspond to the challenges that we find with relation to the adoption of IT-supported shared care
The two cases presented in this article represent some of the first serious initiatives for IT-supported shared care for diabetes treatment in Denmark

Summary

Discussion and conclusion

The two cases faced the same challenges that led to the same problem: The secondary care sector quickly adopted the system while the primary sector was far more sceptical towards using it. In both cases, we observe a discrepancy of needs satisfied, especially with regard to the primary care sector and its general practitioners which hinder bridging the primary sector (general practitioners) and the secondary sector (hospitals and outpatient clinics). We discovered three main challenges related to bridging the gap between the two sectors: [1] Poor integration with the general practitioners’ existing IT systems; [2] low compatibility with general practitioners’ work ethic; [3] and discrepancy between the number of diabetes patients and the related need for shared care. IT-support, challenges, diabetes, organisational implementation, primary care sector, secondary care sector, qualitative case study

Introduction

Findings

Related work

Conclusion