Abstract
Effective sharing of clinical information between care providers is a critical component of a safe, efficient health system. National data-sharing systems may be costly, politically contentious and do not reflect local patterns of care delivery. This study examines hospital attendances in England from 2013 to 2015 to identify instances of patient sharing between hospitals. Of 19.6 million patients receiving care from 155 hospital care providers, 130 million presentations were identified. On 14.7 million occasions (12%), patients attended a different hospital to the one they attended on their previous interaction. A network of hospitals was constructed based on the frequency of patient sharing between hospitals which was partitioned using the Louvain algorithm into ten distinct data-sharing communities, improving the continuity of data sharing in such instances from 0 to 65–95%. Locally implemented data-sharing communities of hospitals may achieve effective accessibility of clinical information without a large-scale national interoperable information system.
Highlights
As modern healthcare systems move towards service centralisation,[1,2,3,4] the care of individual patients is increasingly shared between several providers
To improve inter-organisational communication during transitions of care, it is critical to identify how the complete clinical record of a patient is distributed across care providers
Identification of hospital episodes involving 19.7 million patients over a 12-month period facilitated analysis of inter-organisational connections in England based on the patient-sharing network
Summary
As modern healthcare systems move towards service centralisation,[1,2,3,4] the care of individual patients is increasingly shared between several providers. Healthcare providers involved in patient sharing should coordinate their efforts to provide effective, integrated care across the patient journey. Providers may sometimes operate as ‘silos’, often without knowledge of the problems addressed, services provided or medications prescribed by the previous hospital.[5,6] The incomplete exchange of health information during transitions of care may lead to ineffective care,[7] adverse patient outcomes and additional healthcare spending.[8] Rather than promoting a seamless care continuum, patient sharing can lead to care fragmentation, for patients with multiple co-morbidities and complex-care needs. Identifying patient sharing between healthcare organisations may inform the development of effective, efficient data-sharing practices at local, regional and national levels.[7]
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