Abstract
To explore how the implementation of the concept 'Home hospitalisation of heart patients' by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors. Inter-organisational theory. The case study approach was applied. Triangulations of data collection techniques were used: documentary materials, participant observation, qualitative and focus group interviews. The clinical decision-making and task solving became multidisciplinary and integrated with the implementation of telehomecare and, therefore, complex in terms of the prescription and adjustment of patient medicine. Workflows between healthcare professionals across sectors changed from sequential to collective client flows. Pre-existing procedures for patient care, treatment, and responsibility were challenged. In addition, the number of tasks for the district nurses increased. Integration in the clinical task-solving area increases fragmentation in the knowledge technologies in a network perspective. Implementing the concept of 'Home hospitalisation of heart patients' by means of telehomecare technology will result in a more integrated clinical task-solving process that involves healthcare professionals from various sectors. Overall, the integration of clinical tasks between hospital and district nursing will result in a direct benefit for the heart patients.
Highlights
Today’s healthcare system appears to be fragmented in several aspects of the cross-sector coordination of patient care and treatment
To explore how the implementation of the concept ‘Home hospitalisation of heart patients’ by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors
The integration of clinical tasks between hospital and district nursing will result in a direct benefit for the heart patients
Summary
Today’s healthcare system appears to be fragmented in several aspects of the cross-sector coordination of patient care and treatment. The fragmentation may arise on account of the healthcare professionals asserting their right to conduct specific tasks across sectors by e.g. claiming a monopoly on concrete task assignments w1x. The patient-related cooperation and task solving is often founded on mutual consent and informal organisation, not always in compliance with general policies. In this respect, there is a lack of cohesive power and integration between the sectors. There is insufficient infrastructural support of horizontal processes in a patient-care process in terms of quality assurance, information systems and financial systems. Insufficient infrastructural support of horizontal processes in patient-care may be a result of each sector focusing on singular functions. A network perspective would lead to a stronger infrastructure support w2x
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