Abstract
BackgroundInformational discontinuity can have far reaching consequences like medical errors, increased re-hospitalization rates and adverse events among others. Thus the holy grail of seamless informational continuity in healthcare has been an enigma with some nations going the digital way.Digitization in healthcare in India is fast catching up. The current study explores the components of informational continuity, its impact on clinical decision-making and captures the general perception among the doctors towards a digital solution.MethodsCross-sectional study with snowball sampling. A survey questionnaire was developed and validated through a pilot study, then circulated through online platforms. Responses from doctors were obtained through an online Google form for a period of 3 months and analyzed using SPSS 20. The categorical variables were analyzed using Chi-square test.Results1413 responses were obtained through a national level survey. Respondents were from a wide range of work experiences, locations, sectors, specialties and patient load. Components of patient records like clinical notes, investigation reports, previous diagnosis and treatment details were rated to be very important.41% reported about half and 20% reported about 3/4th of their patients do not bring relevant records. Patients from rural areas, visiting state government hospitals and visiting general practitioners were less likely to bring relevant records during consultations.The fallouts of not having timely relevant patient information of the patients include more time per patient, repeat investigations, difficulty to arrive at definitive diagnosis, difficulty to take further treatment decisions and impaired overall clinical decision making which were said to be significant by respondents across the spectrum. The benefits of having timely relevant patient information were also reported consistently across the spectrum.An overwhelming proportion (83%), from across the spectrum, unequivocally expressed their willingness to use digital platforms for accessing patients’ relevant medical records.ConclusionPrevalence of informational discontinuity and its impact on clinical decision making is significant with definite benefits of having timely relevant medical history. There is strong willingness among the doctors to use digital solution(s) without any extra investment or effort on their part making customized solutions pertinent.
Highlights
Informational discontinuity can have far reaching consequences like medical errors, increased rehospitalization rates and adverse events among others
The following are the profile of respondents; years of experience, type of practitioner, sector, area/ location of practice and average number of patients seen per day
The western countries have been on the quest for the holy grail of informational continuity through early adoption of Electronic Health Record (EHR) systems
Summary
Informational discontinuity can have far reaching consequences like medical errors, increased rehospitalization rates and adverse events among others. The current study explores the components of informational continuity, its impact on clinical decision-making and captures the general perception among the doctors towards a digital solution. Information continuity is one among the important components of continuity of care along with management and relational continuity. Information is the common thread linking care from one provider to another and from one healthcare event to another [1]. Information can be disease or person focused. It is important in the process of patient care as it provides clarity on patient’s condition and events till date.
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