Abstract
BackgroundThis paper explores Norwegian doctors’ use of and experiences with a national tool for sharing core patient health information. The summary care record (SCR; the Kjernejournal in Norwegian) is the first national system for sharing patient information among the various levels and institutions of health care throughout the country. The health authorities have invested heavily in the development, implementation and deployment of this tool, and as of 2017 all Norwegian citizens have a personalised SCR. However, as there remains limited knowledge about health professionals’ use of, experiences with and opinions regarding this new tool, the purpose of this study was to explore doctors’ direct SCR experiences.MethodsWe conducted 25 in-depth interviews with 10 doctors from an emergency ward, 5 doctors from an emergency clinic and 10 doctors from 5 general practitioner offices. We then transcribed, thematically coded and analysed the interviews utilising a grounded theory approach.ResultsThe SCRs contain several features for providing core patient information that is particularly relevant in acute or emergency situations; nonetheless, we found that the doctors generally used only one of the tool’s six functions, namely, the pharmaceutical summary. In addition, they primarily used this summary for a few subgroups of patients, including in the emergency ward for unconscious patients, for elderly patients with multiple prescriptions and for patients with substance abuse conditions. The primary difference of the pharmaceutical summary compared with the other functions of the tool is that patient information is automatically updated from a national pharmaceutical server, while other clinically relevant functions, like the critical information category, require manual updates by the health professionals themselves, thereby potentially causing variations in the accuracy, completeness and trustworthiness of the data.ConclusionTherefore, we can assume that the popularity of the pharmaceutical summary among doctors is based on their preference to place their trust in – and therefore more often utilise – automatically updated information. In addition, the doctors’ lack of trust in manually updated information might have severe implications for the future success of the SCR and for similar digital tools for sharing patient information.
Highlights
This paper explores Norwegian doctors’ use of and experiences with a national tool for sharing core patient health information
A blue summary care record (SCR) icon does not necessarily mean that the patient does not have critical information As we described in the background section, an SCR is accessible from the doctor’s local Electronic Health Record (EHR) system and appears as either a blue or a red icon
The doctors working in the emergency clinic and at the emergency ward opened the SCR to check for critical information
Summary
This paper explores Norwegian doctors’ use of and experiences with a national tool for sharing core patient health information. The summary care record (SCR; the Kjernejournal in Norwegian) is the first national system for sharing patient information among the various levels and institutions of health care throughout the country. The Norwegian summary care record (SCR), known as the Kjernejournal in Norwegian, is a new, national, digital tool that gives all health professionals access to selected health information regardless of where a patient is treated. This is the first national, digital tool for sharing patient information across all institutions and levels of care in Norway [2, 3]. Despite the huge financial investment and resources devoted to its development, implementation and deployment, the SCR is still not a routinely used tool in the Norwegian health care sector
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