Presentation
DH9 - Strategies for Ensuring Accuracy in Information Gathering in CMC Patient Care during the Pandemic: Healthcare Providers' Perspectives
DescriptionIntroduction:
Children with medical complexity (CMC), are children and youth with multiple chronic health conditions, that need intense healthcare utilization and provision. CMC may have functional limitations and/or be dependent on medical technology devices to live their daily life. Because of the multi-disease complexity, these children often encounter many healthcare providers over the course of their lives. For effective care of CMC, it is important to coordinate care and share important information between providers to ensure integrated care and good case management around the child. Modern healthcare makes use of digital systems to document the medical information of children. However, there are challenges preventing easy collaboration and data sharing between healthcare roles, for example, different health information systems used by healthcare providers. Because of the critical nature of CMC, it is important to get accurate data about the child when needed and receive the data on time. This research is a qualitative analysis focused on gathering perspectives of healthcare providers on the current used strategies to ensure accurate and timely medical information exchange while caring for CMC during the pandemic.
Methods:
The study involved 15 healthcare professionals who provided care to children with medical complexity (CMC). The participants consist of 5 home nurses and 10 doctors. The doctors represented various medical roles, including hospitalists, specialists, and primary care physicians, offering a diverse perspective on CMC patient care during the pandemic. Participants were recruited through a sampling approach, ensuring representation across different healthcare roles. Recruitment was carried out via personalized invitations, and participation was voluntary. Semi-structured, in-depth individual interviews were conducted with each participant. The interviews were conducted via Zoom, with each meeting lasting approximately 30 to 45 minutes. The interviews were designed to explore the strategies used by healthcare providers to ensure accuracy in information gathering in CMC care during the pandemic. The central research question guiding this study was: "How did you manage to obtain accurate and timely information about your patients during the pandemic? What were the main sources?". All interviews were audio-recorded with participants' permission to ensure accuracy in data capturing. The results were reported anonymously.
After capturing the data, we performed a thematic analysis to extract insights from the Zoom interview transcripts. This approach facilitated the identification of patterns and key insights shared by healthcare providers. The objective was to gain a comprehensive understanding of the strategies utilized by healthcare professionals in their CMC patient care during the pandemic and identify areas for enhancement.
Results:
Our research findings have been categorized into three primary topics: Data Sharing, The Role of Health Electronic Records, and Care Team Collaboration. These thematic areas encapsulate the key insights and strategies identified during our investigation into how healthcare providers ensured accuracy in information gathering for children with medical complexity during the pandemic.
Data Sharing: From the healthcare provider's perspective, a central topic appeared regarding the importance of maintaining effective communication and accurate information flow during the pandemic. Sharing critical patient details and updates with all relevant healthcare professionals promptly was a challenge, especially when there was an increased demand for services and limited resources. Also, the pandemic raised questions about when and how in-person visits should occur. Some healthcare providers may have shifted to telemedicine or remote consultations, leading to concerns about the appropriateness of these virtual interactions versus physical examinations. One of the doctors mentioned ”I think clinicians all tried their best. I never really felt like anybody completely disappeared. There were a few physicians I felt like completely disappeared, but for the most part, we were still able to communicate. It was just how accurate was our information, who saw the kid in person, and then kind of relaying that information around to everybody”.
The Role of Electronic Health Records: Accessing patient information through the electronic health record (EHR) proved to be a valuable resource during the pandemic. The EHR system facilitated efficient retrieval of essential data, contributing to accurate and timely patient care. The healthcare providers highlighted the challenges associated with using different hospitals and providers' EHR systems. As one doctor explained, “Different hospitals and providers might be using different Electronic medical records in terms of the computerized data system. But what's helpful, at least where I work is that most, but not all, of the children who come to our hospital are already seen by outpatient pediatricians who are part of our health system. So it's all the same electronic medical records. So I can see all their visits with their primary care physician as well as their staff. Specialists are usually visible to us in their electronic charts. So usually, when a patient with medical complexity gets admitted to the hospital, a big part of their care is to review their electronic medical chart, and look at all the problems that are listed, as well as all the recent visits”.
One of the doctors highlighted the role of "Care Everywhere" in addressing the challenge of accessing and exchanging electronic health records across various healthcare institutions. The doctor mentioned, “A lot of people who use these medical records. if they're not in this institution. You can get some idea of what happened during the visit, it is called care everywhere”.
Care Team Collaboration: We found that parents played a crucial role in working closely with doctors and nurses to ensure accurate information gathering for children with medical complexity during the pandemic. This involved activities like verifying medication doses and following up on doctors' appointments. Effective communication between healthcare providers and parents was fundamental to maintaining accurate patient data. As one nurse mentioned, “Parents number one, I would say, because most of them are in with the doctors and pharmacists. If I had I could make calls to verify doses or if the patient did have Covid, how long after they could get their infusion, or something like that. I would communicate with the physician and the pharmacy”. Also, one of the doctors mentioned, “There's something we specifically need, we'll request it from the other specialists, from other sites or we probably rely a lot more on the parents”.
The burden placed on parents in the context of coordinating care for CMC can be emotionally and physically challenging. This requires supporting parents by establishing parent-to-parent support networks, providing parents with comprehensive resources, and training, and ensuring their understanding of their child's medical condition and treatment plan.
Conclusion:
In conclusion, our study explores the strategies used by healthcare providers in the context of caring for CMC during the pandemic. Healthcare providers and parents collaborate closely to validate critical information, coordinate treatments, and bridge gaps in data. Our results shed light on the challenges faced by healthcare providers during the pandemic when caring for children with medical complexity. One of the primary challenges was the direct communication with healthcare providers to verify critical information. Offices were often busy and short-staffed due to the COVID-19 pandemic, which created delays in information verification. Also, our study highlights the importance of ensuring that EHR systems are integrated and shareable across different healthcare providers and institutions. This allows healthcare providers to stay up to date with patient information, regardless of where the patient receives care. Furthermore, our findings revealed the importance of continuously updating healthcare professionals about recent technologies that facilitate the exchange of electronic health records.
Children with medical complexity (CMC), are children and youth with multiple chronic health conditions, that need intense healthcare utilization and provision. CMC may have functional limitations and/or be dependent on medical technology devices to live their daily life. Because of the multi-disease complexity, these children often encounter many healthcare providers over the course of their lives. For effective care of CMC, it is important to coordinate care and share important information between providers to ensure integrated care and good case management around the child. Modern healthcare makes use of digital systems to document the medical information of children. However, there are challenges preventing easy collaboration and data sharing between healthcare roles, for example, different health information systems used by healthcare providers. Because of the critical nature of CMC, it is important to get accurate data about the child when needed and receive the data on time. This research is a qualitative analysis focused on gathering perspectives of healthcare providers on the current used strategies to ensure accurate and timely medical information exchange while caring for CMC during the pandemic.
Methods:
The study involved 15 healthcare professionals who provided care to children with medical complexity (CMC). The participants consist of 5 home nurses and 10 doctors. The doctors represented various medical roles, including hospitalists, specialists, and primary care physicians, offering a diverse perspective on CMC patient care during the pandemic. Participants were recruited through a sampling approach, ensuring representation across different healthcare roles. Recruitment was carried out via personalized invitations, and participation was voluntary. Semi-structured, in-depth individual interviews were conducted with each participant. The interviews were conducted via Zoom, with each meeting lasting approximately 30 to 45 minutes. The interviews were designed to explore the strategies used by healthcare providers to ensure accuracy in information gathering in CMC care during the pandemic. The central research question guiding this study was: "How did you manage to obtain accurate and timely information about your patients during the pandemic? What were the main sources?". All interviews were audio-recorded with participants' permission to ensure accuracy in data capturing. The results were reported anonymously.
After capturing the data, we performed a thematic analysis to extract insights from the Zoom interview transcripts. This approach facilitated the identification of patterns and key insights shared by healthcare providers. The objective was to gain a comprehensive understanding of the strategies utilized by healthcare professionals in their CMC patient care during the pandemic and identify areas for enhancement.
Results:
Our research findings have been categorized into three primary topics: Data Sharing, The Role of Health Electronic Records, and Care Team Collaboration. These thematic areas encapsulate the key insights and strategies identified during our investigation into how healthcare providers ensured accuracy in information gathering for children with medical complexity during the pandemic.
Data Sharing: From the healthcare provider's perspective, a central topic appeared regarding the importance of maintaining effective communication and accurate information flow during the pandemic. Sharing critical patient details and updates with all relevant healthcare professionals promptly was a challenge, especially when there was an increased demand for services and limited resources. Also, the pandemic raised questions about when and how in-person visits should occur. Some healthcare providers may have shifted to telemedicine or remote consultations, leading to concerns about the appropriateness of these virtual interactions versus physical examinations. One of the doctors mentioned ”I think clinicians all tried their best. I never really felt like anybody completely disappeared. There were a few physicians I felt like completely disappeared, but for the most part, we were still able to communicate. It was just how accurate was our information, who saw the kid in person, and then kind of relaying that information around to everybody”.
The Role of Electronic Health Records: Accessing patient information through the electronic health record (EHR) proved to be a valuable resource during the pandemic. The EHR system facilitated efficient retrieval of essential data, contributing to accurate and timely patient care. The healthcare providers highlighted the challenges associated with using different hospitals and providers' EHR systems. As one doctor explained, “Different hospitals and providers might be using different Electronic medical records in terms of the computerized data system. But what's helpful, at least where I work is that most, but not all, of the children who come to our hospital are already seen by outpatient pediatricians who are part of our health system. So it's all the same electronic medical records. So I can see all their visits with their primary care physician as well as their staff. Specialists are usually visible to us in their electronic charts. So usually, when a patient with medical complexity gets admitted to the hospital, a big part of their care is to review their electronic medical chart, and look at all the problems that are listed, as well as all the recent visits”.
One of the doctors highlighted the role of "Care Everywhere" in addressing the challenge of accessing and exchanging electronic health records across various healthcare institutions. The doctor mentioned, “A lot of people who use these medical records. if they're not in this institution. You can get some idea of what happened during the visit, it is called care everywhere”.
Care Team Collaboration: We found that parents played a crucial role in working closely with doctors and nurses to ensure accurate information gathering for children with medical complexity during the pandemic. This involved activities like verifying medication doses and following up on doctors' appointments. Effective communication between healthcare providers and parents was fundamental to maintaining accurate patient data. As one nurse mentioned, “Parents number one, I would say, because most of them are in with the doctors and pharmacists. If I had I could make calls to verify doses or if the patient did have Covid, how long after they could get their infusion, or something like that. I would communicate with the physician and the pharmacy”. Also, one of the doctors mentioned, “There's something we specifically need, we'll request it from the other specialists, from other sites or we probably rely a lot more on the parents”.
The burden placed on parents in the context of coordinating care for CMC can be emotionally and physically challenging. This requires supporting parents by establishing parent-to-parent support networks, providing parents with comprehensive resources, and training, and ensuring their understanding of their child's medical condition and treatment plan.
Conclusion:
In conclusion, our study explores the strategies used by healthcare providers in the context of caring for CMC during the pandemic. Healthcare providers and parents collaborate closely to validate critical information, coordinate treatments, and bridge gaps in data. Our results shed light on the challenges faced by healthcare providers during the pandemic when caring for children with medical complexity. One of the primary challenges was the direct communication with healthcare providers to verify critical information. Offices were often busy and short-staffed due to the COVID-19 pandemic, which created delays in information verification. Also, our study highlights the importance of ensuring that EHR systems are integrated and shareable across different healthcare providers and institutions. This allows healthcare providers to stay up to date with patient information, regardless of where the patient receives care. Furthermore, our findings revealed the importance of continuously updating healthcare professionals about recent technologies that facilitate the exchange of electronic health records.
Event Type
Poster Presentation
TimeMonday, March 254:45pm - 6:15pm CDT
LocationSalon C
Digital Health
Simulation and Education
Hospital Environments
Medical and Drug Delivery Devices
Patient Safety Research and Initiatives