Perspectives on communicative barriers and resources of digital communication between Nursing Homes and Family Practices: a mixed methods study

Eric Kroeber, Kathleen Denny, Thomas Frese, Alexander Bauer

Keywords: e-health, general practice, primary care, digitalisation, nursing homes

Background:
ElectronicE-Health communication in GP (general practitioner) care is becoming increasingly important, especially during the ongoing pandemic. It offersE-Health applications offer the opportunity to exchange relevant patient data quickly and safely. Despite national initiatives, the main communication tools remain telephone and fax.

Research questions:
To establish perspectives of nursing home employees (NSE) and GPs on the possibilities and hurdles of digital communication between nursing homes and GPs in Saxony-Anhalt, Germany.

Method:
Our project consists of two parts. First, a published questionnaire-based cross-sectional survey among 600 randomly selected GPs (PMID: 34781385). Second, an ongoing guideline-based interview study among NSE. The interviews are being transcribed according to Dresing & Pehl (2020) and content-analysed according to Mayering & Brunner.

Results:
The survey’s response rate was 20% (n = 114). The mean age was 53 years and 65% were women. GPs mainly used fax (92%) and telephone (87%) to communicate with nursing homes. Digital technologies were used by less than 10%. Many GPs wanted to use electronic medication plans (85%), follow-up prescriptions (79%) and referrals (69%) in the future.
In preliminary results, NSE generally described communication with GPs as good. Most NSE report telephone and fax as the most common communication tools, while some NSE mentioned the use of chat services for practical reasons despite data protection concerns.

Conclusions:
Despite GPs and NSE being open to digitalized communication, fax and telephone are still most frequently used. NSE name a lack of technical infrastructure in nursing homes as the greatest obstacle to digital communication. GPs prefer digital execution of less complex tasks (change of medication plans, letters of referral) to more complex procedures (e.g. acute health problems). Only 8% of GPs do not want to work digitally at all. However, NSE emphasized the importance of ongoing GP visits in person.

Points for discussion:
What is communication between GPs and nursing homes in other European countries like?

What electronic Health applications are successfully used in your practice to improve communication with nursing homes?