Information Systems Connectivity to Improve Medication Process (LinkedCare)

Peter Putz

Status: Completed

Conditions: Medication Management at Home

Treatments: Device: medication management; Other: Usual Care Group

Study type: Interventional

Funder types: Other

Identifiers

NCT06728254

FHCW EC Nr. 130/2023

Details and patient eligibility

About

Linked Care aims to help healthcare professionals (nurses, doctors, pharmacists) interact efficiently and safely with IT support to improve patient information flows. It focuses on the medication ordering process, which currently involves time-consuming steps like calling doctors and traveling to get prescriptions. The project targets nursing staff, doctors, pharmacists, and patients, with indirect benefits for hospitals, social welfare organizations, and insurance bodies. This study evaluates the Linked Care solution by addressing the research question: Does an electronic ordering system improve the efficiency and quality of the regular medication process?

Full description

Background and rationale:

Linked Care aims to provide access to information relevant to care and support beyond the boundaries of the various care settings and primarily supports caregivers in the acquisition and transfer of information. The development of essential standards (e.g., a myCare Info) and the involvement of all affected target groups make it possible to develop practical IT tools for standardized networking in mobile care and nursing. The result will be an integrated, affordable, easy-to-use and well-connected IT system for care and support. The portal can be operated via mobile devices, PC, or tablets.

The McKinsey study demonstrates the significant potential of digitalization in the Austrian healthcare sector. According to this study, there is a 4.7-billion-euro opportunity for Austria. Approximately 70% of the potential benefits of increased productivity accrue to service providers, such as physicians and hospitals. The remaining 30% can be attributed to other players in the system, particularly health insurers, who benefit from reduced service utilization and improved care. Key factors in achieving these benefits include the implementation of the Austrian electronic health record (ELGA) and e-prescribing, which enable efficiency gains of EUR 690 million. Digitization is also sought after by regulators, patients, payers, and service providers in the Austrian healthcare system for improved efficiency and quicker access to data.

Helmcke et al. (2021) identify the following areas with the greatest potential for savings and benefits in the Austrian healthcare system:

• Online interactions, especially through teleconsultation.
• Paperless data, emphasizing standardized patient records/exchange and electronic prescriptions.
• Automated workflows, particularly the networking of mobile caregivers.
• Decision support and transparency of outcomes, including performance dashboards.
• Patient self-management, primarily through tools for managing chronic conditions like diabetes.
• Patient self-service for electronic scheduling.

Objectives:

This project aims to enable documenting healthcare professionals (such as nurses, general practitioners (GPs), and pharmacists) to interact efficiently, safely, and conveniently, with optimal IT support, to improve (or make more efficient) the patient-related information flows. The specific use cases studied are the process of ordering and in particular reordering medication. A significant time-saving potential has been identified in the transfer of medication information. The ordering process usually begins with nurses calling a GP as soon as they notice that a client has run out of medication and needs to be re-supplied when preparing the prescribed medication. The nurse then usually travels distances (e.g. by car) to obtain a prescription from the GP and collect the medication from the pharmacy. To do this, they need the client's insurance card, which has to be collected separately. The project is therefore aimed at four target groups: i) nursing staff who carry out the documentation, ii) GPs, and iii) pharmacists and finally iv) patients who make use of the care. In addition to the target groups studied in this trial, indirect beneficiaries include healthcare providers such as hospitals, social welfare organizations, rehabilitation clinics, public insurance bodies, etc. who ensure effective and efficient care. The trial aims to evaluate the entire process of data recording and data exchange via the newly created interfaces between the systems involved in practical use.

The primary research question of this study is: Does an electronic ordering system improve the efficiency and quality of the regular medication process?

Secondary research questions are:

• Does the digital ordering system receive end-user acceptance?
• Which impacts on the health and care system are generated by the implementation of the digital ordering system? (evaluated qualitatively)

Enrollment: 70 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria Caregivers:

• Actively pursuing at least one of the following health professions extramurally: nurse, nursing assistant level 1 or level 2 , elderly specialist caregiver, home care assistant
• Active maintenance of nursing documentation and use of the duty cell phone
• Age 18+ years
• Willing to comply with all study-related procedures and provide informed consent

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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70 participants in 2 patient groups

Intervention (using Linked Care system)

Experimental group

Description:

All nurses and caregivers participating in the intervention group use the newly installed mynevaToGo app to reorder medication. Nurses and nursing assistant level 2 also use the myneva Care Center software to keep the medication list prescribed by the GP. The solution is installed in advance on the duty cell phones by the IT department of the relevant care organization. Participating nurses and caregivers in the intervention group are instructed to handle the medication ordering process electronically (i.e., medication orders will be sent to the GPs via the Linked Care platform).

Treatment:

Device: medication management

Control

Active Comparator group

Description:

Care professionals in the convenience sampled control group continue to handle the usual medication process.

Treatment:

Other: Usual Care Group