SIIReN - System Integration & Innovation Research Network

Primary Health Care System


Integrating primary health care and home care through health information technology: Implications for policy, planning, and practice.
Researchers: Dr. Sandra Regan, Dr. Lorie Donelle, Ms. Gwen Vanderheyden

Concerns regarding the shortage of nurses to provide homecare prompted decision-makers in one region of Ontario to explore modifications to the existing deployment of healthcare providers within the home setting using health information technology (HIT). At its core, the eShift (enhanced-Shift) model of care utilize nurses with personal support workers (PSWs), with links to primary care and allied health providers, to provide palliative home care services.

The purpose of this pilot study was to investigate how an HIT enhanced model of care delivery (eShift) can enhance palliative homecare services. Three activities were completed in this pilot study:

  1. A scoping review of the home/ primary care and HIT literature;
  2. Interviews with healthcare providers, decision-makers, and families connected to the eShift model of care, and
  3. Identification of potential outcomes of outcomes of the eShift model.

The scoping review of 71 publications highlighted issues of: technology implementation; workflow and care quality; information ethics. There appears to be a lack of literature focusing on HIT use among allied and unregulated health care workers. Content analysis of interviews with family members of palliative clients suggest that the services alleviated caregiver burden, enabled client’s wishes to die at home, and showed signs of reduced hospitalization. Interviews with decision-makers and healthcare providers pointed to the eShift model as effective in meeting clients’ care needs and wish to die at home.

Preliminary findings from this study suggest client/family member satisfaction with care and avenues for further investigation of the eShift model of care.

Key Messages:
Based on a scoping review of the literature:

  • Literature on the integration of home care and primary health care is limited despite government strategic priorities in this direction
  • Within the Canadian context, research and evaluation on technology enhanced models of care within the home setting is limited; however, there is a perception that technology can enhance home care service delivery

Preliminary findings from interviews with healthcare providers and homecare decision-makers in this pilot study suggest that the technology enhanced deployment of healthcare providers in the eShift model of care may:

  • Support seniors wishes to remain in the home
  • Reduce the caregiver burden
  • Enhance healthcare provider job satisfaction, facilitate retention in the workforce, and interprofessional collaboration
  • Meet home care service delivery demands

For further information, please contact the Principal Investigator:
Sandra Regan, RN, PhD, Assistant Professor
Arthur Labatt Family School of Nursing
Western University Health Sciences Addition H34
London, Ontario N6A 5C1
Tel: (519) 661-2111 ext. 86574

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