Collaboration Requirements for Home Care

Electronic health records (EHRs) are now being adopted in many regions, in part due to their promise of supporting information sharing between distributed health care workers. This technology allows an implicit form of collaboration by providing information about treatments and outcomes among the individuals involved in the patient’s care. However, it is unclear how well collaborative work practices are supported in a standard electronic health record. To investigate this issue, we studied the work and collaboration patterns of a multidisciplinary home care team in a local health district. Home care teams have different collaboration needs than workers in inpatient settings because they are widely distributed, they are mobile, and they maintain separate patient records. Interviews with several home care workers identified five specific areas where team members need to collaborate with one another: scheduling visits, disseminating information, finding answers to questions, short-term treatment coordination, and longer-term treatment planning. For each of these areas, we consider how an electronic health record would support worker collaboration. We identify ways in which EHRs as currently conceptualized are insufficient for meeting collaboration needs, and outline design approaches that would help to support collaboration in distributed health care.