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Original article

Vol. 155 No. 2 (2025)

Communication and information exchange between practices and hospitals: a survey among primary care practitioners in central Switzerland

DOI
https://doi.org/10.57187/s.3585
Cite this as:
Swiss Med Wkly. 2025;155:3585
Published
03.02.2025

Summary

BACKGROUND: Digital tools are widely utilised to improve communication and information exchange among healthcare professionals. The cantonal hospital in Lucerne was the first to implement the Epic clinical information system in a German-speaking country, including information access for primary care physicians via an electronic health record portal.

OBJECTIVES: This study assessed how primary care physicians perceive the communication with hospitals in the canton of Lucerne, including their preferences for discharge summary contents and experiences and utilisation of a regionally implemented electronic health record portal.

METHODS: We performed an online survey among primary care physicians and contacted all 323 primary care physicians enlisted as members of the cantonal medical society in Lucerne, Switzerland.

RESULTS: A total of 109 primary care physicians completed the online survey (34% response rate). Half of the primary care physicians were satisfied with hospital communication. Three-quarters (n = 83) wanted to be informed of patients’ emergency hospital admission within 48 hours, but only 30% (n = 33) reported being notified. In discharge summaries, primary care physicians expect information on the diagnosis, medication, therapies, and recommendations for follow-up care. A large portion of primary care physicians deemed the electronic health record portal beneficial for patient management. Most primary care physicians utilise the portal to retrieve patient data, but it is rarely used for patient referrals.

CONCLUSION: Half of primary care physicians were satisfied with communication with regional hospitals. Primary care physicians reported a lack of timely notifications or reports about emergency admissions, in-hospital deaths, and discharges of their patients. Primary care physicians value the electronic health record portal as a supporting tool for patient management.

References

  1. Moore C, Wisnivesky J, Williams S, McGinn T. Medical errors related to discontinuity of care from an inpatient to an outpatient setting. J Gen Intern Med. 2003 Aug;18(8):646–51. doi: https://doi.org/10.1046/j.1525-1497.2003.20722.x DOI: https://doi.org/10.1046/j.1525-1497.2003.20722.x
  2. Murtagh S, McCombe G, Broughan J, Carroll Á, Casey M, Harrold Á, et al. Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review. Int J Integr Care. 2021 Feb;21(1):4. doi: https://doi.org/10.5334/ijic.5508 DOI: https://doi.org/10.5334/ijic.5508
  3. Barker I, Steventon A, Deeny SR. Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: cross sectional study of routinely collected, person level data. BMJ. 2017 Feb;356:j84. doi: https://doi.org/10.1136/bmj.j84 DOI: https://doi.org/10.1136/bmj.j84
  4. Sheehan J, Laver K, Bhopti A, Rahja M, Usherwood T, Clemson L, et al. Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: A Systematic Narrative Review. J Multidiscip Healthc. 2021 Feb;14:493–511. doi: https://doi.org/10.2147/JMDH.S295549 DOI: https://doi.org/10.2147/JMDH.S295549
  5. Vermeir P, Vandijck D, Degroote S, Peleman R, Verhaeghe R, Mortier E, et al. Communication in healthcare: a narrative review of the literature and practical recommendations. Int J Clin Pract. 2015 Nov;69(11):1257–67. doi: https://doi.org/10.1111/ijcp.12686 DOI: https://doi.org/10.1111/ijcp.12686
  6. Luu NP, Pitts S, Petty B, Sawyer MD, Dennison-Himmelfarb C, Boonyasai RT, et al. Provider-to-Provider Communication during Transitions of Care from Outpatient to Acute Care: A Systematic Review. J Gen Intern Med. 2016 Apr;31(4):417–25. doi: https://doi.org/10.1007/s11606-015-3547-4 DOI: https://doi.org/10.1007/s11606-015-3547-4
  7. Gagnon MP, Légaré F, Labrecque M, Frémont P, Pluye P, Gagnon J, et al. Interventions for promoting information and communication technologies adoption in healthcare professionals. Cochrane Database Syst Rev. 2009 Jan;2010(1):CD006093. doi: https://doi.org/10.1002/14651858.CD006093.pub2 DOI: https://doi.org/10.1002/14651858.CD006093.pub2
  8. Holmgren AJ, Adler-Milstein J. Health Information Exchange in US Hospitals: The Current Landscape and a Path to Improved Information Sharing. J Hosp Med. 2017 Mar;12(3):193–8. doi: https://doi.org/10.12788/jhm.2704 DOI: https://doi.org/10.12788/jhm.2704
  9. Price C, Kwok ES, Cheung WJ, Thiruganasambandamoorthy V, Clapham G, Nemnom MJ, et al. Physician experience with the Epic electronic health record (EHR) system: longitudinal findings from an emergency department implementation. CJEM. 2022 Sep;24(6):630–5. doi: https://doi.org/10.1007/s43678-022-00354-5 DOI: https://doi.org/10.1007/s43678-022-00354-5
  10. Zürcher Hochschule für Angewandte Wissenschaften (ZHAW). Digital Health Report 21/22. 2021. Available from: https://www.zhaw.ch/storage/hochschule/medien/news/2021/210914-digital-health-report-2021.pdf
  11. Rosemann T, Marty F, Bhend H, Wagner J, Brunner L, Zoller M. Utilisation of information technologies in ambulatory care in Switzerland. Swiss Med Wkly. 2010 Sep;140(3738):w13088. doi: https://doi.org/10.4414/smw.2010.13088 DOI: https://doi.org/10.4414/smw.2010.13088
  12. Reich J, Canakis A, Shankar D, Harrington J, Apte M, Weinberg J, et al. The Use of An EHR Patient Portal (Mychart-Epic) in Patients With Inflammatory Bowel Disease. Crohns Colitis 360. 2019 Oct;1(3):otz039. doi: https://doi.org/10.1093/crocol/otz039 DOI: https://doi.org/10.1093/crocol/otz039
  13. Hwang AB, Schuepfer G, Pietrini M, Boes S. External validation of EPIC’s Risk of Unplanned Readmission model, the LACE+ index and SQLape as predictors of unplanned hospital readmissions: A monocentric, retrospective, diagnostic cohort study in Switzerland. Provenzano M, editor. PLOS ONE. 2021 Nov 12;16(11):e0258338. https://doi.org/10.1371/journal.pone.0258338 DOI: https://doi.org/10.1371/journal.pone.0258338
  14. Cross DA, McCullough JS, Banaszak-Holl J, Adler-Milstein J. Health information exchange between hospital and skilled nursing facilities not associated with lower readmissions. Health Serv Res. 2019 Dec;54(6):1335–45. doi: https://doi.org/10.1111/1475-6773.13210 DOI: https://doi.org/10.1111/1475-6773.13210
  15. Eden KB, Totten AM, Kassakian SZ, Gorman PN, McDonagh MS, Devine B, et al. Barriers and facilitators to exchanging health information: a systematic review. Int J Med Inform. 2016 Apr;88:44–51. doi: https://doi.org/10.1016/j.ijmedinf.2016.01.004 DOI: https://doi.org/10.1016/j.ijmedinf.2016.01.004
  16. Sharma A, Minh Duc NT, Luu Lam Thang T, Nam NH, Ng SJ, Abbas KS, et al. A Consensus-Based Checklist for Reporting of Survey Studies (CROSS). J Gen Intern Med. 2021 Oct;36(10):3179–87. doi: https://doi.org/10.1007/s11606-021-06737-1 DOI: https://doi.org/10.1007/s11606-021-06737-1
  17. Bundesamt für Statistik. Luzern. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/regionalstatistik/regionale-portraets-kennzahlen/kantone/luzern.html
  18. Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14. doi: https://doi.org/10.1016/j.npls.2016.01.001 DOI: https://doi.org/10.1016/j.npls.2016.01.001
  19. Afilalo M, Lang E, Léger R, Xue X, Colacone A, Soucy N, et al. Impact of a standardized communication system on continuity of care between family physicians and the emergency department. CJEM. 2007 Mar;9(2):79–86. doi: https://doi.org/10.1017/S1481803500014834 DOI: https://doi.org/10.1017/S1481803500014834
  20. Dixon BE, Embi PJ, Haggstrom DA. Information technologies that facilitate care coordination: provider and patient perspectives. Transl Behav Med. 2018 May;8(3):522–5. doi: https://doi.org/10.1093/tbm/ibx086 DOI: https://doi.org/10.1093/tbm/ibx086
  21. Gutteridge DL, Genes N, Hwang U, Kaplan B, GEDI WISE Investigator T, Shapiro J. GEDI WISE Investigator T, Shapiro J. Enhancing a Geriatric Emergency Department Care Coordination Intervention Using Automated Health Information Exchange-Based Clinical Event Notifications. EGEMS (Wash DC). 2014 Aug;2(3):6. doi: https://doi.org/10.13063/2327-9214.1095 DOI: https://doi.org/10.13063/2327-9214.1095
  22. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007 Feb;297(8):831–41. doi: https://doi.org/10.1001/jama.297.8.831 DOI: https://doi.org/10.1001/jama.297.8.831
  23. Weetman K, Spencer R, Dale J, Scott E, Schnurr S. What makes a “successful” or “unsuccessful” discharge letter? Hospital clinician and General Practitioner assessments of the quality of discharge letters. BMC Health Serv Res. 2021 Apr;21(1):349. doi: https://doi.org/10.1186/s12913-021-06345-z DOI: https://doi.org/10.1186/s12913-021-06345-z
  24. O’Leary KJ, Liebovitz DM, Feinglass J, Liss DT, Evans DB, Kulkarni N, et al. Creating a better discharge summary: improvement in quality and timeliness using an electronic discharge summary. J Hosp Med. 2009 Apr;4(4):219–25. doi: https://doi.org/10.1002/jhm.425 DOI: https://doi.org/10.1002/jhm.425
  25. Centemero NS, Rechel B. Barriers and facilitators to a health information exchange system between general practitioners and hospitals: a qualitative study in Southern Switzerland. Swiss Med Wkly. 2021 Oct;151(4142):w30063. doi: https://doi.org/10.4414/SMW.2021.w30063 DOI: https://doi.org/10.4414/SMW.2021.w30063
  26. Ludwick DA, Doucette J. Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries. Int J Med Inform. 2009 Jan;78(1):22–31. doi: https://doi.org/10.1016/j.ijmedinf.2008.06.005 DOI: https://doi.org/10.1016/j.ijmedinf.2008.06.005
  27. Ajami S, Bagheri-Tadi T. Barriers for Adopting Electronic Health Records (EHRs) by Physicians. Acta Inform Med. 2013;21(2):129–34. doi: https://doi.org/10.5455/aim.2013.21.129-134 DOI: https://doi.org/10.5455/aim.2013.21.129-134
  28. O’Donnell A, Kaner E, Shaw C, Haighton C. Primary care physicians’ attitudes to the adoption of electronic medical records: a systematic review and evidence synthesis using the clinical adoption framework. BMC Med Inform Decis Mak. 2018 Nov;18(1):101. doi: https://doi.org/10.1186/s12911-018-0703-x DOI: https://doi.org/10.1186/s12911-018-0703-x
  29. Fogg JF, Sinsky CA. In-Basket Reduction: A Multiyear Pragmatic Approach to Lessen the Work Burden of Primary Care Physicians. NEJM Catal. 2023 Apr;4(5). doi: https://doi.org/10.1056/CAT.22.0438 DOI: https://doi.org/10.1056/CAT.22.0438
  30. Käufeler M, Beeler PE, Müller LS, Gemperli A, Merlo C, Hug BL. Hospitalists’ perception of their communication with primary care providers - survey results from six hospitals in Central Switzerland. Swiss Med Wkly. 2024 Jul;154(7):3643. doi: https://doi.org/10.57187/s.3643 DOI: https://doi.org/10.57187/s.3643

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