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Understanding health information exchange processes within Canadian long-term care: A scoping review.

BACKGROUND
Providing supportive care to long-term care residents with complex medical conditions generates substantial amounts of health information. This information must be documented, shared and acted upon by the various care providers within the circle of care.


OBJECTIVES
The purpose of this scoping review is to describe the current digital health information exchange (HIE) processes used within Canadian long-term care facilities (LTCFs).


METHODS
The scoping review followed Arksey and O'Malley's approach to the methodology. Electronic databases (e.g. CINAHL, MEDLINE and SCOPUS) were searched between 2010 and 2020 using terms including 'health information exchange', 'communication' and 'health information technology'. Articles were included if they were Canadian-based and relevant to our definition of health information exchange.


RESULTS
The search yielded 2091 citations for title and abstract screening; 78 citations were selected for independent full-text review, 42 of those met study criteria. The findings revealed gaps between the expectations of HIE for quality health care and the realities of HIE processes that impact the provision of care in long-term care.


CONCLUSIONS
We conclude that increased provider engagement and effective use of HIE processes is recommended to improve the safety and quality of health care in the long-term care sector.


IMPLICATIONS FOR PRACTICE
HIE implementation should be preceded a review of various aspects of workflow to identify information gaps and inefficiencies that can be addressed by digitization.