Electronic health records use in primary care of patients with multimorbidity

Abstract

Introduction: healthcare systems worldwide are constantly shifting from an acute, disease focused, and episodic orientation to an approach that acknowledges the increasing prevalence of chronic illness. Patients with chronic conditions and their families must cope with multifaceted challenges - managing symptoms, disability, emotional impacts, complex medication regimens, difficult lifestyle adjustments, and obtaining helpful medical care. These challenges are amplified in patients with multiple chronic conditions - multimorbidity (MM). Care providers often struggle to balance the benefits and risks of multiple recommended treatments. The basis of MM care includes four main aspects of care: comprehensive assessment which is the foundation for an integrative care plan, ongoing coordination and continuously update of the care plan and patients' self -management support. Electronic Health Record systems (EHRs) hold the potential to facilitate the performance of aspects of care of patients with MM. Yet much is unknown regarding EHR use in care of MM patients. Objectives: To map unique expressions of EHR use, which can support the provision of main aspects of care for MM patients: comprehensive assessment, coordination and continuity of care, and patients' self -management support. Methods: concept mapping and integration of main aspects of care for MM patients and EHR characteristics. Result and discussion: The concept mapping reveals potential strengths and challenges in using EHRs during the care for patients with MM. Strengths, such as: the availability of a health information exchange system and the ability to different sources of information, including prescription and dispensing of medications; and challenges such as: need to switch between multiple screens and simultaneously cope with multiple sources of information, which leads to the difficulty in creating Integration. Conclusion: Findings point to the complexity of EHR use in care management of patients with MM. The findings are expected to be used to generate recommendations for the future evaluation research. Lessons Learned: Managing information in patients with multimorbidity is a challenging task that requires further study and recommendations for improvement.