Designing and Implementation of a Digitalized Intersectoral Discharge Management System and Its Effect on...

Area of Science:

• Health Informatics
• Digital Health Transformation
• Healthcare Management

Background:

• Digital transformation offers opportunities to enhance information exchange among diverse healthcare providers.
• Improving intersectoral discharge management is crucial, as patient information is often lost during hospital transitions.
• Current improvement strategies predominantly focus on internal hospital structures.

Purpose of the Study:

• To evaluate the implementation of the digitalized discharge management system, SEKMA (Sektorübergreifende Optimierung des Entlassmanagements).
• To assess the impact of SEKMA on hospital readmission rates.

Main Methods:

• A mixed-methods design incorporating fidelity analysis and statistical evaluation.
• Difference-in-difference approach using routine hospital admission data from 2019 and 2022.
• Intervention group: vascular surgery; Control groups: internal medicine and cardiology.

Main Results:

• 26 interviews identified 21 determinants categorized into optimization potential, barriers, and enablers.
• 19 strategies were developed, with 7 (37%) implemented in SEKMA, including electronic discharge letters and standardized medication plans.
• No significant impact of SEKMA on readmission rates was observed in 14,854 hospital admissions (P=.20).

Conclusions:

• Optimizing intersectoral collaboration holds potential for improving patient care.
• While SEKMA did not significantly reduce readmissions, a connected digital healthcare ecosystem is a promising approach for secure and efficient networking.
• The SEKMA implementation provides a template for developing digital care networking infrastructures in fragmented healthcare systems.