Healthc Inform Res.  2018 Oct;24(4):317-326. 10.4258/hir.2018.24.4.317.

Design of a Hospice Referral System for Terminally Ill Cancer Patients Using a Standards-Based Health Information Exchange System

Affiliations
  • 1Office of e-Health Research and Business, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 2Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. wb0707@yuhs.ac

Abstract


OBJECTIVES
The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients.
METHODS
Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys.
RESULTS
Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed.
CONCLUSIONS
Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.

Keyword

Hospices; Referral and Consultation; Health Information Exchange; Cancer Care Facilities; Methodological Study

MeSH Terms

Advisory Committees
Cancer Care Facilities
Health Information Exchange*
Health Level Seven
Hospices*
Humans
Investments
Methods
Patient Admission
Referral and Consultation*
Terminally Ill*
Tertiary Care Centers
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