Researchers: Efrat Shadmi¹, Tchiya Molcho Falkenberg Luft², Calanit Kay², Alexander Roitman², Maayan Agmon¹

Background: The co-occurrence of two or more chronic conditions in an individual is considered the "most common chronic condition" associated with substantial disability and high care costs. Health Information Technology (HIT) systems hold the potential to facilitate care for multimorbid patients.

Objectives: 1. To map unique expressions of HIT use, which can support the provision of main aspects of care for multimorbid patients;
2. To examine through electronic health records (EHR) use the extent to which providers follow clinical recommendations;
3. To examine the coordination of care of patients and of HIT tools capabilities to overcome coordination challenges.

Method: A mixed-methods design, incorporating qualitative and quantitative methods. Qualitative Phase: in-depth semi-structured interviews among primary care physicians and nurses. Quantitative phase: providers self-administered questionnaire, EHR data collection related to percentage of recommendations followed by health providers and patient questionnaires.

Findings: Strengths of HIT systems included: the availability of a health information exchange system and the availability of a wide-range of sources of information, including prescription and dispensing of medications. Main challenges identified were: lack of efficiency in information retrieval, need to switch between multiple screens and simultaneously cope with multiple sources of information, and difficulties in coordinating among guideline recommendations and providers involved in the care of patients with multimorbidity.

Conclusions: Findings point to the complexity of HIT use in care management of patients with multimorbidity. The findings are expected to be used to generate recommendations for future evaluation research.

Research end date: 07/2019