[HeiCare®: a project aiming to improve medication communication across health care sectors].
OBJECTIVE
Changes between health care sectors represent a critical phase in long-term pharmacotherapy. The aim of the Hei CARE(®) project was to close the communication gap at the interface between primary care physicians (PCP), hospital physicians and patients, and to improve quality and safety of pharmacotherapy.


METHODS
Physicians who enrolled patients with long-term pharmacotherapy were able to participate in the Hei CARE(®) project. After enrolment the patient's medication was entered in the internet-based medication knowledge data base AiD PRAXIS and checked for medication interactions and optimized if necessary. At hospitalisation medication was transferred electronically to the hospital (AiD KLINIK(®)) and on discharge integrated in the discharge letter and faxed to the primary care physician (PCP). The project was evaluated using quantitative and qualitative methods. Hei CARE(®) -cases, in which medication was transferred electronically as planned, were compared with the other cases. PCPs' experiences were collected in focus groups.


RESULTS
One thousand and three chronically ill patients of 56 primary care practices participated. 259 patients were hospitalized between October 2005 and March 2009 of which entrance and discharge medication were transferred both ways via the electronic prescribing platform in 67 cases. The number of changes in medication was reduced in comparison to the other cases. Participating PCPs reported positive changes through Hei CARE(®) as well as further potential for optimizing communication across health care sectors.


CONCLUSIONS
Use of a common internet-based medication knowledge data base (Hei CARE(®) ) in both health care sectors reduced the number of changes in pharmacotherapy. Seamless care in chronically ill patients was thereby improved. The project also demonstrated that improving communication across health care sectors is a slow process.
Universitätsklinikum Heidelberg, Abteilung Allgemeinmedizin und Versorgungsforschung.
C
C
Mahler
S
S
Jank
M G
MG
Pruszydlo
K
K
Hermann
H
H
Gärtner
J
J
Kaltschmidt
S
S
Ludt
T
T
Bertsche
W E
WE
Haefeli
J
J
Szecsenyi
D002908:Chronic Disease / Q000628:therapy*; D003299:Cooperative Behavior; D004346:Drug Information Services; D004347:Drug Interactions; D057915:Drug Substitution; D004358:Drug Therapy / Q000592:standards*; D057286:Electronic Health Records; D055695:Electronic Prescribing; D017144:Focus Groups; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D020407:Internet; D051188:Knowledge Bases; D008134:Long-Term Care; D008505:Medical Staff, Hospital; D010351:Patient Discharge; D011320:Primary Health Care; D011785:Quality Assurance, Health Care / Q000592:standards*; D012984:Software