title: Transfer of data or re-creation of knowledge - experiences of a shared electronic patient medical records system.
abstract: BACKGROUND
  A shared electronic medical record (EMR) can improve communication between primary and secondary care. A consideration of the contents using Data-Information-Knowledge-Wisdom (DIKW) hierarchy could help inform further development of such systems regarding communication about prescribed medication.
  
  
  OBJECTIVE
  To investigate primary and secondary care doctors' experiences of the shared EMR in Uppsala, Sweden, focusing on the creation, use and cross-sector transfer of data, information, knowledge and wisdom about individual patients' prescribed medication.
  
  
  METHODS
  Nine focus groups were held with hospital doctors, of different grades and medical specialties, working at a single large teaching hospital in Uppsala, Sweden and primary care doctors worked in the same geographical area, in urban and rural primary care centers. The transcribed data were analyzed used the constant comparative method, based on data from the participants and application of the DIKW hierarchy.
  
  
  RESULTS
  The doctors were very positive about accessing and using the shared EMR. Data and information in the system were efficiently retrieved and combined with newly collected data and information to create further knowledge. However, they also described a data and information overload, where it was difficult to get a general overview of what had happened over time, coupled with the frequent lack of knowledge being created and shared by other healthcare providers. Doctors were, instead, either explicitly asked or implicitly expected to read and interpret all available data and information and recreate knowledge themselves.
  
  
  CONCLUSIONS
  This study highlighted the differences between access to data and information and access to knowledge in a shared EMR. In rolling out such a system, an increased availability of data and information should not be at the expense of a reduced availability of knowledge.
authors.affiliation: Department of Pharmacy, Uppsala University, Sweden; School of Pharmacy and Pharmaceutical Sciences, University of Manchester, UK. Electronic address: Mary.Tully@manchester.ac.uk.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Tully
authors.forename: Asa
authors.initials: A
authors.lastname: Kettis
authors.forename: Anna T
authors.initials: AT
authors.lastname: Höglund
authors.forename: Claes
authors.initials: C
authors.lastname: Mörlin
authors.forename: Ake
authors.initials: A
authors.lastname: Schwan
authors.forename: Christina
authors.initials: C
authors.lastname: Ljungberg
mesh_terms: D003625:Data Collection; D057286:Electronic Health Records; D017144:Focus Groups; D006761:Hospitals; D006801:Humans; D010820:Physicians; D011320:Primary Health Care; D013548:Sweden
keywords: Electronic medical record; Health informatics; Prescribing; Primary care; Secondary care