title: Improving integrated care: modelling the performance of an online community of practice.
abstract: BACKGROUND
  THIS ARTICLE AIMS TO CONFIRM THE FOLLOWING CORE HYPOTHESIS: a Community of Practice's use of a Web 2.0 platform for communication between primary and hospital care leads to improved primary care and fewer hospital referrals. This core hypothesis will be corroborated by testing a further five partial hypotheses that complete the main hypothesis being estimated.
  
  
  METHODS
  An ad-hoc questionnaire was designed and sent to a sample group of 357 professionals from the Badalona-Sant Adrià de Besòs Primary Care Service in Catalonia, Spain, which includes nine primary care centres and three specialist care centres. The study sample was formed by 159 respondents. The partial least squares methodology was used to estimate the model of the causal relationship and the proposed hypotheses.
  
  
  RESULTS
  It was found that when healthcare staff used social networks and information and communication technologies professionally, and the more contact hours they have with patients, the more a Web 2.0 platform was likely to be used for communication between primary and hospital care professionals. Such use led to improved primary care and fewer hospital referrals according to the opinions of health professionals on its use.
  
  
  CONCLUSIONS
  The research suggests that the efficiency of medical practice is explained by the intensity of Web 2.0 platform use for communication between primary and specialist care professionals. Public policies promoting the use of information and communication technologies in communities of practice should go beyond the technological dimension and consider other professional, organisational and social determinants.
authors.affiliation: Applied Economics Department I, Rey Juan Carlos University, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Díaz-Chao
authors.affiliation: Department of Economic and Business, Open University of Catalonia, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Torrent-Sellens
authors.affiliation: Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Santa Coloma de Gramenet, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Lacasta-Tintorer
authors.affiliation: Department of Health Science, Open University of Catalonia, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Saigí-Rubió
keywords: community of practice; integrated care; partial least squares modelling; teleconsulting; telemedicine