FÖRDERUNG IN PRÜFUNG Is digitalization still an uncharted territory for palliative care? Use of electronic patient records and assessment instruments in German specialist palliative care: results of an online survey

Hodiamont, Farina; Jansky, Maximiliane; Golic, Lilli; Bausewein, Claudia; Hriskova, Katerina (2025): FÖRDERUNG IN PRÜFUNG Is digitalization still an uncharted territory for palliative care? Use of electronic patient records and assessment instruments in German specialist palliative care: results of an online survey. BMC Health Services Research, 26: 108. ISSN 1472-6963

Abstract

Background

The use of routinely collected clinical data from electronic patient records (EPR) offers substantial potential for quality management and health services research, particularly in specialised palliative care (SPC). This study investigates the degree of standardization, outcome assessment practices, and EPR implementation in palliative care units (PCU), palliative care advisory teams (PCA) and specialised palliative home care (SPHC) in Germany.

Methods

Cross-sectional online survey among community and inpatient SPC services in Germany using setting-specific questionnaires with closed and open-ended questions. Descriptive analyses were performed.

Results

209 teams participated (PCU: 71; PCA: 31; SPHC: 107). Of the PCUs, 29.6% document exclusively digitally (PCA: 38.7%; SPHC: 57.9%), 15.5% exclusively paper-based (PCA: 6.5%; SPHC: 0.9%) and 52.1% both digital and paper-based (PCA: 48.4%; SPHC: 24.3%) (missing: PCU: 2.8%; PCA: 6.5%; SPHC: 16.8%). In PCU and PCA various EPR systems are used (PCU at least 10, PCA at least 7); in SPHC, two systems are employed by 96% of the teams. More than one EPR is used in 13.0% (PCU) and 27.0% (PCA). The majority of teams employ at least one standardised assessment to record functional status (PCU: 95.7%, PCA: 90.3%, SPHC: 66.4%) and symptom burden (PCU: 85.9%, PCA: 87.1%, SPHC: 64.5%). Assessments during care processes were limited: 25.4% of PCUs, 16.1% of PCAs, and 30.8% of SPHC teams documented symptom burden, and 8.5% of PCUs; 0% of PCA; and 17.8% of SPHC documented functional status daily or during visits.

Conclusion

The use of routine health care data in SPC is limited by fragmented documentation practices, lack of standardization, poor interoperability, and the insufficient relevance of many health information systems for capturing patient-centred outcomes. To improve both care quality and research, there is a need for consensus on assessment instruments, as well as the development of interoperable digital infrastructures.

• Dokumententyp: Artikel (Klinikum der LMU)
• Organisationseinheit (Fakultäten): 07 Medizin > Klinikum der LMU München > Klinik und Poliklinik für Palliativmedizin
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892