Table 3.

Definitions of information management-related process failures during the hospital-to-home health transition

Information management-related process failure	Definition	Related Quote
Information overload	Difficulty identifying relevant information among all of the information provided (eg, a medical record with too much detail). It becomes challenging to organise, synthesise, interpret or act on the information.	‘Husband has binder given to him by [discharging hospital] with a full summary of the rehab hospitalization, labs, scripts, educational materials…Husband says binder is overwhelming—he hasn’t had time to read it…he is rifling thru all the papers to try and find something in the binder that he can’t find about the meds. Spends a long time on this.’ Excerpt from researcher field notes at Site 2.
Information underload	Information needed to perform a task ismissing (eg, key aspects of the medical history needed to implement care plan).	‘We are sometimes seeing inappropriate homecare referrals…the information that we’re getting in terms of case referrals [documents] sometimes is like five sentences, so you’re really not getting a lot of information when you’re going into the home…Basically, you’re going in there blind. You don’t know even what [kind of diagnoses] you’re seeing…’ Home health provider at Site 1.
Information scatter	Needed information is located in multiple places (eg, medical record, administrative databases, adult’s home, physician’s office).	‘…[some information] is not in the electronic medical [record]…you…go to the [paper] chart…I also skim the physician’s orders and make sure that the medications match up…, [I make sure to check for other information]…that may have to be put on my referral document that was not [told to me by the social worker]…[The information needed is not in one place]…you definitely search back and forth…’ Home healthcare coordinator at Site 5
Information conflict	Challenges determining which pieces of conflicting information are correct (eg, medication discrepancies).	‘…[When I was in the hospital]…the social worker said ‘you will get a home health aide who can do laundry, do light shopping and light cleaning.’…[and then I later] heard no…because Medicare doesn’t pay for that.’ [Interviewer:] ‘It’s unfortunate …that you were told one thing and then something else happened.’ ‘You only learn…when these things happen to you, you know.’ Patient from Site 2.
Erroneous information	Information that is wrong (eg, incorrect address, incorrect medication dose).	‘…Some of the information that we get on the referrals is incomplete, we sometimes get information that according to the patient is completely wrong… And if they don’t have the discharge papers, it’s difficult to kind of verify…’ Home health nurse from Site 1.