Implementation of interprofessional digital communication tools in primary care for frail older adults: An interview study

Figures & data

Table 1. Overview of functionalities of the digital communication tools.

Functions:	VIPLive	OZOverbindzorg	Doktr.nl
Web portal or app	Both	Both	Web portal
One to one chat function	X	X	X
Group conversation	X	X
Participation of informal caregiver	X	X	X
Multidisciplinary care planning support	X	X
Store results of medical investigations	X
Order drug prescription		X
Send questionnaires and documents			X

X = functionality present

Table 2. Characteristics of primary healthcare professionals using one of the three interprofessional digital communication tools.

	Professionals, n = 28
Dominant profession, n (%)
General practitioner	4 (14%)
Practice nurse	4 (14%)
Community nurse	10 (36%)
Case manager	7 (25%)
Geriatric specialist	1 (4%)
Dietician	1 (4%)
Physiotherapist	1 (4%)
Woman, n (%)	25 (89%)
Work experience in current profession in years, n (%) ≤5	5 (18%)
5–10	14 (50%)
>10-20	9 (32%)
Tool, n (%)
VIPLive	19 (68%)
OZOverbindzorg	6 (21%)
Doktr.nl	3 (11%)
Number of patients for whom the tool is/was used, median (min-max)	6 (1–30)
Number of healthcare professionals available to contact, median (min-max)	4 (1–8)
Number of conversations with an informal caregiver, median (min-max)	5 (1–30)
Mean frequency of use, n (%)
Once per day or more	6 (21%)
1–2 times per week	13 (46%)
1–2 times per month	6 (21%)
Less than once a month	3 (11%)

Table 3. Characteristics of informal caregivers using one of the three interprofessional digital communication tools.

	Informal caregivers, n = 10
Informal caregiver (IC) for, n (%) Spouse Parents (in law)	1 (10%) 9 (90%)
Age, median (min-max)	59 (50–71)
Woman, n (%)	7 (70%)
Tool, n (%) VIPLive OZOverbindzorg Doktr.nl	8 (80%) 2 (20%)-
Number of healthcare professionals available to contact, median (min-max)	3 (1–7)

Table 4. Themes and categories related to the barriers and facilitators of implementation of interprofessional digital communication tools experienced by professionals and caregivers.

Themes	Categories
Tool characteristics	Training
	Ease of use
	Functionalities
	Sharing information
Context of use	Attitudes toward the tool
	Work agreements
	Overload communication tools
	Situations for application
	Remote care
	Availability
Involvement of professionals	Interdisciplinary involvement
	GP Involvement
Involvement of caregivers	Increased caregiver involvement
	Approachability of professionals
	Professional jargon

Table 5. Quotes on the experienced barriers and facilitators of interprofessional digital communication tools by healthcare professionals and informal caregivers.

Category	Participant	Quote
Tool characteristics	IC 1	(1) It (the tool) is self-explanatory, it is not that difficult at all. It is very user-friendly.
	GP 1	(2) You need to use it (the tool) in practice, otherwise you forget how it works.
	CM 1	(3) I frequently do house visits, then I use it (the app) in between visits.
	CN 1	(4) I do not exactly know the possibilities of the tool, I neither have gotten around or confronted with it.
Context of use	GP 1	(5) We have used a digital interprofessional tool. I was therefore also enthusiastic about this new tool. Although I also thought, another way of information sharing, we already use many applications.
	IC 10	(6) Everything went via phone.
	CM 2	(7) I hope for uniformity, we already work with a lot of GP practices, and it (work agreements) cannot differ between them. Then it does not work, and you cannot remember it.
	PN 1	(8) During the start of the project we talked about work agreements with our team. No urgent problems via the tool.
	CN 8	(9) Including more professionals would be nice, they can be contacted more easily then, but it is difficult that they can see all information. You would like to hide some information.
	GP 2	(10) Once I counted all lines of communication, I came to fifteen or so. Which you all use at least once a week, that is just too much.
	CN 2	(11) The first person where we implemented the tool was for someone where a lot was happening in a short time with many different professionals involved.
	CN 4	(12) Because of the COVID-19 pandemic we decided to include more and a broader range of patients in the tool to enable easier communication and to lower the number of GP home visits.
	IC 1	(13) We all work of course. So sometimes you want to ask a question in the evening … I like this flexibility.
Involvement of professionals	CM 1	(14) The tool works really well, but you really need involvement of professionals, especially the GP. Otherwise, you will never get anywhere.
	PT 1	(15) It is nice to sit together at a virtual table and let each other know what you are working on, if it is progressing or if you need help from someone. I think this is a great advantage.
	PN 2	(16) We know how to find each other sooner and ask questions, then you can immediately adapt things. The communication lines are just much shorter.
	CN 3	(17) Adding other professionals to a conversation was something the GP was reluctant about. The GP wanted to keep it rather small, but I thought for some patients it is quite important that other professionals can read along, but that made the GP uncomfortable.
Involvement of caregivers	IC 8	(18) With shorter communication lines problems can be solved instantly.
	CM 1	(19) We talk in a completely different way when caregivers are not present.
	CM 1	(20) Now I have to think very carefully, do I have the right chatgroup.

GP = general practitioner; PN = practice nurse; CN = community nurse; CM = case manager; PT = physiotherapist; IC: informal caregiver.

Data availability statement

Data consists of qualitative interviews in Dutch. Data is available upon reasonable request from the corresponding author.