IntroductionAfter discharge, patients face multiple risks where timely communication with healthcare professionals is required. eHealth has proposed new possibilities for asynchronous text-based two-way communication between patients and healthcare professionals during this time, and studies show positive effects on clinical outcomes, care coordination and patient satisfaction. However, there are challenges to the adoption of text-based two-way communication, potentially undermining the positive effects in clinical practice. Knowledge of these factors may inform future research and implementations. No reviews have provided an overview of the use of text-based two-way communication after discharge and the identified facilitators and barriers. Therefore, the objective of this scoping review is to systematically identify and map available research that assess the use of text-based two-way communication between patients and healthcare professionals after hospital discharge, including facilitators and barriers to implementation.Methods and analysisWe will include all studies describing the use of text-based two-way communication between patients and healthcare professionals after discharge from hospital. A preliminary search of PubMed (PubMed.gov), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), Cochrane Library (Wiley), Web of Science (Clarivate) and Scopus (Elsevier) was undertaken on 9 November 2021. The search will be updated for the full scoping review, and reference lists of relevant papers reviewed. Two reviewers will independently screen the literature for inclusion. Data will be extracted and charted in accordance with a data extraction form developed from the research questions and inspired by Consolidated Framework Implementation Research. Findings will be presented in tabular format and a descriptive summary, and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.Ethics and disseminationThis scoping review will not require ethics approval. The dissemination strategy involves peer review publication and presentation at conferences.
Background Over the past decade, hospital admissions for patients undergoing orthopedic surgery have been shortened, and the time for informing and educating patients prior to discharge has been compromised. The transition of care from hospital to home poses a substantial risk of adverse events. Patients have difficulty remembering information and struggle to assess the severity of symptoms after discharge, leading to unplanned telephone contacts and clinic visits. These inquiries are frequent and pose a substantial burden on the health care system and patients. The COVID-19 pandemic showed an emerging need to implement new communication technologies. Asynchronous digital communication (DC) may provide easy access to health care and seamless communication across sectors. Objective This study aimed to investigate how DC can facilitate easy communication between patients and health care professionals (HCPs) across sectors and the effects of DC on patient-initiated telephone contacts after discharge. Methods The overall theoretical approach was inspired by Continuity of Care and the Consolidated Framework for Implementation Research. Substudy I was a scoping review on DC between patients and HCPs after hospital discharge. Substudy II explored DC in an orthopedic surgery setting and through a triangulation of qualitative data collection techniques. Substudy III investigated the effect of DC on patient-initiated telephone contacts after discharge. Results Preliminary findings from substudy I show that DC is increasingly used to support patient-provider communication after discharge. In substudy II, preliminary findings show that DC is feasible in a real-life setting, providing patients with easy access to HCPs, who accept and adapt DC to existing cross-sectoral workflows. However, barriers exist related to the technological integration between systems and individuals’ hesitation to use DC. In substudy III, DC is to be tested in a randomized controlled trial. Conclusions This study generates new knowledge of asynchronous DC that may guide future implementations across the health care system.
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