FRAGMENTED CARE INTERFACES: EVALUATING INTERSECTORAL COMMUNICATION BARRIERS AND DIGITAL HEALTH INTEGRATION IN RURAL CARE PATHWAYS
Author(s)
Christin Juhnke, BSc, MA1, Steffen Fleßa, Prof. Dr.2.
1Research Fellow, PhD Student, University of Greifswald, Greifswald, Germany, 2University of Greifswald, Greifswald, Germany.
1Research Fellow, PhD Student, University of Greifswald, Greifswald, Germany, 2University of Greifswald, Greifswald, Germany.
OBJECTIVES: Seamless cross-sectoral communication and structured care pathways are critical to ensuring care continuity, yet rural health systems frequently suffer from resource constraints and fragmented interfaces. This study quantified outpatient physicians' awareness, utilization, and evaluation of regional care pathways, cross-sectoral communication deficits, and digital infrastructure performance.
METHODS: A standardized online-survey was deployed in spring 2025 to 677 outpatient physicians in Germany’s second-largest district by area. Measures included pathway familiarity and usage frequency, coordination quality, clinical contact accessibility, discharge summary quality, and digital communication tool (e.g., Direct Secure Messaging) utility. Data were analyzed using descriptive and cross-specialty comparative methods.
RESULTS: Among 71 respondents, a profound structural gap emerged: only 27% were aware of regional care pathways and just 14% utilized them regularly, despite 78% stating that increased pathway standardization is urgently required. The inpatient-to-outpatient transition was highly problematic: 69% experienced delays in appointment and medication organization, and 57% reported ambiguities in diagnostic responsibilities. Intersectoral communication was rated as insufficient by 52%, driven by delayed or incomplete discharge documentation (74%) and poor hospital contact accessibility (63%). Furthermore, a digital adoption paradox was identified: while 67% used digital communication systems at least occasionally, only 22% assessed them as truly beneficial. Major digital barriers included systemic non-interoperability (71%), unclear administrative jurisdictions (54%), and prohibitive time burdens (48%).
CONCLUSIONS: Rural healthcare delivery faces severe bottlenecks caused by fractured pathway utilization and deficient intersectoral communication. Resolving these inefficiencies necessitates binding cross-sectoral cooperation models and localized coordination frameworks. Digital solutions cannot bridge these gaps unless they are fully interoperable, standardized, and seamlessly embedded into existing clinical workflows to improve process quality.
METHODS: A standardized online-survey was deployed in spring 2025 to 677 outpatient physicians in Germany’s second-largest district by area. Measures included pathway familiarity and usage frequency, coordination quality, clinical contact accessibility, discharge summary quality, and digital communication tool (e.g., Direct Secure Messaging) utility. Data were analyzed using descriptive and cross-specialty comparative methods.
RESULTS: Among 71 respondents, a profound structural gap emerged: only 27% were aware of regional care pathways and just 14% utilized them regularly, despite 78% stating that increased pathway standardization is urgently required. The inpatient-to-outpatient transition was highly problematic: 69% experienced delays in appointment and medication organization, and 57% reported ambiguities in diagnostic responsibilities. Intersectoral communication was rated as insufficient by 52%, driven by delayed or incomplete discharge documentation (74%) and poor hospital contact accessibility (63%). Furthermore, a digital adoption paradox was identified: while 67% used digital communication systems at least occasionally, only 22% assessed them as truly beneficial. Major digital barriers included systemic non-interoperability (71%), unclear administrative jurisdictions (54%), and prohibitive time burdens (48%).
CONCLUSIONS: Rural healthcare delivery faces severe bottlenecks caused by fractured pathway utilization and deficient intersectoral communication. Resolving these inefficiencies necessitates binding cross-sectoral cooperation models and localized coordination frameworks. Digital solutions cannot bridge these gaps unless they are fully interoperable, standardized, and seamlessly embedded into existing clinical workflows to improve process quality.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD21
Topic
Health Service Delivery & Process of Care, Organizational Practices, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas