Time Well Spent? Time Use for Health Information Management Across Home Care Roles: A Cross-Sectional Survey Study in Finland

Inka Sylgren; Esa Jämsen; Paulus Torkki

doi:10.5334/ijic.9881

Time Well Spent? Time Use for Health Information Management Across Home Care Roles: A Cross-Sectional Survey Study in Finland

International Journal of Integrated Care

Volume 26 (2026): Issue 3

By: Inka Sylgren , Esa Jämsen and Paulus Torkki

Open Access

|Sep 2026

Violan C, Foguet-Boreu Q, Flores-Mateo G, et al. Prevalence, determinants and patterns of multimorbidity in primary care: A systematic review of observational studies. PLoS One. 2014;9. DOI: 10.1371/journal.pone.0102149
Open DOI Search in Google Scholar Back to article
Barnett K, Mercer SW, Norbury M, et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet. 2012;380:37–43. DOI: 10.1016/S0140-6736(12)60240-2
Open DOI Search in Google Scholar Back to article
Doessing A, Burau V. Care Coordination of Multimorbidity: A Scoping Study. J Comorb. 2015;5:15–28. DOI: 10.15256/joc.2015.5.39
Open DOI Search in Google Scholar Back to article
Schiøtz ML, Høst D, Frølich A. Involving Patients with Multimorbidity in Service Planning: Perspectives on Continuity and Care Coordination. J Comorb. 2016;6:95–102. DOI: 10.15256/joc.2016.6.81
Open DOI Search in Google Scholar Back to article
Skou ST, Mair FS, Fortin M, et al. Multimorbidity. Nat Rev Dis Primers. 2022;8. DOI: 10.1038/s41572-022-00376-4
Open DOI Search in Google Scholar Back to article
Dinh TS, Hanf M, Klein AA, et al. Informational continuity of medication management in transitions of care: Qualitative interviews with stakeholders from the HYPERION-TransCare study. PLoS One. 2024;19. DOI: 10.1371/journal.pone.0300047
Open DOI Search in Google Scholar Back to article
Kern LM, Lau JD, Rajan M, et al. Associations among claims-based care fragmentation, self-reported gaps in care coordination, and self-reported adverse events. BMC Health Serv Res. 2024;24. DOI: 10.1186/s12913-024-11440-y
Open DOI Search in Google Scholar Back to article
Dyer SM, Suen J, Williams H, et al. Impact of relational continuity of primary care in aged care: a systematic review. BMC Geriatr. 2022;22. DOI: 10.1186/s12877-022-03131-2
Open DOI Search in Google Scholar Back to article
Goodwin N. Understanding Integrated Care. Int J Integr Care. 2016;16. DOI: 10.5334/ijic.2530
Open DOI Search in Google Scholar Back to article
Leutz WN. Five Laws for Integrating Medical and Social Services: Lessons from the United States and the United Kingdom. Milbank Q. 1999;77:77–110. DOI: 10.1111/1468-0009.00125
Open DOI Search in Google Scholar Back to article
Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13. DOI: 10.5334/ijic.886
Open DOI Search in Google Scholar Back to article
Vesinurm M, Sylgren I, Bengts A, et al. Concept analysis of patient journey disruptions: the obstacle of integrated care. Journal of Integrated Care. 2024;32:37–58. DOI: 10.1108/JICA-08-2023-0060
Open DOI Search in Google Scholar Back to article
The Academy of Medical Sciences. Multimorbidity: a priority for global health research. 2018. https://acmedsci.ac.uk/file-download/82222577 [cited 11th September 2025].
Search in Google Scholar Back to article
Vaartio-Rajalin H, Näsman Y, Fagerström L. Nurses’ activities and time management during home healthcare visits. Scand J Caring Sci. 2020;34:1045–1053. DOI: 10.1111/scs.12813
Open DOI Search in Google Scholar Back to article
Haggerty JL, Reid RJ, Freeman GK, et al. Continuity of care: a multidisciplinary review. The British Medical Journal. 2003;327. DOI: 10.1136/bmj.327.7425.1219
Open DOI Search in Google Scholar Back to article
Blijleven V, Koelemeijer K, Wetzels M, et al. Workarounds emerging from electronic health record system usage: Consequences for patient safety, effectiveness of care, and efficiency of care. JMIR Hum Factors. 2017;4. DOI: 10.2196/humanfactors.7978
Open DOI Search in Google Scholar Back to article
Moy AJ, Schwartz JM, Chen RJ, et al. Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review. Journal of the American Medical Informatics Association. 2021;28:998–1008. DOI: 10.1093/jamia/ocaa325
Open DOI Search in Google Scholar Back to article
Norlyk A, Burau V, Ledderer LK, et al. Who cares?—The unrecognised contribution of homecare nurses to care trajectories. Scand J Caring Sci. 2023;37:282–290. DOI: 10.1111/scs.13120
Open DOI Search in Google Scholar Back to article
Lindberg MH, Venkateswaran M, Abu Khader K, et al. eRegTime, Efficiency of Health Information Management Using an Electronic Registry for Maternal and Child Health: Protocol for a Time-Motion Study in a Cluster Randomized Trial. JMIR Res Protoc. 2019;8:e13653. DOI: 10.2196/13653
Open DOI Search in Google Scholar Back to article
Pinevich Y, Clark KJ, Harrison AM, et al. Interaction Time with Electronic Health Records: A Systematic Review. Appl. Clin. Inform. 2021;12:788–799. DOI: 10.1055/s-0041-1733909
Open DOI Search in Google Scholar Back to article
Alasalvar FE. Analysis of home care nurses’ workload: A time-motion study. Home Health Care Serv Q. 2023;42:311–327. DOI: 10.1080/01621424.2023.2202149
Open DOI Search in Google Scholar Back to article
De Vliegher K, Declercq A, Aertgeerts B, et al. The Activity Profile of Home Nurses: A Systematic Review. Home Health Care Manag. Pract. 2014;26:257–265. DOI: 10.1177/1084822314527293
Open DOI Search in Google Scholar Back to article
Holm SG, Angelsen RO. A descriptive retrospective study of time consumption in home care services: How do employees use their working time? BMC Health Serv Res. 2014;14. DOI: 10.1186/1472-6963-14-439
Open DOI Search in Google Scholar Back to article
Väisänen V, Pesonen T, Corneliusson L, et al. Hoitoajan jakautuminen ikäihmisten palveluissa ja päivitetty RUG-luokitus Aikamittaus-hankkeen loppuraportti (eng. Distribution of care time in services for older people and updated RUG classification — Final report of the Aikamittaus project). Helsinki: Finnish Institute for Health and Welfare (THL); 2022.
Search in Google Scholar Back to article
Endalamaw A, Zewdie A, Wolka E, et al. Care models for individuals with chronic multimorbidity: lessons for low- and middle-income countries. BMC Health Serv Res. 2024;24. DOI: 10.1186/s12913-024-11351-y
Open DOI Search in Google Scholar Back to article
Möckli N, Simon M, Denhaerynck K, et al. Care coordination in homecare and its relationship with quality of care: A national multicenter cross-sectional study. Int J Nurs Stud. 2023;145. DOI: 10.1016/j.ijnurstu.2023.104544
Open DOI Search in Google Scholar Back to article
Sherifi D, Memory Ndanga R, Thomas R, et al. The symbiotic relationship between health information management and health informatics: opportunities for growth and collaboration. Perspect Health Inf Manag. 2021;18:1c.
Search in Google Scholar Back to article
Kemp T, Butler-Henderson K, Allen P, et al. The impact of health information management professionals on patient safety: A systematic review. Health Info. Libr. J. 2021;38:248–258. DOI: 10.1111/hir.12400
Open DOI Search in Google Scholar Back to article
Finnish Institute for Health and Welfare. Sotkanet statistical database. 2026. https://sotkanet.fi/sotkanet/en/index [cited 19th May 2026].
Search in Google Scholar Back to article
Finnish Institute for Health and Welfare. Avohilmo: Kotihoidon asiakkaat. (eng. Home Care Clients, Avohilmo Database). https://sampo.thl.fi/pivot/prod/fi/avo/perus11/fact_ahil_perus11 [cited 23rd May 2026].
Search in Google Scholar Back to article
Paatela S, Karreinen S, Tynkkynen Liina-Kaisa. Ylimmän johdon näkemyksiä integraation etenemisestä ja edellytyksistä hyvinvointialueilla. (eng. Senior Management Perspectives on the Progress and Preconditions of Integration in Wellbeing Service Counties). THL Tutkimuksesta tiiviisti. 2024. https://urn.fi/URN:ISBN:978-952-408-272-3 [cited 19^th May 2026].
Search in Google Scholar Back to article
Tiirinki H, Sulander J, Sinervo T, et al. Integrating Health and Social Services in Finland: Regional Approaches and Governance Models. Int J Integr Care. 2022;22. DOI: 10.5334/ijic.5982
Open DOI Search in Google Scholar Back to article
Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381. DOI: 10.1016/j.jbi.2008.08.010
Open DOI Search in Google Scholar Back to article
Reinhammar R, Waernbaum I. Covariate selection strategies and estimands – a review of current practice of risk factor analysis from a causal perspective. BMC Med Res Methodol. 2025;25. DOI: 10.1186/s12874-025-02704-0
Open DOI Search in Google Scholar Back to article
R Core Team. A Language and Environment for Statistical Computing. Foundation for Statistical Computing, Vienna, Austria; 2022. Retrieved from https://www.R-project.org/.
Search in Google Scholar Back to article
Fraser K, Baird LG, Laing D, et al. Factors That Influence Home Care Case Managers’ Work and Workload. Prof Case Manag. 2019;24:201–211. DOI: 10.1097/NCM.0000000000000320
Open DOI Search in Google Scholar Back to article
Sinsky C, Colligan L, Li L, et al. Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Ann Intern Med. 2016;165:753–760. DOI: 10.7326/M16-0961
Open DOI Search in Google Scholar Back to article
Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: Primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med. 2017;15:419–426. DOI: 10.1370/afm.2121
Open DOI Search in Google Scholar Back to article
Yahanda AT, Mozersky J. What’s the Role of Time in Shared Decision Making? AMA J Ethics. 2020;22. DOI: 10.1001/amajethics.2020.416
Open DOI Search in Google Scholar Back to article
Ministry of Social Affairs and Health. Selvitys kirjaamisen kuormittavuudesta ja hyötykäytöstä hyvinvointialueiden kokemana. kokemana (eng. Assessment of the Workload and Utilization of Documentation as Experienced by Wellbeing Services Counties) 2024. https://stm.fi/-/stm-n-selvitys-tuo-uutta-tietoa-sote-ammattilaisten-kirjaamisen-ongelmista-ja-kehittamiskohteista [cited 19^th May 2026].
Search in Google Scholar Back to article
Viitanen J, Reponen J, Lääveri T, et al. Potilastietojärjestelmissä on yhä paljon parannettavaa. (eng. There Is Still Much Room for Improvement in Electronic Health Record Systems). Suom Lääkärilehti. 2024.
Search in Google Scholar Back to article
Kyytsönen M, Hyppönen H, Koponen S, et al. Tietojärjestelmät sairaanhoitajien työn tukena eri toimintaympäristöissä: kokemuksia tuotemerkeittäin. (eng. Information systems supporting nurses’ work across different care settings: experiences by product) 2020. DOI: 10.23996/fjhw.95704
Open DOI Search in Google Scholar Back to article
Ring M, Ristolainen H, Tiilikainen E. From Restricted Resources to Ethical Burden—Former Home Care Workers’ Reasons for Leaving Their Jobs. Journal of Applied Gerontology. 2024;43:1111–1119. DOI: 10.1177/07334648241231404
Open DOI Search in Google Scholar Back to article
Cowie MR, Blomster JI, Curtis LH, et al. Electronic health records to facilitate clinical research. Clinical Research in Cardiology. 2017;106. DOI: 10.1007/s00392-016-1025-6
Open DOI Search in Google Scholar Back to article
Giliberto JP, Ator G, Carroll TL, et al. National Trends in Daily Ambulatory Electronic Health Record Use by Otolaryngologists. Laryngoscope. 2021;131:975–981. DOI: 10.1002/lary.29073
Open DOI Search in Google Scholar Back to article
Nijor S, Rallis G, Lad N, et al. Patient Safety Issues From Information Overload in Electronic Medical Records. Background and Objective: Electronic health records (EHRs) have. J Patient Saf. 2022;e999–e1003. DOI: 10.1097/PTS.0000000000001002
Open DOI Search in Google Scholar Back to article
Cahill M, Cleary BJ, Cullinan S. The influence of electronic health record design on usability and medication safety: systematic review. BMC Health Serv. Res. 2025;25. DOI: 10.1186/s12913-024-12060-2
Open DOI Search in Google Scholar Back to article
Wawrzyniak C, Marcilly R, Baclet N, et al. EHR usage problems: A preliminary study. Stud Health Technol Inform. 2019;257:484–488. DOI: 10.3233/978-1-61499-951-5-484
Open DOI Search in Google Scholar Back to article
Schopf TR, Nedrebø B, Hufthammer KO, et al. How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC Health Serv Res. 2019;19. DOI: 10.1186/s12913-019-4763-0
Open DOI Search in Google Scholar Back to article
Chao CA. The impact of electronic health records on collaborative work routines: A narrative network analysis. Int J Med Inform. 2016;94:100–111. DOI: 10.1016/j.ijmedinf.2016.06.019
Open DOI Search in Google Scholar Back to article
Lopetegui M, Yen PY, Lai A, et al. Time motion studies in healthcare: What are we talking about? J. Biomed. Inform. 2014;49:292–299. DOI: 10.1016/j.jbi.2014.02.017
Open DOI Search in Google Scholar Back to article
Lillrank P, Khalil FG, Bengts A, et al. Personalized care with mass production efficiency: integrating care with a virtual care operator. Journal of Integrated Care. 2022;30:282–295. DOI: 10.1108/JICA-01-2022-0006
Open DOI Search in Google Scholar Back to article
Robertson ST, Brauer SG, Burton-Jones A, et al. From use, value and user-centered design to context: A mixed methods analysis of a hospital electronic medical record enhancement. Digit Health. 2024;10. DOI: 10.1177/20552076241279208
Open DOI Search in Google Scholar Back to article
Wani D, Malhotra M. Does the meaningful use of electronic health records improve patient outcomes? Journal of Operations Management. 2018;60:1–18. DOI: 10.1016/j.jom.2018.06.003
Open DOI Search in Google Scholar Back to article
Ebbers T, Takes RP, Smeele LE, et al. The implementation of a multidisciplinary, electronic health record embedded care pathway to improve structured data recording and decrease electronic health record burden. Int J Med Inform. 2024;184. DOI: 10.1016/j.ijmedinf.2024.105344
Open DOI Search in Google Scholar Back to article
Najafabadipour M, Zanin M, Rodríguez-González A, et al. Reconstructing the patient’s natural history from electronic health records. Artif Intell Med. 2020;105. DOI: 10.1016/j.artmed.2020.101860
Open DOI Search in Google Scholar Back to article