Abstract
Background: Greece: Health System Review (Economou et al., 2017), highlighted that integrated primary health care has not received adequate attention in Greece and transitional care management remains limited. There is no gatekeeping mechanism to manage the referral system, and the use of health care services is based largely on the user's personal choice (Philalithis, 2021). Pathways guiding users through the health care system are not clearly defined, and digital technology is used sporadically across the care continuum (WHO. Regional Office for Europe, 2024). Digital tools have the potential to enhance transitional care by improving information flow, and supporting clinicians in decision-making. This study explores the perspectives of healthcare professionals working within Greek healthcare system on the importance and necessity of adopting digitalization and technology in transitional care.
Approach: This study is part of the exploratory phase of a research protocol designed to evaluate the feasibility of integrating digital tools to improve care transitions (Petsani et al., 2022). Employing an exploratory sequential mixed methods design, it began with qualitative data collection to capture insights from healthcare professionals. A focus group session was conducted at 'Hippokration' General Hospital in Thessaloniki, Greece, involving six (6) participants—three nurses, one cardiologist, and two residents specializing in internal medicine. Following the qualitative phase, a questionnaire was distributed for quantitative validation, allowing the team to quantify the findings. Twenty one (21) professionals across fields like clinical care, nursing, social work, palliative care, and psychology brought varied perspectives on the current status of transitional care, the existing challenges and importance of digitalization and technology usage.
Results: A key issue identified in the focus groups was the lack of resources for transitional care management, confirmed by 52% of respondents who rated resource availability as poor or very poor in their facility. Most participants highlighted a need for major or important improvements in post-discharge support (66%), discharge protocols (57%), and follow-up procedures (57%). Focus group findings, supported by literature, also indicated the absence of a standardized discharge protocol, with decisions primarily left to the attending doctor. While 76% of respondents noted limited or no use of technology in discharge protocols, 57% felt that digital tools could significantly improve this area. Additionally, follow-up often depends solely on patients without a structured referral system, with 66% seeing high or very high potential for digital tools in follow-up and 71% for post-discharge support. Participants further stressed the need for risk stratification within hospitals, allowing all stakeholders immediate access to patient data, with 52% emphasizing the importance of assessment and patient evaluation prior to discharge and 47% believing digital tools could have high or very high impact in this area.
Implications: Overall, the study underscores the urgent need for improved care integration through transitional care management in Greece, revealing strong support for digital enhancement across all aspects of transitional care. Successful implementation of digital tools should begin with a thorough understanding of the current landscape by engaging those who experience it firsthand.
This work is funded by the EVOLVE2CARE project (grant agreement 101158152).