What Are The Roles Involved In Establishing And Maintaining Informational Continuity Of Care Within Family Practice? A Systematic Review

Background: Central to establishing continuity of care is the development of a relationshipbetween doctor and patient/caregiver. Transfer of information between these parties facilitates thedevelopment of continuity in general; and specifically informational continuity of care. Weconducted a systematic review of published literature to gain a better understanding of the rolesthat different parties – specifically doctors, patients, family caregivers, and technology – play inestablishing and maintaining informational continuity of care within family practice.Methods: Relevant published articles were sought from five databases. Accepted articles werereviewed and appraised in a consistent way. Fifty-six articles were retained following title andabstract reviews. Of these, 28 were accepted for this review.Results: No articles focused explicitly on the roles involved in establishing or maintaininginformational continuity of care within family practice. Most informational continuity of careliterature focused on the transfer of information between settings and not at the first point ofcontact. Numerous roles were, however, were interpreted using the data extracted from reviewedarticles. Doctors are responsible for record keeping, knowing patients' histories, recallingaccumulated knowledge, and maintaining confidentiality. Patients are responsible for disclosingpersonal and health details, transferring information to other practitioners (including new familydoctors), and establishing trust. Both are responsible for developing a relationship of trust.Technology is an important tool of informational continuity of care through holding importantinformation, providing search functions, and providing a space for recorded information. There isa significant gap in our knowledge about the roles that family caregivers play.Conclusion: The number of roles identified and the interrelationships between them indicatesthat establishing and maintaining informational continuity of care within family practice is a complexand multifaceted process. This synthesis of roles provided serves as an important resource forcontinuity of care researchers in general, for the development of continuity of care qualityindicators, and for the practice of family medicine.