Information Systems Connectivity to Improve Medication Process (LinkedCare)

Effects of Care Information Systems Connectivity on Medication Process Efficiency and Quality (Linked Care): Protocol for a Cluster Allocated Controlled Trial

Linked Care aims to help healthcare professionals (nurses, doctors, pharmacists) interact efficiently and safely with IT support to improve patient information flows. It focuses on the medication ordering process, which currently involves time-consuming steps like calling doctors and traveling to get prescriptions. The project targets nursing staff, doctors, pharmacists, and patients, with indirect benefits for hospitals, social welfare organizations, and insurance bodies. This study evaluates the Linked Care solution by addressing the research question: Does an electronic ordering system improve the efficiency and quality of the regular medication process?

Study Overview

• Status: Completed
• Conditions: Medication Management at Home
• Intervention / Treatment: Device: medication management; Other: Usual Care Group

Detailed Description

Background and rationale:

Linked Care aims to provide access to information relevant to care and support beyond the boundaries of the various care settings and primarily supports caregivers in the acquisition and transfer of information. The development of essential standards (e.g., a myCare Info) and the involvement of all affected target groups make it possible to develop practical IT tools for standardized networking in mobile care and nursing. The result will be an integrated, affordable, easy-to-use and well-connected IT system for care and support. The portal can be operated via mobile devices, PC, or tablets.

The McKinsey study demonstrates the significant potential of digitalization in the Austrian healthcare sector. According to this study, there is a 4.7-billion-euro opportunity for Austria. Approximately 70% of the potential benefits of increased productivity accrue to service providers, such as physicians and hospitals. The remaining 30% can be attributed to other players in the system, particularly health insurers, who benefit from reduced service utilization and improved care. Key factors in achieving these benefits include the implementation of the Austrian electronic health record (ELGA) and e-prescribing, which enable efficiency gains of EUR 690 million. Digitization is also sought after by regulators, patients, payers, and service providers in the Austrian healthcare system for improved efficiency and quicker access to data.

Helmcke et al. (2021) identify the following areas with the greatest potential for savings and benefits in the Austrian healthcare system:

• Online interactions, especially through teleconsultation.
• Paperless data, emphasizing standardized patient records/exchange and electronic prescriptions.
• Automated workflows, particularly the networking of mobile caregivers.
• Decision support and transparency of outcomes, including performance dashboards.
• Patient self-management, primarily through tools for managing chronic conditions like diabetes.
• Patient self-service for electronic scheduling.

Objectives:

This project aims to enable documenting healthcare professionals (such as nurses, general practitioners (GPs), and pharmacists) to interact efficiently, safely, and conveniently, with optimal IT support, to improve (or make more efficient) the patient-related information flows. The specific use cases studied are the process of ordering and in particular reordering medication. A significant time-saving potential has been identified in the transfer of medication information. The ordering process usually begins with nurses calling a GP as soon as they notice that a client has run out of medication and needs to be re-supplied when preparing the prescribed medication. The nurse then usually travels distances (e.g. by car) to obtain a prescription from the GP and collect the medication from the pharmacy. To do this, they need the client's insurance card, which has to be collected separately. The project is therefore aimed at four target groups: i) nursing staff who carry out the documentation, ii) GPs, and iii) pharmacists and finally iv) patients who make use of the care. In addition to the target groups studied in this trial, indirect beneficiaries include healthcare providers such as hospitals, social welfare organizations, rehabilitation clinics, public insurance bodies, etc. who ensure effective and efficient care. The trial aims to evaluate the entire process of data recording and data exchange via the newly created interfaces between the systems involved in practical use.

The primary research question of this study is: Does an electronic ordering system improve the efficiency and quality of the regular medication process?

Secondary research questions are:

• Does the digital ordering system receive end-user acceptance?
• Which impacts on the health and care system are generated by the implementation of the digital ordering system? (evaluated qualitatively)

• Study Type: Interventional
• Enrollment (Actual): 70
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Austria
  • Linz, Austria, 4200
    • Volkshilfe Gesundheits- und Soziale Dienste GmbH
  • Vienna, Austria, 1210
    • Johanniter Österreich Ausbildung und Forschung gem. GmbH
  • Vienna, Austria, 1030
    • Wiener Rotes Kreuz- Rettungs-, Krankentransport-, Pflege- und Betreuungsgesellschaft m.b.H.
  • Vienna, Austria
    • Volkshilfe Wien gemeinnützige Betriebs-GmbH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria Caregivers:

• Actively pursuing at least one of the following health professions extramurally: nurse, nursing assistant level 1 or level 2 , elderly specialist caregiver, home care assistant
• Active maintenance of nursing documentation and use of the duty cell phone
• Age 18+ years
• Willing to comply with all study-related procedures and provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention (using Linked Care system); All nurses and caregivers participating in the intervention group use the newly installed mynevaToGo app to reorder medication. Nurses and nursing assistant level 2 also use the myneva Care Center software to keep the medication list prescribed by the GP. The solution is installed in advance on the duty cell phones by the IT department of the relevant care organization. Participating nurses and caregivers in the intervention group are instructed to handle the medication ordering process electronically (i.e., medication orders will be sent to the GPs via the Linked Care platform).	Device: medication management; The test system consists of: Linked care platform (backend) which provides a new possibility of data exchange for IT systems of caregivers, pharmacies, and GPs; User interfaces for caregivers as well as for the systems myneva.carecenter and mynevaTOgo; An extension of the user interface for GPs in their IT system (in the test only for the physician software PCPO by CompoGroup Medical ); An extension of the user interface for pharmacists in their IT system (in the test only for pharmacies with software from Apothekerverlag) Functionally, the solution should, coordinate the medication requirements between pharmacies, GPs, and caregivers (subarea medication).
Active Comparator: Control; Care professionals in the convenience sampled control group continue to handle the usual medication process.	Other: Usual Care Group; Usual care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time spent on medication related processes	Measure of time efficiency recorded on a project-specific 14-day medication log. / Minimum value: 0 [minutes], maximum value: N/A. Higher scores mean a worse outcome. / Analysis metric: difference test vs. control, test group trend analysis. / Method of aggregation: mean.	Baseline, 3-month follow-up, 6-month follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall score from the "Survey on psychological stress in mobile care (BGW miab)	Self-reported indications on 6 subitems on a 5-point Likert pseudometric scale. / Minimum value: 1, maximum value: 5. Higher scores mean a worse outcome. / Analysis metric: Difference test vs. control & test group trend analysis. / Method of aggregation: mean score.	Baseline, 3-month follow-up, 6-month follow-up
Overall score from a "Project-specific questionnaire on care-process quality".	Self-reported indications on 21 subitems on a 5-point Likert pseudometric scale. / Minimum value: 1, maximum value: 5. Higher scores mean a worse outcome. / Analysis metric: Difference test vs. control & test group trend analysis. / Method of aggregation: weighted mean score.	Baseline, 3-month follow-up, 6-month follow-up
Overall score from the "Usefulness, Satisfaction, and Ease of Use (PSSUQ) Questionnaire"	Self-reported indications on 16 subitems on a 7-point Likert pseudometric scale. / Minimum value: 1, maximum value: 7. Higher scores mean a worse outcome. / Analysis metric: Difference test vs. control & test group trend analysis. / Method of aggregation: mean score.	3-month follow-up, 6-month follow-up
Overall score from the "Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) Questionnaire"	Self-reported indications on a 7-point Likert pseudometric scale with subitems in 4 domains: i) performance expectancy, ii) effort expectancy, iii) social influence, and iv) facilitating conditions. / Minimum value: 1, maximum value: 7. Higher scores mean a worse outcome. / Analysis metric: Difference test vs. control & test group trend analysis. / Method of aggregation: mean score.	3-month follow-up, 6-month follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sample Characteristic Affiliation	Affiliation to a care-providing organization (selection from 4 participating organizations GSD, VHW, WRK, JOHA). Scale: nominal.	Baseline
Sample Characteristic Profession	Profession (selection from 5 options: certified nurse, specialist nursing assistant, nursing assistant level 1 or level 2 , home care assistant. Scale: nominal.	Baseline
Sample Characteristic Age	Age (years). Scale: metric.	Baseline
Sample Characteristic Gender	Gender (selection from 3 options: male, female, divers). Scale: nominal.	Baseline
Sample Characteristic Employment Extent	Employment extent (weekly contractual hours). Scale: metric.	Baseline

Collaborators and Investigators

• Sponsor: Peter Putz
• Collaborators: Johanniter Österreich Ausbildung und Forschung gem. GmbH; Wiener Rotes Kreuz- Rettungs-, Krankentransport-, Pflege- und Betreuungsgesellschaft m.b.H.; Volkshilfe Wien gemeinnützige Betriebs-GmbH; Volkshilfe Gesundheits- und Soziale Dienste GmbH
• Investigators: Study Director: Elisabeth Haslinger-Baumann, FH-Prof. Dr., FH Campus Wien University of Apllied Sciences

Publications and helpful links

General Publications

• Helmcke Stefan, Biesdorf Stefan, Bauer Florian, Berger Wernhard (2021). mckinseystudiedigitalisierung im gesundheitswesen die 47mrdeurochance fur Österreich.
• BGW miab für die Pflege und den stationären Wohnbereich der Behindertenhilfe Erstveröffentlichung 2002, Stand 01/2013 Hrsg. Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW). Hamburg, Online: www.bgw-online.de

Study record dates

Study Major Dates

• Study Start (Actual): January 7, 2025
• Primary Completion (Actual): June 29, 2025
• Study Completion (Actual): June 29, 2025

Study Registration Dates

• First Submitted: December 6, 2024
• First Submitted That Met QC Criteria: December 6, 2024
• First Posted (Actual): December 11, 2024

Study Record Updates

• Last Update Posted (Estimated): September 24, 2025
• Last Update Submitted That Met QC Criteria: September 19, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: nursing; home care; telehealth; medication process; medication order
• Other Study ID Numbers: FHCW EC Nr. 130/2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Because the trial deals with sensitive health-related data, neither person-identifiable nor coded raw data will be made publicly available or shared upon request from other researchers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No