Evidence map›Paper›PMID 39982779›Full record

ArticleJMIR nursing2025

Detailed Analysis and Road Map Proposal for Care Transition Records and Their Transmission Process: Mixed Methods Study.

Elisabeth Veronica Mess, Matthias Regner, Sabahudin Balic, Lukas Kleybolte, Lisa Daufratshofer, Andreas Mahler, Sabrina Tilmes, Viktor Werlitz, Claudia Reuter, Alexandra Teynor

Abstract read
In one paragraph

Article in JMIR nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Elisabeth Veronica MessInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0000-0003-1205-9141
Matthias RegnerInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0009-0004-0062-0530
Sabahudin BalicInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0000-0003-4858-9494
Lukas KleybolteInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0000-0002-9886-5592
Lisa DaufratshoferDigitization Staff Unit, University Hospital Augsburg, Augsburg, Germany.ORCID 0009-0004-7753-1202
Andreas MahlerDigitization Staff Unit, University Hospital Augsburg, Augsburg, Germany.ORCID 0009-0004-9109-140X
Sabrina TilmesDigitization Staff Unit, University Hospital Augsburg, Augsburg, Germany.ORCID 0009-0008-8956-3673
Viktor WerlitzInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0009-0006-8965-6058
Claudia ReuterInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0009-0008-5594-6844
Alexandra TeynorInstitute for agile Software Development, Technical University of Applied Sciences Augsburg, Augsburg, Germany.ORCID 0000-0002-8141-0428

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe digitalization of health care in Germany holds great potential to improve patient care, resource management, and efficiency. However, strict data protection regulations, fragmented infrastructures, and resistance to change hinder progress. These challenges leave care institutions reliant on outdated paper-based workflows, particularly for patient data transmission, despite the pressing need for efficient tools to support health care professionals amid a nursing shortage and rising demand for care.

objectiveThis paper aims to analyze Germany's care transition record (CTR) and CTR transmission process as part of transition management and suggests improvements toward a seamless digital solution.

methodsTo understand the current challenges of manual CTR transfers, we used a mixed methods approach, which included a web-based questionnaire with nursing professionals, field observations, business process model and notation modeling, semantic and frequency analysis of CTR entries, and user story mapping.

resultsA web-based questionnaire involving German nursing professionals (N=59) revealed considerable delays in patient care due to manual, patient-transferred CTRs. Of the 33 usable responses (n=33), 70% (n=23) of the respondents advocating for digital transmission to improve efficiency. Observations (N=11) in care facilities (n=5, 45%) and a hospital (n=6, 55%) confirmed the high administrative burden, averaging 34.67 (SD 10.78) minutes per CTR within a hospital and 44.6 (SD 20.5) minutes in care facilities. A semantic analysis of various CTRs (N=4) highlighted their differences and complexity, stressing the need for standardization. Analyzing a new CTR standard (care information object CTR) and manually mapping an existing CTR to it showed that the procedure was ambiguous, and some associations remained unclear. A frequency analysis of CTR entities revealed which were most used. In addition, discussions with care staff pointed out candidates for the most relevant entities. On the basis of the key findings, a stepwise transition approach toward a road map proposal for a standardized, secure transfer of CTRs was conceptualized. This road map in the form of a user story map, encompassing a "CTR transformer" (mapping of traditional CTRs to a new standard) and "care information object CTR viewer/editor" (in short, CIO-CTR viewer and editor; a new standard for viewing, editing, and exporting), shows a possibility to bridge the transition time until all institutions fully support the new standard.

conclusionsA future solution should simplify the overall CTR transmission process by minimizing manual transfers into in-house systems, standardizing the CTR, and providing a secure digital transfer. This could positively impact the overall care process and patient experience. With our solutions, we attempt to support care staff in their daily activities and processes until nationwide state regulations are implemented successfully, though the timeline for this remains uncertain.

Indexed as

Electronic Health RecordsPatient TransferAdultFemaleGermanyHumansMaleSurveys and QuestionnairesAIartificial intelligencecare information object care transition recordcare transition recordCIO-CTRFast Healthcare Interoperability ResourcesFHIRHealth Level 7HL7medical information objectMIOobservationsPflegerisches Informationsobjekt-ÜberleitungsbogenPIO-ULBprocess modelingtelematics infrastructureTItransmission management

Identifiers

PMID39982779
PMCPMC11890131

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.