{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:25:08Z","timestamp":1780482308761,"version":"3.54.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["# R01 HS024537"],"award-info":[{"award-number":["# R01 HS024537"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Patient transitions into home health care (HHC) often occur without the transfer of information needed for critical clinical decisions and the plan of care. Owing to a lack of universally implemented standards, there is wide variation in information transfer. We sought to characterize missing information at HHC admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We conducted a mixed methods study with 3 diverse HHC agencies. Focus groups with nurses at each agency identified what information supports patient care decisions at admission. Thirty-six in-home admissions with associated documentation review determined the available information. To inform information standards development for the HHC admission process, we compared the types of information desired and available to an international standard for transitions in care information, the Continuity of Care Document (CCD) enhanced with Office of the National Coordinator for Healthcare Information Technology summary terms (CCD\/S).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three-quarters of the items from the focus groups mapped to the CCD\/S. Regarding available information at admission, no observation included all CCD\/S data items. While medication information was needed and often available for 4 important decisions, concepts related to patient medication self-management appeared in neither the CCD\/S nor the admission documentation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The CCD\/S mostly met HHC nurses\u2019 information needs and is recommended to begin to fill the current information gap. Electronic health record recommendations include use of a data standard: the CCD or the proposed, more parsimonious U.S. Core Data for Interoperability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Referral source and HHC agency adoption of data standards is recommended to support structured, consistent data and information sharing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocaa087","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T19:43:16Z","timestamp":1588189396000},"page":"1278-1286","source":"Crossref","is-referenced-by-count":17,"title":["Incorporating home healthcare nurses\u2019 admission information needs to inform data standards"],"prefix":"10.1093","volume":"27","author":[{"given":"Paulina S","family":"Sockolow","sequence":"first","affiliation":[{"name":"Department of Health Systems and Sciences Research, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn H","family":"Bowles","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA"},{"name":"Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Wojciechowicz","sequence":"additional","affiliation":[{"name":"Department of Biology, College of Arts and Sciences, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7553-0004","authenticated-orcid":false,"given":"Ellen J","family":"Bass","sequence":"additional","affiliation":[{"name":"Department of Health Systems and Sciences Research, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA"},{"name":"Department of Information Science, College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"issue":"23\u201324","key":"2020110613085324200_ocaa087-B1","doi-asserted-by":"crossref","first-page":"3389","DOI":"10.1111\/jocn.12991","article-title":"Patients in transition\u2013improving hospital-home care collaboration through electronic messaging: providers\u2019 perspectives","volume":"24","author":"Melby","year":"2015","journal-title":"J Clin Nurs"},{"issue":"2","key":"2020110613085324200_ocaa087-B2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/00004045-200702000-00011","article-title":"The effect of frontloading visits on patient outcomes","volume":"25","author":"Rogers","year":"2007","journal-title":"Home 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