Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Dr. Booth, Richard, G.

2nd Supervisor

Dr. McMurray, Josephine


Wilfrid Laurier University



Research Questions: The research questions within this thesis aimed to examine the current state of health information exchange (HIE) processes within the Canadian long-term care (LTC) setting and identify opportunities to improve these processes through the proliferation of health information technology (HIT).

Methods: The first study undertook a scoping review following Levac et al’s. approach to the methodology. Next, an interpretive study using semi-structured interviews and Hsieh and Shannon's conventional content analysis methodology was undertaken.

Findings: The scoping review highlighted that effective HIE processes are susceptible to variations in HIT resources, workload, and social and organizational cultures. The findings of the interpretive study describe common breakdowns in HIE processes and identifies opportunities to connect fragmented information flows through HIT proliferation.

Significance: We recommend accelerating the implementation and adoption of HIT to facilitate intra- and inter-organizational HIE for direct-care providers, to strengthen the efficiency of HIE processes, and to improve the safety and quality of care within the LTC sector.

Summary for Lay Audience

The term health information exchange (HIE) in healthcare largely describes how healthcare providers gather and share information about patients or long-term care (LTC) residents that is needed to make decisions during care delivery. Technology can be a useful tool to improve the efficiency of HIE, but the long-term care (LTC) sector has been slow to use technology to its full potential during HIE processes. Consequently, care quality within the LTC sector is impacted by providers using inefficient HIE processes while the complexity of coordinating healthcare for these residents increases. Improving HIE processes in LTC is important because healthcare providers need the right information, at the right time, to make decisions about residents’ care. This thesis consists of two studies that aim to understand the current state of HIE within LTC to identify opportunities to improve these processes through increased technological adoption. The first research study is a scoping review of the literature on the topic of HIE within Canadian LTC to understand current processes, gaps in HIE that might be closed by technology adoption, and opportunities for future research. The second study in this thesis co-creates an understanding of the current state of HIE within LTC through semi-structured interviews with LTC providers; through this study, researchers built an interpretive understanding of current HIE processes and identified opportunities for improvement through increased technological adoption. Increasing technology within LTC is an important opportunity to improve HIE and the quality of healthcare within this sector; however, careful consideration of social, organizational, and cultural factors impacting a healthcare providers level of technology adoption is important to consider alongside implementing new technological processes.

Available for download on Thursday, November 16, 2023