The Discharge Summary Divide: A Review of Electronic Solutions, Obstacles and Benefits

The seamless transition from hospital to home is essential for patient safety and continuity of care. This transition is challenged when primary care physicians receive incomplete, delayed, and inaccurate information about their patients' hospital stay. The discharge summary is the major vehicle for communicating post-discharge patient information from the hospital to primary care physicians. Considered the most comprehensive document in the health record, and despite numerous efforts to automate and computerize it, a complete, timely, and accurate discharge summary remains elusive in practice. From hand-written and delivered to collaborative generation, we trace the journey of the discharge summary through three decades of evolving information and communication technologies. In an attempt to narrow the divide between hospital and primary care physicians we discuss the evidence needed to improve the quality of patient care and to support more significant physician adoption of electronic discharge summaries.