The digital care convoy
Exploring the impact of increased digital communication in the primary care sector
DOI:
https://doi.org/10.7146/qhc.155941Keywords:
communication dynamics, digitalisation, digital communication, healthcare documentation, homecare sector, literacy skills, oral communicationAbstract
Background: The digitalisation of care services has significantly altered communication among healthcare professionals, care recipients and their families. Interactions now rely heavily on digital documentation, which affects interpersonal engagement. Digital communication plays a central role in care delivery, from the reading of patient records before visits to the composition of detailed reports afterwards. Aim: This article examines the role and perception of digital communication and documentation in the care of older individuals, focusing on the challenges of increased reliance on written digital communication, as well as time constraints, literacy barriers and reduced direct verbal interaction. Methods: The study is based on 14 interviews conducted in 2023 and 2024 with professional caregivers and 20 interviews with individuals aged 75 or older receiving care at home or in residential facilities and five interviews with their relatives, friends and family members. The analysis is primarily based on the 14 interviews with professional caregivers. Results: Three key challenges were identified: (1) Reading, writing, and categorisation are cognitively demanding and require caregivers to process large amounts of information while managing tasks. (2) Written communication, although intended to be clear and efficient, is often misinterpreted, which necessitates verbal clarification. (3) Documentation serves both communication and accountability purposes, thus increasing administrative burdens. Discussion: Although digital communication systems enhance efficiency and transparency, they also limit access for informal caregivers, which leads to communication gaps. Conclusion: Written digital communication is challenging for professional caregivers and is part of a complex communication landscape that, in order to function optimally, also includes oral communication and analogue letters and documents.
References
Alexander, G. L., & Madsen, R. (2009). IT Sophistication and Quality Measures in Nursing Homes. Journal of Gerontological Nursing, 35(7), 22–27. https://doi.org/10.3928/00989134-20090527-05
Antonio, M. G., Petrovskaya, O., & Lau, F. (2020). The State of Evidence in Patient Portals: Umbrella Review. J Med Internet Res, 22(11), e23851. https://doi.org/10.2196/23851
Antonucci, T. C., Ajrouch, K. J., & Birditt, K. S. (2014). The convoy model: explaining social relations from a multidisciplinary perspective. Gerontologist, 54(1), 82-92. https://doi.org/10.1093/geront/gnt118
Bargaje, C. (2011). Good documentation practice in clinical research. Perspectives in Clinical Research, 2(2), 59-63. https://doi.org/10.4103/2229-3485.80368
Berg, M. (1999). Patient care information systems and health care work: a sociotechnical approach. International Journal of Medical Informatics, 55(2), 87-101. https://doi.org/10.1016/S1386-5056(99)00011-8
Berg, M. (1996), Practices of reading and writing: the constitutive role of the patient record in medical work. Sociology of Health & Illness, 18(4), 499-524. https://doi.org/10.1111/1467-9566.ep10939100
Burgess, E. O., Kemp, C. L., & Bender, A. A. (2022). “It’s Going to be Different for Everyone”: Negotiating Quality of Life and Care Priorities Within Care Convoys. Journal of Aging and Health, 34(4-5), 602-613. https://doi.org/10.1177/08982643211052367
Coolbrandt, A., Sterckx, W., Clement, P., Borgenon, S., Decruyenaere, M., de Vleeschouwer, S., Mees, A., & Dierckx de Casterlé, B. (2015). Family Caregivers of Patients With a High-Grade Glioma: A Qualitative Study of Their Lived Experience and Needs Related to Professional Care. Cancer Nursing, 38(5), 406-413. https://doi.org/10.1097/ncc.0000000000000216
Demsash, A. W., Kassie, S. Y., Dubale, A. T., Chereka, A. A., Ngusie, H. S., Hunde, M. K., Emanu, M. D., Shibabaw, A. A., & Walle, A. D. (2023). Health professionals' routine practice documentation and its associated factors in a resource-limited setting: a cross-sectional study. BMJ Health & Care Informatics, 30(1), e100699. https://doi.org/10.1136/bmjhci-2022-100699
Duval Jensen, J. (2024, 5 March). Hvordan kan digital dokumentation blive en vej til sammenhæng i borgerforløb? [How can digital documentation become a pathway to a coherent citizen journey?]. Sygeplejevidenskab.dk. https://doi.org/10.62680/FA0724
Duval Jensen, J., Ledderer, L., Kolbæk, R., & Beedholm, K. (2023a). Fragmented care trajectories in municipal healthcare: Local sensemaking of digital documentation. Digital Health, 9, 20552076231180521. https://doi.org/10.1177/20552076231180521
Duval Jensen, J., Ledderer, L., & Beedholm, K. (2023b). How digital health documentation transforms professional practices in primary healthcare in Denmark: A WPR document analysis. Nursing Inquiry, 30(1), e12499. https://doi.org/10.1111/nin.12499
Ejersbo, N., Lindeberg, N. H., & Pedersen, L. H. (2017, 5 March). Dokumentationskrav på dagtilbudsområdet [Documentation requirements in the area of day care]. KORA, Det Nationale Institut for Kommuners og Regioners Analyse og Forskning. https://uvm.dk/media/g1yij0gu/170305-dokumentationskrav-paa-dagtilbudsomraadet-kora.pdf
FOA. (2009). Registrering og dokumentation i hjemmeplejen - indtryk fra syv kommuner [Registration and documentation in home care - impressions from seven municipalities]. https://www.foa.dk/~/media/_Files/Fildeling/undersgelser/Registrering%20og%20dokumentation%20i%20aeldreplejen%20pdf.ashx
Hackett, S. E., Peterson, L. J., Vogel, C. E., & Dobbs, D. (2023). “We Did More Damage”: How COVID-19 Collapsed the Care Convoys of Residents Living With Dementia. Journal of Applied Gerontology, 42(7), 1565-1573. https://doi.org/10.1177/07334648231162360
Hansen, A. M., & Kamp, A. (2018). Welfare professionals in transformation : The case of elderly care. In H. Hvid & E. Falkum (Eds.), Work and Wellbeing in the Nordic Countries : Critical Perspectives on the World's Best Working Lives (1 ed., pp. 243-259). Routledge. https://doi.org/10.4324/9781351169967-17
Ho, K. H. M., Cheung, D. S. K., Lee, P. H., Lam, S. C., & Kwan, R. Y. C. (2022). Co-living with migrant domestic workers is associated with a lower level of loneliness among community-dwelling older adults: A cross-sectional study. Health & Social Care in the Community, 30(4), e1123-e1133. https://doi.org/10.1111/hsc.13520
Håland, E. (2011). Introducing the Electronic Patient Record (EPR) in a Hospital Setting: Boundary Work and Shifting Constructions of Professional Identities. Sociology of Health & Illness, 34(5), 761–775. https://doi.org/10.1111/j.1467-9566.2011.01413.x
Kahn, R. L., & Antonucci, T. C. (1980). Convoys over the Life Course: Attachment, Roles, and Social Support. In P. B. Baltes & O. G. Grim (Eds.), Life Span Development and Behavior (Vol. 3, pp. 253-267). Academic Press.
Kamp, A., & Hansen, A. M. (2018). Nordic New Public Management : The case of Denmark. In H. Hvid & E. Falkum (Eds.), Work and Wellbeing in the Nordic Countries : Critical Perspectives on the World's Best Working Lives (1 ed., pp. 221-242). Routledge. https://doi.org/10.4324/9781351169967-16
Kemp, C. L. (2020). #MoreThanAVisitor: Families as “Essential” Care Partners During COVID-19. The Gerontologist, 61(2), 145-151. https://doi.org/10.1093/geront/gnaa161
Kemp, C. L., Ball, M. M., Morgan, J. C., Doyle, P. J., Burgess, E. O., & Perkins, M. M. (2018). Maneuvering Together, Apart, and at Odds: Residents’ Care Convoys in Assisted Living. The Journals of Gerontology: Series B, 73(4), e13-e23. https://doi.org/10.1093/geronb/gbx184
Kent, P., & Morrow, K. (2014). Better documentation improves patient care. Nursing Standard, 29(14), 44-51. https://doi.org/10.7748/ns.29.14.44.e9267
Kozinets, R. V. (2015). Netnography: redefined (2nd ed.). Sage.
Kuusisto, A., Saranto, K., Korhonen, P., & Haavisto, E. (2023). Accessibility of care plan information from previous treatment setting in palliative care unit: A qualitative study. Nursing Open, 10(2), 498-508. https://doi.org/10.1002/nop2.1315
Lambotte, D., Smetcoren, A.-S., Zijlstra, G.A.R., De Lepeleire, J., De Donder, L., Kardol, M. J. M. (2020). Meanings of Care Convoys: The Structure, Function, and Adequacy of Care Networks Among Frail, Community-Dwelling Older Adults. Qualitative Health Research, 30(4), 583-597. https://doi.org/10.1177/1049732319861934
Latour, B. (2005). Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford University Press.
Nielsen, A. S., & Grønning, A. (2025). Co-Actors and Inequities in Digital Health from a Nursing Home Perspective. European Journal of Health Communication, 6(2), 1-16. https://doi.org/10.47368/ejhc.2025.201
Olsson, T., Samuelsson, U., & Viscovi, D. (2019). At risk of exclusion? Degrees of ICT access and literacy among senior citizens. Information, Communication & Society, 22(1), 55–72. https://doi.org/10.1080/1369118X.2017.1355007
Paré, G., Sicotte, C., Poba-Nzaou, P., & Balouzakis, G. (2011). Clinicians' perceptions of organizational readiness for change in the context of clinical information system projects: insights from two cross-sectional surveys. Implementation Science, 6(1), 15. https://doi.org/10.1186/1748-5908-6-15
Petersen, M., Winterton, R., Warburton, J., & Wilson, J. (2024). Negotiating the care convoys for a diverse group of older Australians living in rural communities: a large qualitative study. Ageing and Society, 44(7), 1494-1514. https://doi.org/10.1017/S0144686X22000125
Platz, M. (1987). Længst muligt i eget hjem: en undersøgelse blandt ældre i Odense. [As long as possible in one's own home: a survey among older people in Odense]. Socialforskningsinstituttet.
Puustinen, J., Kangasniemi, M., & Turjamaa, R. (2021). Are comprehensive and individually designed care and service plans for older people's home care a vision or a reality in Finland?. Health & social care in the community, 29(5), e144–e152. https://doi.org/10.1111/hsc.13255
Reckrey, J. M., Russell, D., Fong, M.-C., Burgdorf, J. G., Franzosa, E. C., Travers, J. L., & Ornstein, K. A. (2024). Home Care Worker Continuity in Home-Based Long-Term Care: Associated Factors and Relationships With Client Health and Well-Being. Innovation in Aging, 8(3), igae024. https://doi.org/10.1093/geroni/igae024
Shade, S. B., Chakravarty, D., Koester, K. A., Steward, W. T., & Myers, J. J. (2012). Health information exchange interventions can enhance quality and continuity of HIV care. International Journal of Medical Informatics, 81(10), e1-e9. https://doi.org/10.1016/j.ijmedinf.2012.07.003
Simonsen, L. M. (2022). Digitalization of the Wild: The everyday enaction of digital consultations in interprofessional interactions. [Ph.D. dissertation, SDU]. Syddansk Universitet. Det Humanistiske Fakultet. https://doi.org/10.21996/akgm-9v84
Simonsen, L. M. (2025). Reading With Care: A Distributed Perspective on Reading Digitally Mediated Text in Healthcare. Digital Society, 4(1), article 10. https://doi.org/10.1007/s44206-025-00165-y
Tindle, R., & Longstaf, M. G. (2015). Writing, Reading, and Listening Differentially Overload Working Memory Performance Across the Serial Position Curve. Advances in Cognitive Psychology, 11(4), 147–155. https://doi.org/10.5709/acp-0179-6
VMK, & NVK. (2024, 31 October). Hvad skal IKKE anmeldes? [What does not require approval from the ethics committee?]. videnskabsetik.dk. https://www.videnskabsetik.dk/ansoegning-til-etisk-komite/overblik-over-anmeldelsespligten/hvad-skal-ikke-anmeldes
Wolff, J. L., Darer, J. D., Berger, A., Clarke, D., Green, J. A., Stametz, R. A., Delbanco, T., & Walker, J. (2017). Inviting patients and care partners to read doctors’ notes: OpenNotes and shared access to electronic medical records. Journal of the American Medical Informatics Association, 24(e1), e166-e172. https://doi.org/10.1093/jamia/ocw108
Wolff, J. L., Dukhanin, V., Burgdorf, J. G., & DesRoches, C. M. (2022). Shared Access to Patient Portals for Older Adults: Implications for Privacy and Digital Health Equity. JMIR Aging, 5(2), e34628. https://doi.org/10.2196/34628
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Amalie Søgaard Nielsen, Anette Grønning

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles submitted to Qualitative Health Communication should not be submitted to or published in other journals.
Articles published in Qualitative Health Communication may be used (downloaded) and reused (distributed, copied, cited) for non-commercial purposes with reference to the authors and publication host.
For all publications published in the first four issues, i.e. 1(1), 1(2), 2(1) and 3(1), copyright is shared between the author and QHC. For all future publications, the author is the sole copyright holder.