|Barrier / Stakeholder||1||2||3||4||Overview of perceived barriers|
|Pressures of costs and efficiency||Time constraints||Individual time constraints||x||x||
On the operational level, the stakeholders face time constraints due to various reasons, which leads to a focus on the day-to-day activities, hindering systemic collaborations.|
Supposedly, this concerns mainly the referring practitioners in private practice and the surgeon/anesthetist at the hospital. It might be reasonable to take the geriatric center into account, but due to a lack of integration in the perioperative treatment, it is not concerned at this point.
|Other resource constraints||Lack of funding||x||x||
Reimbursement concerns the re-payment for the conducted patient treatments. The geriatric center is not systematically included in the pre-operative patient treatment, raising reimbursement issues.|
Referring to the standardization of data sets and of processes, the alignment of the information systems and communication tools, it is apparent that data sharing requires a great amount of financial effort.
Notably, the decentralized structure of ambulant sector (e.g. practitioners in private practice) requires early-stage financing to mount the innovation.
|Non-aligned/non-adapted action frames||Incompatible goals||Incompatible organizational goals and time horizons||x||x||x||
This refers to the divergent operational speed and the difficulties caused by these in the attempt of a cooperation.|
In this regard, this concerns primarily the stakeholders and cooperation between the practitioner in private practice, geriatric center, and hospital.
|Legitimation and interpretation frames||No legitimate action frame for preoperative treatment||(x)||x||x||(x)||The stakeholders face uncertainty regarding their action frame, due to a missing systemic perioperative process, the separation of the ambulant and clinical sector and the lack of financial support.|
|Unclear interpretation of rules and responsibilities||x||x||(x)||x||
Data security and the responsibility for the handling and exchanges of patient data remain unclear for the concerned stakeholders.|
Notably, by looking at the role of the practitioners in private practice in the treatment process (early stage, data generation and transfer) and their resources, it becomes apparent that this group of stakeholders faces the greatest challenges in understanding, interpreting and acting on the data protection guidelines.