Development and User Evaluation of a LINE Alert–Based Communication System to Support Interhospital Patient Referral in the Kalasin Hospital Network

Abstract

Background: Inter-hospital patient transfers often face delays, instability, and data
duplication. Kalasin Hospital developed the LINE Alert communication system to support
coordination between referring and receiving teams.
Objective: To develop a suitable LINE Alert system for the network context, evaluate
healthcare personnel's satisfaction and perceptions, and investigate operational problems,
obstacles, and recommendations.
Methods: Sequential explanatory mixed-methods research was conducted from
September 2024 to March 2025 among 116 healthcare personnel, structured in three phases: (1)
analyzing problems and needs, (2) developing and implementing LINE Alert, and (3) evaluating
the system using cross-sectional questionnaires along with quantitative and qualitative analyses.
Results: Qualitative findings highlighted four key issues: transfer delays and instability, lack
of EMR integration, the need for rapid communication, and the necessity of standard guidelines
and training. Most respondents were female (82.8%), registered nurses (72.4%), and emergency
department staff (69.0%). Overall satisfaction with LINE Alert was high, with usability scoring
highest (mean 4.00, SD 0.65) and data detail scoring lowest (mean 3.24, SD 0.99). Conversely,
satisfaction with MOPH Refer was moderate, with system stability receiving the lowest score (mean
2.93, SD 0.96). A key recommendation was to integrate inter-system data to reduce duplicate data
entry.
Conclusion: LINE Alert was well-accepted for real-time communication convenience.
However, due to limitations in data completeness, it is best suited as a supplementary alert
channel rather than a replacement for the primary health information system.