Background: Digital interventions are currently used in Western countries, including Australia, the UK and the US, to support the coordination and integration of patient care through documentation and sharing of advance care planning information between healthcare services and settings. Within the UK, Electronic Palliative Care Coordination Systems (EPaCCS) are an example of this.

Aim: To explore and understand how EPaCCS are used to support documentation and sharing of patient advance care planning decisions and preferences.
Methods: An exploratory qualitative design informed by Normalisation Process Theory. Semi-structured interviews were conducted with Healthcare professionals (HPs) across two large UK regions.  HPs were purposefully sampled by care setting and profession. Data were analysed using thematic framework analysis. 

Results: Fifty-two participants across six care settings (general practice, community nursing, community palliative care, hospital palliative care, ambulance services and aged care homes) were recruited. Having electronic systems that were operable across different care settings and services was central to EPaCCS uptake. EPaCCS were viewed as beneficial in supporting documentation of patient decisions and preferences where HPs were confident that these could be shared appropriately with services contributing to patient care. HPs knowledge that patients' advance care planning information was appropriately accessed, reviewed and acted upon by other services further increased confidence, however, this was not always known. Furthermore, few means of monitoring EPaCCS access and use by different services were reported.

Conclusion/Discussion: Multiple factors that optimise EPaCCS use for patient benefit were identified and there is variation across services and professions in the extent to which these are present. Exploration of these factors could be targeted for intervention development to optimise how EPaCCS are used to maximise HP engagement leading to patient benefit.