Five Megatrends Driving the Adoption of Care Coordination

Posted by Gary Winzenread

February 5, 2016 at 6:30 AM

  1. The continuing rise of value-based care: What Harvard Business Review once called the “the strategy that will fix healthcare” will continue gaining traction as more hospitals and healthcare organizations adopt value-based payment models for larger pieces of their business and more specialties. With more revenue at risk, executives will seek management techniques and operational models that can improve both effectiveness and efficiency. Care coordination is proven to do both.
  1. Increasing focus on population health: Large percentages of healthcare costs are driven by relatively small portions of the population needing care, most often for complex specialty conditions. Thus, success in the business of healthcare is increasingly measured by an organization’s or health system’s ability to identify the people who may become high-cost and high-risk patients. That requires some sophisticated predictive modeling up front (or at least a clear sense of the attributes of patients who may need chronic care in the future) and strong care coordination capabilities to keep such patients on the right treatment plans across long timelines. There are many innovative templates and leading practices to follow, such as the highly proactive approach used by The Breast Center at Floyd. For obvious reasons, population health will become more important as value-based payment models become more prevalent in healthcare.
  1. The interoperability imperative: As EHRs have become the central pillar within the IT environments of many hospitals and health systems, their particular limitations have become increasingly evident. Lack of easy data-sharing may be the biggest issue. The AMA has been pushing for improvements in this area and the pressure is likely to increase as the high costs and risks of EHR interoperability challenges become clearer. There is some progress as leading vendors acknowledge the need to share patient data with other healthcare systems – not surprising given the pressure coming from nearly every constituency in healthcare.
  1. The limits of EHR architecture and design: Another major gap with EHRs is their limited ability to support process-driven workflows and patient events outside their system. These limitations are built into the design of EHRs, which were designed to be physician-facing and to capture data specifically for treatment plans and clinical recommendations. For instance, EHRs were not designed to handle the core and essential tasks of effective care coordination, which are patient-facing. Thus, it’s not surprising that organizations that try to use their EHRs find themselves in a square-peg/round-hole problem. Care coordination technologies will grow more powerful as hospitals and health systems recognize this limitation and further push EHR systems to open up to broader integration to other useful tools and technologies.
  1. Patient engagement moves up the agenda: Once considered something of a “nice to have,” patient engagement is now viewed as an enabler for higher-quality and lower-cost care. Certainly, the Cleveland Clinic sees care coordination as key to “improving patient experience, outcomes and affordability.” One recent study found that the “main driver of the overall patient experience relies not as much on the individual provider, and much more so on the after-visit communication of plan and coordination of follow-ups.” But some organizations mistake patient communication (which is a good thing, of course) for care coordination. Some EHR systems feature patient portals to make it easier for providers to share information with their patients. Again, that is useful, but is effective mainly in situations where single providers are involved. But when care teams include multiple specialists and facilities, each of which likely uses its own separate EHR systems. That sets the stage for missed appointments, low treatment plan conformance and those other common risks that true and robust care coordination is meant to solve. In other words, if you’re looking to improve outcomes through increased patient engagement, you’ll need effective care coordination processes and tools to do it.

Topics: ROI, EHRs, health IT, Navigation & Care Coordination, Barriers to Care, Healthcare, Patient Engagement, Population Health

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