- Care coordination is often described as a game-changing approach to healthcare. With all members of a care team—including physician providers, nurses, and other support staff members—being able to effectively communicate with one another regarding a patient’s care, the team can reduce duplicative care measures and provide more comprehensive, efficient care.
2015 has been filled with a flurry of health IT policy and initiatives, many of which drive care coordination. Between an industry-wide push for EHR interoperability to the emergence of patient-centered medical homes, health IT is doing its part in driving care coordination. Here is a breakdown of the top health IT initiatives driving care coordination this year:
Underlying all care coordination initiatives is EHR interoperability. Interoperable systems have the ability for one product to seamlessly share information with another, which fuels several burgeoning approaches to care.
In order for members of a care team to work cohesively, they must be able to securely send one another patient information. This gives all team members the ability to make effective care decisions. Furthermore, physicians from different healthcare organizations must also be able to send one another patient information in the event that an individual seeks care at two different locations.
Earlier this year, a study published in the Journal of the American Informatics Management Association (JAMIA) showed that the primary benefit of EHR technology was indeed interoperability and information sharing over different EHR features.
“Improved access to patient information, instant messaging, in-chart notes, phone messages, and task assignments made the EHR technology a valuable platform for care coordination,” EHRIntelligence.com reported at the time of publication.
Although interoperability has been a hot-button topic in the healthcare industry since the surge in EHR use, the Centers for Medicare & Medicaid services has recently put it to the top of the priority list, mainly for its care coordination benefits.
According to CMS’s Acting Administrator Andy Slavitt, using health IT and EHRs to change the way physicians approach care will help to change the care itself. This means increasing the connectivity of EHRs to enable patient-centered, coordinated care.
"At the end of the day, people have to change the way they practice and the way they view information to match it to the way that we treat patients. Until that happens, we won't make progress. And once that happens, we'll make fast progress," Slavitt said during a Bipartisan Policy Center event on interoperability earlier this year.
Also critical to care coordination are patient portals, the component of an EHR that is accessible by patients. Patient portals are regularly lauded for giving patients ownership of their health information, allowing them to better engage with their care.
Recent research from Deloitte shows that more and more patients are using patient portals, and nearly half wish to be more engaged with their physicians. This highlights an integral member of a coordinated care team: the patient.
As a part of an industry push to increase patient engagement—and thus the patient as a member of a care team—CMS has included provisions for patient engagement in their meaningful use rules. Both Stage 2 and Stage 3 call for reported patient engagement measures, all intended to create a place for the patient on the coordinated care team.
Patient portals also serve as a point of further data integration, allowing physicians to access more information on a patient’s care and well-being. When physicians have more complete pictures of patient health, they are able to make more informed decisions and further inform other members of the care team.
For example, if the physician knows something of the patient due to patient aggregated data, they are able to opt out of an unnecessary exam, delivering care more efficiently.
Industry experts maintain that patient portals will serve as an vital part of the care team through this data integration. For example, in a past interview with us, the University of Missouri Health Care’s CEO & COO Mitch Wasden, EdD, explained the important role patient portals play at his specific health system.
“We have been pretty aggressive about patient portal. In the future it’s about migrating it to be more of a mobile platform. Today, we’re one of a few organizations where you can go on to hundreds of doctors’ schedules and book your appointment without any permission from the clinic,” Wasden told us.
Patient Centered Medical Homes
In conjunction, EHR interoperability and patient portals and integral in the patient-centered medical home model for primary care. Operating under the fundamental tenet of care coordination, patient-centered medical homes thrive off of effective use of health IT and EHR technology.
Between all of the specific requirements included in patient-centered medical homes, such as predictive analytics and risk assessments, adequate technological infrastructure is crucial to PCMH success.
In a past interview with HealthITAnalytics.com, University of Colorado Health’s CIO Steve Hess explained the importance of health IT in creating an environment suited for patient engagement and care coordination.
“We are using real-time algorithms within and outside of the EHR to look at risk, and predict and inform clinical and operational pathways,” he said. “While still early, we are starting to see patterns related to how our patients are interacting with our system and the reimbursement impact of those changes. It is important that our systems are set up to provide the complete patient picture and to ensure that the patient is getting the appropriate care in the appropriate setting at the right time.”
While the emergence of patient-centered medical homes has not been mandated by policy, it is being considered a notable shift in healthcare practice. For example, the Physician Hospital Organization at Holyoke Medical Center shifted to the PCMH model because it made financial sense. After the initial EHR investment in health IT and workflow changes, the hospital saw success.
“We found out last month that everyone who committed to the patient-centered medical home initiative succeeded,” said Dr. Robert M. Fishman, DO, FACP, in an interview with HealthITAnalytics.com. “So we think this was a slam dunk, massive success.”
Because patient-centered medical homes operate fundamentally on care coordination, this initiative keeps the concept at the forefront of healthcare delivery. As more healthcare organizations continue to adopt PCMH models, the industry will in theory see an upsurge in care coordination initiatives.
Accountable Care Organizations
Like patient-centered medical homes, accountable care organizations (ACOs) incentivize connected and coordinated care through value-based payments. Additionally, both of these care delivery models require robust health IT infrastructure in order to maintain this care coordination.
In a report from the eHealth Initiative and Premier, Inc., researchers highlighted the importance of health IT in fostering care coordination in the ACO.
“As ACOs pull data from more sources, they also report lower abilities to leverage their health IT infrastructure to support care coordination, patient engagement, physician payment and contract adjudication, population health management and quality measurement,” the report explained.
Operating under the goal of delivering accountable, value-based care, ACOs rely heavily on care coordination to reduce duplicative procedures and delivery efficient care. In fact, these are the financial payoff of care coordination is sometimes thought of as one of the primary benefits of ACOs.
“Once members see the benefits of ACO care coordination for themselves, they convince their doctors to become advocates of the program,” Dr. Daniel Bluethsome, Chief Medical Officer at Santé Community Physicians IPA, told HealthITAnalytics.com in a past interview.
As the healthcare industry sees an influx in healthcare policy, it is likely that care coordination will continue to be of high priority of providers and organizations. Between its benefits in patient engagement and value-based payment, care coordination is permeating nearly every part of the healthcare space, showing that it is a valuable concept for providers to adopt.