The healthcare system is moving away from fee-for-service models that reward fragmented care toward fee-for-value models that reward a more holistic continuum of care. But many hospital systems, medical practices and health plans lack the care coordination software to truly collaborate and succeed in this new environment.
Care coordination software offers collaboration tools for team-based care among providers and payers, as well as care management and analytical solutions for tracking, managing and analyzing patients, and improving population health.
In order to leverage the costly investments already made by providers in existing systems such as electronic health records (EHRs), it is essential that the right care coordination software has the capabilities to work hand in hand with EHRs ensuring a seamless end user experience with all critical applications unified.
When selecting care coordination software, avoid these five problem areas:
- “Inside-the-four-walls” EHR systems focused on documentation rather than collaboration: Many healthcare providers today rely on EHRs. While they are important systems to document the patient care details for charting and billing purposes, EHRs are not, however, designed to support the coordination of care among multiple care providers collaborating in a new care continuum model, and are insufficient for sharing relevant, actionable information. Many EHR vendors are trying to retrofit their legacy systems into care coordination solutions. Care coordination software needs to be a flexible, extensible platform enabling team-based care, with corresponding accountability and transparency of information and reporting across the continuum.
- Upfront license fees: The business model for many health IT systems used by providers and payers is to charge an upfront license fee on a pre-determined per user basis. For care coordination programs such as accountable care organizations, ACO software is a more cost effective approach, offering a pay-as-you-grow structure based on patient volume instead of pre-determined user seats. This is important because it allows providers and payers to implement clinical programs on an incremental cost effective basis, phasing in enabling technology along the way to ensure adoption and optimization. A pay-as-you-grow model also allows for organizations to add additional functionality and new applications that are commensurate with clinical strategies.
- Proprietary health information exchange (HIE) systems: Some HIE vendors provide care coordination and population health tools, but lock you into using their proprietary HIE infrastructure, which may be too expensive, unnecessary or impractical given the heterogeneous environment in any given delivery system and care team network. Instead, look for a flexible platform that embraces the heterogeneity of the network, interconnects with 3rd party HIE systems, fills in any gaps in HIE capabilities, and provides open HIE infrastructure enabling workflow applications to support the care team across the continuum.
- Prescriptive Care Plans: Many systems have prescriptive care plan tools that not only address medical issues but also dictate the goals and interventions for a patient based on generic single condition rules. For care coordination and population health purposes, care plans must: support whole person care including all medical, behavioral and social issues; always be available and up to date for the care team; be customized, adapted and supportive to the individual patient need; work along side multi-disciplinary clinical protocols to inform appropriate care steps. Clinical decision support capabilities can be utilized in a flexible fashion through assessments and prompts based on clinical protocols to drive best practices and evidence-based medicine, rather than prescribed care plans that don’t take into account a wide range of services and patient-specific needs.
- Single Data Type For Analytics: In order to do the type of analytics and reporting required for care coordination and population health, systems must evolve from relying on only one type of data (e.g., claims data), to analyzing various data types such as clinical data from HIE and EHR systems, administrative data from hospitals and claims data from public and private payers. Using multiple data types in population health analytics is essential to understanding the performance, quality and total cost of care across the continuum as well as predicting future events, costs and diagnoses.
For clinical, social and behavioral health services and inpatient, outpatient and long-term/post-acute providers to collaborate on patient care, all parties involved – from physicians, nurses, care managers, payers, specialists to community service – need fast, streamlined access to a patient’s care coordination records.
Avoiding the five problem areas above helps organizations choose care coordination software that provides a solution across the care continuum — a flexible platform that is available to everyone treating the patient. Source
