What is Care Coordination?

by Lydia Pineault

August 30, 2019

Care Coordination unifies the delivery of patient care from multiple healthcare providers and specialties. Coordinated care is designed to improve health outcomes by removing “siloed” care, while also reducing costs by decreasing redundant tests and procedures.

Elements of Successful Care Coordination

  1. Care that is easily accessible for patients across a wide spectrum of specialties and different providers
  2. Effective communication between providers that leads to seamless care transitions
  3. Addressing the “whole patient”
  4. Clear communication between patient and provider
  5. Means of sharing information between provider

Why is Care Coordination Important?

Care Coordination is a care strategy that has the potential to increase the effectiveness and efficiency of healthcare delivery while working to reduce costs. When implemented correctly, it can improve outcomes for patients, providers and health plans.

While the benefits of care coordination are clear, the methods for implementing it are not. It requires a complete redesign of the current healthcare system, and there are many obstacles to this such as:

  • Disjointed processes and care between different organizations
  • Lack of patient knowledge regarding his/her care plan and reasons for referrals to specialists
  • Breakdown in communication and information exchange between providers
  • Information being lost during the referral process

Different Perspectives

Success and failure will be judged differently in different organizations, so it is important to look at how care coordination is viewed in these settings.

Patients and their families

Patients consistently experience gaps in coordinated care during transition periods. Examples of transitions may be primary care to specialty care, seeing a new doctor, or changing health plans. Patients see these failures as requiring unreasonable amounts of their time and effort to manage. This leads to a lack of adherence to their treatment plan and poor outcomes in the long term.

Health Care Professionals

Healthcare professionals are interested in finding the most efficient way to meet the needs of their patients across the continuum of care. Clinical care coordination for the healthcare professional will involve finding the right specialty doctor or clinic for the patient, determining what information needs to be exchanged and with whom, and managing responsibility and accountability among the care team. Healthcare professionals notice failures when patients are directed to the “wrong” place in the system or have a poor outcome related to gaps in information exchange and hand-offs. Similar to patients, healthcare providers also perceive failures when it requires an unreasonable amount of time and effort to accomplish the level of coordination needed to care for their patients.

Systems of Care

Any Accountable Care Organization (ACO) has a responsibility to coordinate care across the spectrum of patient needs. Their top priority is to facilitate the appropriate and effective delivery of care services both within and between different systems. ACOs will feel failure the most when it impacts the financial performance of the system, and these failures will likely motivate corrective action. They will also notice failures when one of their members experiences a clinically significant mishap due to the breakdown of care coordination.

The diagram above illustrates the way these three parties interact with each other within the healthcare environment.

While the need for care coordination and the benefit it brings is great, it can often be challenging to execute. One way organizations can further coordinate their care delivery is to leverage technology that helps connect with other involved parties. If you want to learn more about how iTether can help your organization optimize care coordination, please email engage@itethertech.com.

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