One of the bizarre paradoxes of being a healthcare provider in 2017 is that we are asked to do many things... that are made increasingly difficult to do.
For instance, patient satisfaction is the watchword, but our time with the patient is chiseled down, year by year.
Or we are pushed to ensure care coordination happens -- and our pay depends on it -- but it is made increasingly impossible for us to actually do it.
A recent article by Medical Economics really brought this point home for me. They thoughtfully laid out many of the most pressing obstacles to care coordination -- while also highlighting how crucial this kind of collaboration has become in today's medical setting.
As the articles author, Sweeney, describes, “Virtually all primary care physicians engage in coordinated care to some degree, but the extra emphasis placed on it now by healthcare policymakers, along with new reimbursement models and reporting requirements, has primary care doctors looking for new ways to improve how they coordinate care.”
This article highlights several important obstacles to care coordination, but these three resonated with us the most:
Most technology doesn't support it. The article quotes a doctor as saying “Nothing beats doctor-to-doctor communications, ” but he goes on to say that he gets that communication through phone or text. As we often talk about, texting medical information about patients through a regular phone is never HIPAA compliant and can be subject to huge fines for the provider. But we understand why providers resort to this. The alternatives for communication and collaboration are dwindling. That's precisely why we created iClickCare, giving every provider access to a healthcare collaboration tool that is simple enough to solve the problem without creating further workflow challenges.
Confusion about roles in care coordination.
One of the issues that was highlighted in the article is that not all healthcare providers are excellent at coordination and collaboration. Whatever the discipline, some providers feel it's "not my job" to coordinate care, outside of the medical visit. Especially when providers are having to improvise, get creative, and work with complex patient histories and contexts, a reluctant collaborator can make it very difficult to coordinate care effectively.
- Provider burnout. The final obstacle that really stood out to us in the article was an overwhelming, underlying sense of frustration, despite good intentions. The cry that each provider quoted seemed to have was, "I want to do it right, but I'm being foiled at every turn!" This frustration and burnout is pervasive in the healthcare field right now (up to half of healthcare providers are burnt out.) And it creates a vicious cycle in which providers become unwilling to collaborate -- and when they do, they're met be resistance and obstacles.
All of that said, we believe there are significant and overwhelming reasons that care coordination is a smart choice for providers to make:
- It's increasingly rewarded with payment.
As the Medical Economics article highlights, payment systems have lagged behind care coordination, but as pay-for-performance becomes the standard, and care coordination is increasingly valued, it will become the smart financial thing to do. “It’s been an unofficial mandate for decades, and it’s only now that the primary care physician is being recognized for all the work they do in coordinating care,” says Emily Briggs, MD, who has a primary care practice in New Braunfels, Texas.
- It helps with burnout.
Ironically, when we become burnt out and overworked, we tend not to do healthcare collaboration -- but healthcare collaboration can be one of the most satisfying routes to beating burnout and feeling good about the work we did that day.
- Care improves.
Of course, we know that care coordination improves the care that a patient receives. The complex issues within a case, or the contextual "human" factors,f are only appropriately addressed when multiple healthcare providers are working together. “It’s all based on the patient’s sociological situation at the time. If you’re not looking at those things, you’re not a [primary care] physician,” says Briggs.
Care coordination can't happen in a vacuum and it can't happen without giving healthcare providers the proper tools, payment, and support to do it. But it doesn't have to be all-or-nothing. If you can collaborate on behalf of one patient today, you may not have changed the healthcare system, but you did change healthcare -- and maybe health -- for that patient.
You don't have to wait for healthcare to change. Know your options for using telemedicine to do care coordination today: