I live in a beautiful rural area, which is great -- unless you are trying to grow a vegetable garden.

It seems like the country would be perfect for vegetables, but I've found that when gardening where I live, wildlife becomes a daily battle, with deer seizing upon produce with the stealthy precision of Navy SEALs. I had always seen more proficient gardeners with pro-built custom fencing solutions and felt that I obviously couldn't choose one of those. I could build that myself! It's just a little fencing and I could see what they were trying to achieve with each component. Plus, the all-in-one solution cost $600.

Anyone that's ever tried a home improvement project knows where this story is headed: $540 of materials, nine days of work, and three trips to Home Depot later, I had tried to replicate the all-in-one solution, cut myself with the fencing, had to return all the materials, and eventually just bought the all-in-one solution.

Now, the DIY version is not always worse. I make bread and cheese at home, and my wife sews. But usually the cobbled-together solution is better when you don't care as much about the outcome as the process. For instance, when you include the books, materials, and resources that I've bought to make my homemade bread, it certainly doesn't come out cheaper than the stuff from the bakery. But I love the process, so it makes sense to do.

Every day, we're under increasing pressure to cut costs while improving outcomes: more and more is demanded, with fewer and fewer resources. In that context, many people have come to us looking for ways to save money on care coordination tools, platforms, and protocols. You know that you really need an efficient solution to prevent readmission and manage care of your patients, but you don't want to waste resources.

So when is an all-in-one system worth it? And when does it make sense to create your own care coordination system?

These are some of the common functions that Accountable Care Organizations and managed care organizations tell us they need in a care coordination platform (whether telemedicine or not):

• Make your information technology network very secure and impenetrable from the outside. Be sure that files on the network cannot be seen by everyone.
• Find a way to prevent transmission of pictures or taking of pictures. (We have found this to be a frequent answer, and while secure, does little to coordinate care.)
• Use a checklist so that nothing gets dropped.
• Enable both provider-to-provider communication as well as patient-to-provider communication.
• Send secure messages between providers
• Archive unique cases for teaching to medical students and residents.
• Create a patient portal so they can understand the course of treatment and engage in options.
• Integrate with EMRs and EHRs
• Manage admissions and discharge.

These are all functions that can be handmade, homemade, or patched together using existing tools. So when hospital systems and managed care organizations come to us to ask, we always tell them the same thing: if you're excited about the process of piecing together your own care coordination / medical collaboration / telemedicine system, then go for it! But if you're looking for the most efficient and effective outcome,  you may be better off with the pro-built system (iClickCare is one option) that has it all included already. Just as I would have been with the vegetable garden fencing. 

If you've been doing cost comparisons of telemedicine systems for care coordination, maybe our guide to one all-in-one system can help:

Image courtesy of hardworkinghippy on Flickr, used under Creative Commons rights.