Sometimes I'm amazed at how much has changed since we started ClickCare.

Digital cameras have gone from being rare and confusing and low-resolution to being part of every smartphone, and better than the professionals' cameras.

Almost all states now support reimbursement for telemedicine.

Other barriers, including regulatory obstacles, are starting to crumble.

So, I'm often optimistic about the directions that medicine is moving in, and how far we've come.

That said, I'm deeply frustrated by how siloed medicine continues to be. In fact, a recent New York Times article highlighted just how accepted it has become that "patients who are hospitalized or have complex medical conditions" are advised to just monitor their own care, "tracking what each specialist advises and prescribes, ensuring it gets done and informing other doctors about it."

Care is siloed, by our organizational structures, by geography, by workflow, and with the tools we use. Our EMRs and EHRs keep us from being able to collaborate even within the same organization. As this article summarizes the consequences of poor care coordination: "Balls get dropped and care suffers. In part, it’s a consequence of siloed medical practice."

One answer that is popular these days is to consolidate. Hospitals buy provider practices. Hospitals merge. The theory is that with larger, more consolidate systems, providers will coordinate care more effectively. 

In fact, when hospital systems become larger and more consolidated, studies seem to be showing that costs actually increase. The data all show: bigger health care organizations are not necessarily better.

The reason for this is simple, from our perspective. If providers do not have the tools to collaborate and do care coordination -- or the obstacles to these removed -- they cannot collaborate. Whatever the size of the organization, healthcare providers need tools to coordinate care and do healthcare collaboration -- completely apart from the EMR or EHR they use, as those do not serve this function.

The article concludes that for individual patients, they should not "count on the health system" to do care coordiantion for them.

That's probably true, unfortunately. But we also believe that healthcare providers can't count on the system to offer the tools to do care coordination for their patients, either. We need to advance care coordination despite the structures that surround us, if those structures won't support us in doing what's right for the patient. 

If you want to take care coordination into your own hands, you can try iClickCare for free: