ClickCare Café

Key Things Smart Buyers Look for in Telemedicine Solutions

Posted by Lawrence Kerr on Wed, May 07, 2014 @ 09:11 AM

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When it comes to using technology -- for medical collaboration, communication, meaningful use of medical records, or any other crucial function -- there are a lot of considerations that come into play.

In our relationships with current and prospective iClickCare users, we've seen decision parameters run the gamut from savvy to uninformed. And we were intrigued to see a recent report on key features that home health agencies look for in software, from Software Advice, a company that reviews medical software. In 385 interactions with home health software buyers, they found:

  • 97% of buyers prefer a cloud-based system over an on-premise solution.
  • Field support (mobile and remote access) was the most requested feature to better track care in the patient’s home.
  • First-time buyers want the benefits of going digital, and top reasons for purchasing included improving efficiency (58%) and “going paperless” (35%).

We think that this orientation toward cloud-based, efficient, adaptable systems that allow remote access is right on.

This is a smart way for home health agencies -- any group, really -- to make the most of their technology dollars, comply with regulatory issues, and positively impact patient and provider satisfaction. That's one reason we had concerns about a report that Time Warner Cable and the Cleveland Clinic are collaborating on a pilot project installing video conferencing hardware in patient's homes to lower hospital readmissions. This kind of focus on expensive hardware installations can actually make outcomes for patients worse. By not using simple software, cloud-based systems that can be accessed from anywhere, and leveraging hardware that providers already have (like the smartphone in their pocket), a lot of resources tend to be wasted. For that reason, we recommend keeping the following things in mind in any big health IT investment: 

  • Keep hardware investment to a minimum. Always see whether you can use existing hardware -- whether computers, smartphones, or other resources -- and invest your dollars in good software and systems. Hardware can easily go obsolete, while software can be updated.
  • Make sure it's easy to use. Medical providers have enough on their plate without having to learn complicated systems or having to operate completely new hardware. Look for something that leverages what people already know... and demand a well-designed, easy-to-use interface.
  • Prioritize flexibility and collaboration. Some systems can only be used or shared with providers that are "in the network." Look for a service that allows you to get consults and support from any provider, regardless of their status with your service.
  • Invest in systems that can be used from anywhere. As the study above shows, savvy buyers are looking for cloud-based services (SaaS) that can be accessed from anywhere -- that kind of flexibility tends to pay off in the long run.
And for our summary of telemedicine options and pros and cons, click here: 
ClickCare Quick Guide to Telemedicine

Tags: medical collaboration, telemedicine roi, patient satisfaction, provider burnout, assisted living facilities, telemedicine solutions, healthcare collaboration, decrease readmissions, decrease length of stay

Opportunities for Medical Collaboration in Long Term Care

Posted by Lawrence Kerr on Thu, Apr 03, 2014 @ 07:33 AM

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It may be a cliché to say that "two heads are better than one" but it's a cliché because it's true. In fact, "putting our heads together" with other medical providers has been one of the best parts of our career. It's good medicine and it's good for us as medical providers -- almost across the board. In particular, though, we find medical collaboration crucial when:

  • There are several different providers that need to coordinate care for a single patient
  • Length of stay and readmissions are key metrics for the organization
  • There are providers at different points in the spectrum of care who need to communicate and ring-in on care (e.g., an aide, a nurse, and a specialist)
  • A single patient may have several, intersecting medical issues

Medical collaboration can greatly help the interdisciplinary team formulate their care plans. When we speak with Long Term Care leaders about telemedicine and medical collaboration, they often express prioritization of all of the above.

That's why we believe that there are significant opportunities in Long Term Care Communities to use medical collaboration, including:
  • Better patient care. When providers collaborate effectively, it prompts better care coordination, fewer delays in care, and more nuanced treatment plans. And when those things happen, better care is the result. 

  • Cutting risk. Risk management is a big part of Long Term Care communities. Because the prioritization of patient independence is fundamental to their work, there is always a balancing of risk with wanting to avoid unnecessary interventions. Medical collaboration can effectively cut risk by providing the reassurance of multiple provider opinions.

  • Improved patient satisfaction. Patients and families are happier when patients stay off the examining table. Because medical collaboration can avoid unnecessary visits to the doctor and because it can improve communication with patients and their families, it often also increases satisfaction. 

  • Decrease healthcare provider burnout. Studies show that the more isolated that providers feel, the more burned out they become. So beyond all the patient benefits, medical collaboration also benefits providers by helping them feel connected and supported.

  • Compliance with regulatory issues. Good medical collaboration and care coordination cuts length of stay and slashes readmissions -- so it will also help Long Term Care facilities keep their community members in their homes and lives -- and out of the hospital.

It doesn't matter whether you collaborate via Hybrid Store-and-Forward telemedicine because it's the easiest way to go -- or whether you use lower-tech means. The important thing is to look for ways to collaborate, even if it's a little at a time.

To get our free guide on collaboration -- with stories from the front lines of collaboration in real life click here:

ClickCare Quick Guide to Medical Collaboration


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

Tags: interdisciplinary care, telemedicine, coordinated care, communication with patients, patient satisfaction, long term care, care coordination, decrease readmissions, decrease length of stay

Medical Collaboration Tips From a Typhoon-Ravaged Hospital

Posted by Lawrence Kerr on Fri, Mar 07, 2014 @ 08:59 AM

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Collaboration in Response to Disaster


It's hard to imagine the devastation of a large-scale disaster like that of Typhoon Yolanda in November of last year.

As the New England Journal of Medicine reports, an Israeli medical team that arrived in the days following the storm found a pretty desperate situation. Throughout the Philippines, more than 5,000 people were confirmed dead and 22,000 were still reported missing. Upon reporting to the hospital, where the Israeli team was to work, they found 120 hospitalized patients, no electricity, no running water, and an Operating Room with a staff of 2.

The World Health Organization guidelines suggest that a team like this one should set up their own hospital, not integrating or collaborating with teams on the ground. But the Israeli team had a strong sense that an unintegrated path wouldn't be the best course of action. Within hours, they worked with the Philippine hospital and local resources to create an integrated plan for medical collaboration.

And within 10 days, this collaborative, transnational team of medical providers deftly dealt with 2,686 cases.

What allowed them this kind of success in such difficult conditions?

This brave team gives medical collaboration takeaways anyone can learn from:

  • Accepting resource limitations. We all have limited resources, and sometimes these limitations can seem insurmountable. For this team, however, giving up was not an option, so they accepted their resources and did whatever they could within them. 
  • Being willing to go against protocol. Despite the WHO guidelines, this team decided to collaborate and integrate. It was a risk, but it seemed like the right thing to do for the patients, so they went with it. Their success was their reward.
  • Open communication and quick decisions. One of the most important pieces of this story is the way that decisions were made quickly, but with transparency, and good communication. Sometimes people think that communication has to be sacrificed for speed. But this high-pressure situation shows that good communication actually facilitated a speedy response.
  • Clear lines of responsibility. We've covered the ways that clear lines of responsibility decrease length of stay and drop readmissions. Similarly, having very clear roles and responsibilities helped this team quickly triage and treat, without duplication or gaps in care.

As the team said, reflecting on the experience: "Following a cooperative model may pose some challenges… In this instance, however, by relinquishing our well-established habit of operating as a highly independent unit, we found that, when feasible, a cooperative model can have additional and important benefits for the victims of a disaster."


For more medical collaboration stories and strategies, get our Quick Guide to Medical Collaboration:

ClickCare Quick Guide to Medical Collaboration



Image courtesy of ihhinsaniyardimvakfi on, used under Creative Commons rights.

Tags: medical collaboration, medical responsibilities, care coordination, decrease readmissions, decrease length of stay, emergency first responders

7 Ways Telemedicine Helps Compliance with Accountable Care

Posted by Lawrence Kerr on Wed, Feb 26, 2014 @ 08:52 AM

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Barely a day has gone by recently, that the Affordable Care Act (ACA), Accountable Care Organizations (ACO), or the Centers for Medicare & Medicaid Services (CMS) have not been in the news.

In the broadest strokes, the Accountable Care movement attempts to shift the health payment system from a pay-for-service (fee based) system, to a pay-for-performance (outcomes based) system. Of course, for hospitals that want to accept Medicare and Medicaid, these reforms are mandated. But the overall approach affects almost all practices, regardless of status or whether you are an ACO.

Part of the reason that these policies aren't going anywhere is that early data shows they're working. In 2012, ACOs established in the Medicare's Shared Savings Program generated nearly $400 million in savings, the Centers for Medicare & Medicaid Services said in a statement released last week. 

Despite the laws, it's not always clear how to use telemedicine to improve outcomes in a pay-for-performance system. Interestingly, telemedicine and telehealth has been identified as a key tool in compliance with Accountable Care. It is even written into CMS' final rule for the Medicare Shared Savings Program: accountable care organizations must "define processes to promote evidence-based medicine and patient engagement, report on quality and cost measures, and coordinate care, such as through the use of telehealth, remote patient monitoring, and other such enabling technologies.

So here are 7 ways telemedicine can help you comply with Accountable Care: 

  1. Telemedicine makes care coordination possible and effective. Just changing incentives is not enough to improve outcomes. As the New England Journal of Medicine reports, "Merely aligning financial incentives will not improve quality and reduce costs for episodes of care... True coordination of care is required to ensure the best possible outcomes." Telemedicine makes this kind of care coordination possible and effective, particularly in a hybrid store-and-forward context that adapts to provider parameters.
  2. Telemedicine makes transportation less necessary. Whether home monitoring or distance consults, telemedicine can save costs of unnecessary visits and lengthy transportation. When payment is linked to outcomes, even saving a patient or provider a single trip can make a big difference over an organization.
  3. Telemedicine leverages provider time. In an age of provider shortages, telemedicine can make each provider's minutes count as much as possible. Through consults, collaboration, and even remote patient visits, provider time is leveraged. 
  4. Telemedicine can decrease readmissions. Because telemedicine can help the right at-home care to happen, clarify which provider is responsible, and make sure patients follow through, telemedicine has been shown to have a strong effect on decreasing readmissions.
  5. Telemedicine can drop length of stay. Data shows that care coordination, especially the kind of collaboration supported by telemedicine, is one of the strongest ways to drop length of stay. And length of stay is a key outcome in Accountable Care.
  6. Telemedicine improves access to care. Telemedicine can improve access for the underserved in rural, urban, or Veteran populations. Especially as provider shortages worsen in different parts of the country, and for different specialities, this kind of access to care is proving crucial in keeping costs down and meeting patient needs.
  7. Telemedicine supports good patient care, regardless of political climate and payment changes. Truth be told, many of our colleagues have been using telemedicine to improve the ways they care for patients -- regardless of whether it's rewarded by the current political context. We think that's good practice, in every election cycle.


Click here for our free guide on the pros, cons, and ROI of telemedicine options:


ClickCare Quick Guide to Telemedicine



Image courtesy of chelseastirlen on, used under Creative Commons rights.

Tags: coordinated care, collaboration, accountable care, telemedicine roi, communication with patients, telemedicine solutions, decrease readmissions, decrease length of stay, ACO, affordable care act

4 Easy Ways to Try Telemedicine Before Lunchtime

Posted by Lawrence Kerr on Fri, Feb 07, 2014 @ 09:15 AM

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We've been hearing from a lot of people that they want to give telemedicine a try. Many providers have been noticing the overall thriving of the field. Others are drawn in by data showing collaboration (especially using telemedicine) can decrease length of stay, cut readmissions, and improve rates of healthcare provider burnout. 

But despite the interest in medical collaboration with telemedicine, many people aren't sure where to start. We're the first to admit that it can feel overwhelming to pick up a new tool or adopt a new habit!

So here are 4 easy ways you can try telemedicine before the day is over:

  • Start with someone you know and trust. Think of the last colleague -- it might be a nurse, doctor, or other provider -- that you had a great conversation with or who solved a problem with you. That's the person with whom to try telemedicine and collaboration. Start with people you already know and trust, and grow your collaborative circle from there. 
  • Keep it simple. Even chatting with a colleague about their day can open the door to problem-solving, so that is a great place to start. And when you are ready to collaborate using telemedicine, start with a simple case. You can always build up to consults on your most complex case, but getting a consult or two on more basic issues lets you build up confidence. That way, when you do reach out about a tricky patient, you're not worried about the telemedicine piece of it.
  • Organize a “cool case” breakfast or lunch. We used to take medical students out to egg sandwiches before work to discuss unusual cases and share stories. While this isn't technically telemedicine, it is definitely collaboration -- and that is the important part. 
  • Try iClickCare for free. You can start inviting colleagues, sharing cases, and connecting for a couple of weeks with no cost and no complicated set-up.

Plus, we put together a couple of "quick guides" to telemedicine and medical collaboration, and we're offering them for free -- so take your pick and get started.


ClickCare Quick Guide to Telemedicine

ClickCare Quick Guide to Medical Collaboration



Image courtesy of svoalex on, used under Creative Commons rights.

Tags: collaboration, hybrid store and forward medical collaboration, medical collaboration software, healthcare provider burnout, telemedicine solutions, collaboration leadership, care coordination, healthcare collaboration, decrease readmissions, decrease length of stay

Care Coordination Saves Careers -- Learnings from the Super Bowl

Posted by Lawrence Kerr on Tue, Feb 04, 2014 @ 08:50 AM

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After Percy Harvin's father left, his Mom started a daycare out of the home to make ends meet. Percy, always wanting to contribute to his family, would help with the little ones when he got out of school.

Percy wasn't just conscientious or a hard worker, though: Percy had a spark. His athletic talent grew through his high school and college years. And then, he won the sports lottery -- Percy was drafted to the NFL.

After his rookie year, things changed. Percy suffered a string of illnesses and injuries that made him miss game after game. Finally, just last year, Percy was traded to the Seahawks. A new franchise that had never won a Super Bowl, the team's motto was "why not us." Unfortunately, though, Percy was suffering from serious injuries. Over the course of the '13-'14 season, he only played a couple of minutes.

As Percy navigated hip surgery, inflammation, pain, and finally a concussion, the Seahawks made their way steadily toward the Super Bowl. Just 10 days before the big game, Percy was still on the injured list.

Percy's doctors, physical therapists, and other providers were obviously doing effective care coordination, though, because suddenly, just 7 days before the Super Bowl, Percy was cleared for play. Once Percy made it onto the field, he mage a significant contribution. His kick-off runback seemed to break the spirit of the Denver Broncos, eventually leading to his new team and beaming coach winning their first-ever championship.

Had Percy's recovery taken just a week longer, he would have missed the Super Bowl and maybe led to a loss -- an event potentially hugely damaging to his career. Those seven days of speedier recovery, likely due to care coordination and thoughtful medical care, were profoundly valuable to Percy, his team, and his family. When we save patients days, weeks, or months of injury and sickness -- whether the issue is cancer, hip issues, colitis, or congestive heart failure -- we don't always see the benefits so starkly. But Percy Harvin's story shows that care coordination with telemedicine not only saves lives -- it can save careers, whether you're an NFL player, a mom, or a mid-level manager.

So the next time you're wondering whether care coordination could help your patient, even if you don't have a system in place, ask yourself, "why not us?" And give coordination, collaboration, and telemedicine a shot. It will definitely contribute to a life, and might even save a career.


Get our guide to medical collaboration and care coordination here:

ClickCare Quick Guide to Medical Collaboration



Image courtesy of ifindkarma on, used under Creative Commons rights. Percy Harvin's story and facts from his wikipedia page

Tags: telemedicine, coordinated care, hybrid store and forward medical collaboration, accountable care, mhealth, telemedicine solutions, decrease readmissions

Can Telemedicine Lower the Cost of Healthcare?

Posted by Lawrence Kerr on Thu, Jan 23, 2014 @ 08:14 AM

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Telemedicine is thriving these days -- there is even an ad on prime-time featuring it -- and a key reason are the ways telemedicine lowers the cost of healthcare. One indicator of this is the political support: "Telehealth is a major contributing factor to increased health care quality, convenience, and lower costs," said Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio). And there is certainly anecdotal evidence from around the country, like this tele-dermatology program in Nantucket saving nearly $29,000 a year.

In fact, we've found that the people and organizations that use iClickCare experience such significant and immediate cost savings that we've even incorporated an ROI calculator on our website. Dr Michael Moore, director of a wound care program, reported that "During a 3 month period, 70 patients were treated solely using iClickCare with an overall healing rate of 93% and an estimated savings of $24,000 in transportation costs alone."

Of course, despite its clear potential and proof points, telemedicine doesn't always cut costs. It's important to look at projects like this one for lessons from the front lines about what really works, and what doesn't.

So if you're considering a telemedicine program in your hospital, practice, or region... 

5 things to keep in mind to ensure telemedicine lowers the cost of healthcare:

  1. As we shared in this post, you are not setting yourself up for success if you make huge investments in hardware. We recommend investing in software (which can be updated, and is generally the lowest portion of costs) rather than hardware which gets obsolete quickly. Use the equipment you already have, the spaces already available to you, and just start. 
  2. Give special attention to readmissions and length of stay. Readmissions within a month of discharge cost $16 billion per year. And as we all know, readmissions and length of stay are big parts of the ACA shared outcomes focus. So we're interested in data showing that medical collaboration may be one of the strongest ways to decrease length of stay... and in this Connected Cardiac Care program, which has achieved a 51% decrease in readmissions with telehealth monitoring.
  3. Prioritize rural areas or very urban areas. Geographically removed areas (whether rural or inner-city) find the most cost-cutting benefits from telemedicine. "By decreasing the importance of location for healthcare provision, telemedicine can help increase competition and further lower healthcare spending for primary care and specialist consultations... using technology to allow health care workers to quickly serve those where there is the greatest demand will create a more efficient health care system overall," says Ben Miller of the WFS.
  4. Use your people effectively. Because of the provider shortage, the leveling of access helps cut costs and use our provider workforce most efficiently. As Dr. Brian Rosenfeld, Chief Medical Officer at Philips Healthcare, said, "Telehealth offers the opportunity to provide the access, quality and cost that will be necessary to increase prevention and leverage our current workforce."
  5. Work in coordination with the Affordable Care Act. Telemedicine may prove to be the linchpin in controlling costs and outcomes as the Affordable Care Act comes into being more broadly, according to Mario Gutierrez, executive director for the Center for Connected Health Policy.

Overall, we've seen over and over again the cost savings that can be experienced through telemedicine. But we do suggest keeping it simple, start small, and start today.

For an overview of choices in telemedicine, download the Quick Guide to Telemedicine

ClickCare Quick Guide to Telemedicine



Image courtesy of seeminglee on, used under Creative Commons rights. 

Tags: telemedicine, accountable care, telemedicine roi, telemedicine solutions, decrease readmissions, decrease length of stay, affordable care act

5 Medical Collaboration Tips from Military Vets

Posted by Lawrence Kerr on Wed, Sep 25, 2013 @ 08:40 AM

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A few months ago, a young veteran was struggling to get the therapy he needed. He drove 45 minutes each way, fighting traffic. By the time he arrived, he was frustrated, upset, and not in the best frame of mind for a productive session.

Unfortunately, this vet was not alone. However, these struggles in vets' access to the healthcare they needed prompted the VA Hospitals to use telemedicine to solve it -- at least for vets with mental health needs. Now this vet participates in the VA's tele-mental health program, meaning that he does his therapy from home, feeling relaxed, prepared, and ready to heal.

This piece on the VA's program is a rare bright spot in news on the VA. The much-embattled department has been struggling to keep up with claims and services. So the fact that they've been able to integrate telemedicine is even more impressive.

Clearly, there is an opportunity for a more comprehensive and thoughtful usage of telemedicine (particularly Hybrid Store-and-Forward Telemedicine) throughout the VA. But we think that the fact that military vets are accessing the service and the VA is administering it demonstrates a number of key medical collaboration and telemedicine insights:

  1. Start small. The VA created a pilot program first, them expanded to multiple hospitals. They're still only using telemedicine in mental health so they're still "starting small" but the impacts remain important.
  2. Consider the reputational effect. The fact that this article was written is strong proof that even incremental innovations can have a strong and positive effect on organizations' reputations and goodwill in the community.
  3. See it as an investment, not an expense. The VA says the telehealth program has reduced veterans’ bed days by 58 percent and admissions by 38 percent. It's very possible that they're already seeing a net profit from the program. 

Want the "cliff notes" to telemedicine options? Click here for our Quick Guide: 

ClickCare Quick Guide to Telemedicine

Tags: telemedicine, medical collaboration, collaboration, hybrid store and forward medical collaboration, decrease readmissions, decrease length of stay

Is Your Compensation Structure Causing Provider Burnout?

Posted by Lawrence Kerr on Tue, Sep 03, 2013 @ 08:10 AM

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New compensation structures start with the best of intentions: keep costs down and patients healthy. But healthcare providers can become a casualty on the road to lower costs.

So, is your pay system causing provider burnout? The short answer is: probably.

Exhibit 1: Pay for volume.
Volume-related incentives were the compensation fad of the last decade. However, since provider burnout is exacerbated by feeling disconnected to patients and not having enough time to spend with them, this short-sighted policy contributes to many frustrated providers. As Dr. Robert Centor said at the Medscape Roundtable, "Too often the current finances of medicine force physicians to spend inadequate time with patients… I would argue that our payment system, especially for outpatient internists and family physicians, is a leading cause of burnout." 

Exhibit 2: Pay for performance.
A recent New York Times article shows how the Affordable Care Act is prompting hospitals to link provider pay with performance (measured by patient outcomes, cost containment, and patient satisfaction.) It sounds like a plan that makes sense, but physicians tend to resent this time of micro-level intervention in how they care for patients. And some point out that they're held responsible for things they can't influence (like whether a hospital floor is clean.) In fact, experts say that this plan of "carrots for doctors" is unlikely to work, even outside of physician considerations. 

What works?
There is no doubt that healthcare has to be more accountable and costs need to come down. But when it comes to designing a compensation plan that works, healthcare provider needs have to be front and center. The big problem with igorning provider needs and stressing them out? Well, it doesn't work. Patient satisfaction starts with happy healthcare providers. And research shows that doctors with lower incomes, more debt, and less savings tend to be more burned out than their peers. So if your compensation structure is burning out your providers, it's very possible that you're gouging patient outcomes and even elevating costs at the same time.


Compensation is a headache, but coding doesn't have to be. Get our free guide to ICD-10:  

ICD-10 Primer

Tags: accountable care, healthcare provider burnout, provider burnout, decrease readmissions, decrease length of stay, affordable care act

3 Surprising Ways Medical Collaboration Decreases Readmissions

Posted by Lawrence Kerr on Fri, Aug 02, 2013 @ 08:01 AM

readmissions are decreased by medical collaborationAlthough the push to decrease readmissions at hospitals is nothing new, the fines and new rules are. To give just one example, Medicare is pushing to reduce readmissions by 20%, imposing penalties on hospitals with higher-than-average readmissions rate.

As the New York Times is reporting, hospitals are scrambling to figure out ways to reduce readmissions. Among these efforts are Boston Unversity's Project RED, initiatives at the Mayo Clinic, and an extensive study at Dartmouth. 

Each project gets at the complexity of decreasing readmissions in different ways, but there are some common threads. For instance, in Project RED's itemized list of common causes of unnecessary readmissions, about half of the causes related to poor communication with patients and the other half is related to poor coordination and collaboration among healthcare providers (including coordinating upcoming visits, labs, etc.)

These studies and initiatives found that medical collaboration can decrease readmissions for 3 surprising reasons: 

  • The right at-home care actually happens. When medical collaboration happens, that means that healthcare providers across and within organizations actually communicate. For instance, ClickCare allows the home-care nurse to coordinate with the specialist before discharge, as well as when problems come up during the care. A quick exchange about a wound -- as long as the proper at-home care is arranged and understood -- may be all it takes to prevent a readmission. 
  • The patient gets to their follow-up appointment easily and quickly. Unfortunately, it can be difficult for patients to know who to make an appointment with and understand whether that follow-up is urgent. Medical collaboration tools allow the responsible providers to facilitate next steps and make sure that the next visit isn't to the ER.
  • Providers know who is responsible for the patient. Throughout all the literature, coordination of care was repeatedly cited as a key influencer in readmissions rates. When patients and providers don't know who the people "in charge" are, the systems start to break down. Further, the current communications systems (paging, EHRs, etc) don't actually facilitate the communication that would clarify this. So successful providers coordinate care through a medical collaboration tool like ClickCare, avoiding problems before they happen. 

We believe that medical collaboration is one of the most important components of decreasing readmissions. So we're offering free trials of iClickCare for providers or hospitals that want to experiment with going this route.

Join providers nationwide using a simple technology to make discharge a more human experience: 

Try the iClickCare 14-day evaluation

Tags: medical collaboration, collaboration, care coordination, decrease readmissions

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