For the older people at Long Term Care facilities, nursing homes, and assisted living facilities, even small issues — like a simple fall — end up with a transfer to the emergency room. Those visits to the ER can often mean a hospital stay as well. And of course, hospital stays can cause backtracking for overall strength, wellness, dementia, and disease. The best case scenario — a visit to a doctor instead of a visit to an ER — can still mean bouncing from provider to provider, with a lot of stress and physical challenges along the way. 

But aren't these ER visits, hospital stays, and doctors' visits simply the necessary realities of life. New insights and ways of working point to innovative solutions to this Business As Usual problem. 

There are 30,000 assisted living facilities in the US. As the New York Times reports, “most assisted living facilities have no doctors on site or on call; only about half have nurses on staff or on call.”

That means that if an event happens — a virus, a fall, a concern about a worsening condition — it results in a transfer, doctor's appointment, or ER visit, the vast majority of the time. Of course, coordination of medical transfers, tests, appointments, and the like can be a huge challenge for any person — but throw in significant physical challenges and perhaps cognitive impairment and the challenges compound.

“The assisted living industry has to recognize that the model of residents going out to see their own doctors hasn’t worked for a long time,” said Christopher Laxton, executive director of The Society for Post-Acute and Long-Term Care Medicine. “It’s an expensive, disruptive response to problems that often could be handled in the building, if health care professionals were more available to assess residents and provide treatment when needed.”

It's a way of caring for people that hurts the patient, the provider, the Long Term Care facility, and even the hospitals. Hospitals will stay away from sending their patients back to the community if they are afraid they’ll be readmitted within 30 days of discharge. And Long Term Care organizations may shy away from getting the right care for their residents if it often results in backsliding in their care. 

So what is the solution?

One solution has been to have a geriatrician on staff. But realistically, that doesn’t solve the problem. There will be myriad medical problems that fall outside of the expertise or time of that provider. 

There are two key things that need to happen:

• Hospitals should partner with assisted living and nursing home facilities that have the means to do medical collaboration and prevent readmissions.
• Long Term Care facilities must find ways to get the medical consults they need without putting their residents through the stress and danger of ER visits and bouncing among doctors’ appointments.

To facilitate those goals, though, hospitals, doctors, nurses, aides, and care providers at Long Term Care facilities need a platform to collaborate. The ideal scenario is that if a resident has a fall that isn't actually worrisome but could use "an extra pair of eyes,"  an aide can take a photo or video, consult with a trusted provider at a practice or hospital in the community, and keep the patient at home base until or unless a transfer is needed. It's good care in every way: it saves money, decreases readmissions, and ultimately supports the best possible health, wellness, and quality of life for the patient. It's a classic example, too, of why email or text messaging — in addition to not being HIPAA compliant — aren't nearly sufficient. In cases like this, whole teams are involved and cases need to by asynchronously collaborated on, over the span of time. A one-off question won't fit the bill. 

Care coordination and healthcare collaboration aren't a panacea. But I do believe that when it comes to Long Term Care, the impact of collaboration and coordination can be dramatic. 

If you're involved in Long Term Care, get our ebook on using telemedicine to improve care and make workflows more efficient:

By the end of their career, nearly half of all doctors will be sued.

Any suit is gut-wrenching for a doctor. It means that not only was there an undesired patient outcome, but the relationship with the patient has broken down to such an extent, that a lawsuit has become the chosen path forward.

That said, medical malpractice lawsuits involving children are especially disturbing and concerning. No doctor wants a child to have less than perfect care — and the litigation process itself can be deeply painful for all involved. So I was really interested to notice a recent study that seems to point to a commonsense way of decreasing your risk of being involved in a malpractice suit involving a child.

A recent study, by The Doctors Company, looked at 1,215 malpractice claims filed on behalf of pediatric patients, from 2008 through 2017. These claims spanned 52 specialities and subspecialties.

What’s fascinating isn’t so much the claims themselves, but rather the root causes, allegations, and factors of the malpractice suits. Many of the most common factors in the lawsuits actually boil down to poor communication and poor medical collaboration among providers.

3 crucial highlights of the medical malpractice study that boil down to bad medical collaboration:

• Missed, failed, or wrong diagnoses were the main reason for lawsuits.
• Poor communication between the physician and the patient or family was a factor in up to 22% of claims, depending on the age of the child.
• System and collaboration failures, such as not notifying treating physicians of critical test results, was also a primary cause of patient injuries. 

No doctor wants to put their patients at risk. And no doctor wants to be sued. But the sad truth is that many doctors think they're "too busy" for medical collaboration -- even though in all three of the determinants of medical malpractice above, medical collaboration could have been preventative. 

It's easy to say "an ounce of prevention is worth a pound of cure" for our patients. But the ounce of prevention created by medical collaboration is worth far more than trying to "cure" a bad outcome or lawsuit once it has already occurred. 

Learn more about how easy and fast medical collaboration can be:

For many decades, we’ve thought about vaccines as a battle of science catching up with disease.

Conquering polio or measles was about finding the vaccine that would protect human bodies from those diseases, and then distributing those vaccines broadly enough to create immunity across the population.

However, there have been recent outbreaks of diseases that call into question this understanding. In places like the US and Europe, where the vaccines are established and the distribution is strong, we’ve seen a recent backsliding, with outbreaks of diseases like measles affecting communities. For instance, Washington State has had 71 cases of measles, just in the last few months.

So what are we to learn, as healthcare providers and leaders? And is there any way to win?

These outbreaks are of such concern, in fact, that there was a congressional hearing recently to explore the causes and potential fixes for these outbreaks.

Saad Omer, MBBS, MPH, PhD, from the Emory Vaccine Center, told the U.S. Senate Committee on Health, Education, Labor and Pensions that to battle new outbreaks, funding is needed not just for vaccines and research — but also for communication with the public about vaccines.

The biggest chink in the armor of our protection against these diseases is actually misinformation about vaccines, not limitations of the vaccines themselves. We all know about the concerns that boiled up in recent years about the supposed link between vaccines and autism. As Fierce Healthcare summarizes, “A paper published in The Lancet more than 20 years ago was long ago retracted after the author admitted to falsifying the information, but the concerns among many parents have persisted.”

This context shows clearly that in this case, protection against disease is about more than just science and treatment -- it's about the emotions, fears, and ideals of human beings. Whatever the science shows, if a mom believes the vaccine will cause autism, her child won't receive it. John Wiesman, DrPH, MPH, who is Washington's secretary of health said, “We need to be looking at how it is we get to the hearts and minds of people around vaccines and to not put science on the shelf."

Healthcare can't be distilled to a procedure, a recommendation, a scientific finding, or a single intervention. It's a messy, complex art that involves the hearts, minds, bodies, and social context. Which is exactly why healthcare collaboration can't just be secure text messages between two providers. It needs to allow the complex, long-term interactions of a whole medical team, across the continuum of care, and over time.

Hybrid store-and-forward telemedicine is a technology that supports this very human way of caring. And when the human context is respected -- it means that the science can succeed.

We've all been blindsided by technology taking the place of a human, when and where it shouldn't. 

It's the labyrinthine customer service switchboard when we just want to ask a simple question of a real person. It's the app that sends us in circles when we really just want to pay a bill. 

But a recent technology screw-up touched a serious nerve for one family -- and even called into question whether and how telemedicine should be used. 

Mr. Ernest Quintana was in the hospital for the third time in 15 days, as the New York Times recently recounted. His lung cancer was beginning to get the best of him and he was struggling. His family remained hopeful, though, and they were all with him throughout the hospital stay. 

One afternoon, though, Mr. Quintana was surprised to find a machine with a video screen on it being wheeled into his room. With his granddaughter by his bedside, Mr. Quintana listened as a doctor in an undisclosed location, and whom he had never met, began to discuss his care. His surprise turned to sadness and dismay when the doctor shared that Mr. Quintana was likely not going to survive this hospital stay and prepared him for end-of-life care.

A prognosis of death is never easy news for a person or a family. But hearing the news from a doctor you have a relationship with, who brings compassion, presence, and leadership, can decrease the suffering and ease the way forward. In Mr. Quintana's case, the terrible news and challenging decisions were worsened by the impersonal and jarring way that they were broached. No one wants to have a conversation about death with a stranger on a video screen. 

So is this a condemnation of telemedicine? Of technology?

I don't think so. I believe that this sad turn of events simply points to positive and negative uses of telemedicine and positive and negative uses of technology. 

So many people default to videoconferencing as the go-to (or even default) form for telemedicine to take. We believe videoconferencing has severe limitations because it requires expensive hardware and circuitous scheduling coordination. Those are some of the reasons that we believe hybrid Store-and-Forward telemedicine is significantly more powerful of a tool.

But this story brings into focus an even more important and powerful reason that we believe telemedicine should be about team-based collaboration -- not videoconferencing between a doctor and a patient. When telemedicine is used for healthcare providers to collaborate among each other, the patient can interact primarily or exclusively with the providers that they have a relationship with -- and the "other opinions" on the team can be shared among the medical team. That way, the providers can be leaders, healers, and human beings FIRST -- but use telemedicine to consult with other people on the team as necessary, and without disruption to the care for that patient.

For instance, in Mr. Quintana's case, perhaps an outside opinion was necessary regarding his end-of-life care. But rather than that opinion being piped in through a video screen, we believe it would have been far better for his provider, obviously, to consult with the outside doctor -- and then have a conversation with Mr. Quintana in person, within the context of their existing relationship. 

Don't risk this kind of technology screw-up. Prioritize human relationships and let technology -- and telemedicine -- serve them. 

My daughter recently signed her new baby up as a patient at a pediatric practice and had to choose one of the doctors in the group. “Dr. Salno,” they said, “is great. But you have to wait at least an hour to see him, every time.” She ended up choosing another doctor in the practice.

Her experience isn’t uncommon — so many of the very best healthcare providers we know have long wait times in their offices or are frequently running behind. Is that a problem for healthcare, or is it simply part of the reality?

In our experiences as medical providers, there is sometimes a sense that long wait times, doctors who are hours behind, and extensive travel to get medical care are all just facts of life in medicine. And that makes sense — there is a shortage of providers, especially physicians, and every healthcare provider I know has far more work to do each day than time to do it in. For some of us, long wait times and long travel times are practically badges of honor, showing just how in demand our practice is. 

In fact, those travel and wait times are long, and aren't decreasing. A recent study by Altarum shows that “Despite significant investments in the United States [from 2006 to 2017] in improving access to health care through better insurance, the use of innovative delivery systems, and advances in digitizing health care records and automating administrative processes, travel and wait times show no discernable improvements.”  These dynamics haven't been improving in decades.

The place that I see travel times really come into play are for patients with complex, chronic, or even acute but serious conditions. According to the Altarum study, patients who reported their health as “poor”, spent an average 26.4 hours per month on healthcare. That time may be transiting from provider to provider, from appointment to appointment, in addition to actually accessing care. 

But is this time that patients spend a bad thing? Is it something that should be decreased? And further, are travel and wait times something that healthcare providers should concern themselves with, or is it someone else’s problem?

Long travel times may not seem like the healthcare provider's problem until we consider the health cost of that time. Of course, there is the element of lost productivity and wages. But even just focusing on health itself, I believe that spending so much time accessing healthcare, as well as transit and waiting, has a severe and negative impact on our patients' health. Time spent at home with loved ones, hours invested in hobbies, focus at work, and rest in our own beds are all crucial elements of healing from disease. Every hour that a patient spends in a waiting room or driving to yet another appointment detracts from this healing time. 

So what can healthcare providers do? Most importantly, we can try to understand our patients' lives, travel times, wait times, and recovery and see it as "our problem." We can use medical collaboration tools to loop in other providers' input without the patient needing to trek across the state to gain that input when a picture and a discussion is actually all that is required (and this is reimbursable). When tools like iClickCare exist, that use telemedicine to dramatically decrease transit and wait times, there is the opportunity for health to truly improve, because the patients are able to spend more time healing and less time transporting or waiting 

If there is one thing we all agree on, it’s that healthcare is complex.

The health of any individual is, of course, complex — with thousands of variables in the matrix of health, illness, and healing. Further, healthcare itself is complex, with so many challenges and opportunities that it’s easy to lose hope that things can change or improve.

So it’s deeply heartening when we stumble across a healthcare initiative that is outrageously simple, but with profound results.

Recently, I stumbled across two healthcare interventions that are deeply effective but very, very simple.

First, a group of California hospitals implemented a simple post-hospital educational initiative to reduce MRSA infections. 2000 patients were given either education on preventing infections via hygiene or that education plus antiseptic for bathing, antiseptic mouthwash, and antibiotic nasal ointment. The results? MRSA infections came down by 30%, with the education-plus-supplies group showing the most improvement. No new technologies were pioneered; nothing expensive was implemented. Just a simple “care package” to send home with patients from the hospital.

Second, a Virginia VA hospital had its nurses spend extra minutes with patients plus spend $5 on a toothbrush and toothpaste to encourage patients to brush their teeth. The results? Non-ventilator cases of hospital-acquired pneumonia have decreased by 90%. So far, they estimate that they’ve saved 21 lives and reduced costs by $4.69 million. Pretty phenomenal results for something as simple as a toothbrush and a helping hand.

So is there anything that we can conclude from these two studies, other than celebrate the ingenuity of their pioneers? I think there is. 

2 Key Learnings From These Pioneering (But Simple!) Studies: 

• Simple and inexpensive can be best. 
  One thing that we love about iClickCare is that it's a simple, inexpensive way to do telemedicine -- no expensive new hardware or computers or huge software implementations required. Sadly, some in healthcare believe that complexity is always better -- so they'd almost prefer a more expensive, more difficult product. But these studies are yet another proof point of how misguided that approach is. 
• Real life trumps theory. 
  In both of these studies, the initiatives were thoughtful about the reality that patients would face as people receiving care (one in the hospital, and one after the hospital stay.) It's easy for us in healthcare to focus on the glamorous treatment -- like a sophisticated surgery -- and forget that something as simple as nasal ointment or tooth-brushing can save lives. Similarly, we believe it's crucial to collaborate across the continuum of care -- not just between specialists -- since often, aides or nurses or others on the team will have a more "real life" perspective that can help.

The bottom line? Don't be afraid to do what is right for your patients, even if it doesn't sound fancy. It's possible that the deeply un-fancy is what's going to save healthcare -- and save lives. 

For more stories of smart collaboration, download our Quick Guide:

The US opioid epidemic is reaching unprecedented levels. Almost 48,000 people died of an overdose in 2017 and millions of people are affected by opioid abuse. 

One challenge in the treatment of opioid abuse and overdose is that they lie at the intersection of multiple disciplines, providers, and dynamics. Mental health, public policy, law enforcement, social work, housing, emergency care, and medication all play a role. But too often, only the immediate problem is addressed -- and care coordination fails -- which means that patients end up experiencing chronic repetition of that problem. 

A recent study looks at why opioid overdoses reveal the significant cracks in the care coordination that exist -- and endanger all patients.

You could say that West Virginia is Ground Zero for the opioid epidemic. The state has an opioid overdose rate more than three times the national average and the highest death rate from drug overdoses in the country. So the challenges that patients and providers face there are instructive for providers in states with less severely affected populations but who face similar dynamics.

In an effort to understand the trajectory of care for these patients, Fierce HealthCare looked at a recent West Virginia study of Medicaid claims. Researchers followed the treatment of patients after the overdose code to see whether follow-up care was billed. For instance, checking to see whether mental health visits, opioid counseling visits or prescriptions for psychiatric and substance abuse medications were billed after the initial Emergency Room care. 

Following ER care for an overdose, less than 10% of patients received a substance abuse drug and fewer than 15% received mental health counseling. Of course, it’s possible that the rate of referrals was higher and that many patients didn’t access the counseling. But realistically, follow-up may be as crucial a part of the care as the initial care itself. As one patient who was treated for an overdoes in the ER said, “There were a lot of times I could have gone down a better path, and I fell through the cracks."

I noticed several key insights from this study that I think are meaningful for any provider, regardless of how relevant opioid abuse in particular feels to them. 

4 key learnings from opioid overdose and care coordination failures:

• The more complex the disease, the greater the risks for coordination.
  But "complexity" doesn't just come from the details of the disease itself. In opioid abuse, multiple parties, including healthcare providers and social services all need to come together to care for the patient effectively. And these providers must collaborate across institutional lines, across the continuum of care, and across a long time horizon. This complexity is where we start to see care coordination fall apart -- but really it just reveals the weakness in care coordination that exists for all patients.
• Some diseases are associated with less sympathy than others. 
  The reality is that with drug overdoses, there may be an aspect of moral condemnation in the ways that healthcare approaches the problem. As healthcare providers, we know that opioid abuse is really a complex disease. But it's very possible that bias sneaks in and the complex coordination of providers, services, and care falls short because providers may feel less sympathetic about the particular aspects of this disease. Some of our most vulnerable populations may have healthcare challenges that are frustrating or overwhelming to providers -- and it's important that providers are able to collaborate with social services and colleagues that can support these patients in ensuring appropriate care.
• All good care goes beyond acute care. 
  It’s never enough to simply treat the acute illness that is right in front of us. But as providers, we need the tools and collaboration to care for patients more broadly than that. Most emergencies require more than simply treating the situation in front of us. A baby's stitches in the ER require follow-up with the pediatrician. An overdose necessitates counseling and substance abuse drugs.

Our EHRs and systems simply don't support this more broad understanding of what it means to provide care in complex situations. And that means our patients are receiving subpar care, due to the limitations of our tools and workflows. Each healthcare provider is doing his or her job to the best of his or her ability. But the demands of caring for our patients mean that sometimes just "doing our job" isn't good enough -- we must also look at the big picture of that care. And we must demand tools to help us act well and care appropriately within that big picture. 

You can try iClickCare for free, and get started in one day. Sign up for free here:

The New England Journal of Medicine's Catalyst blog has been doing a really strong job recently -- and their post on value-based care captures the challenging, difficult, and opportunity-filled place we're at in medicine, right now. 

If, as a healthcare provider, you've ever felt like the definition of "value," and how your organization pursues it, is a moving target... or if you've wondered what direction the whole reimbursement system is moving in... then this piece may have some fascinating insights for you, especially as we start 2019.

There has been a remarkable change in how reimbursement happens, even in the last couple of years. Now, a full 25% of healthcare is based on value-based reimbursement, as reported in JAMA (with the other 75% remaining fee-for-service.)

As you're likely aware, this value-based reimbursement is done in two ways: 

• 1. Capitated Payments. Accountable Care Organizations ACOs use capitated payments (“subscription” per covered life per month)
• 2.  Bundled payments. One payment, based on the patient's condition, which is split up among whatever services or providers treated that condition.

The mechanics of value-based payment models aren't complicated. But the perceptions of these models, the differing levels of support, and our diverse abilities to meet the models' challenges, all vary dramatically. So JAMA's New Marketplaces Insight Report, exploring the understanding and thoughts of different players in the healthcare system around these shifts, is fascinating.

First and foremost, the report suggests deep ambivalence: "Nearly half (46%) of respondents — who are clinical leaders, clinicians, and executives at U.S.-based organizations that deliver health care — say value-based contracts significantly improve the quality of care, and another 42% say value-based contracts significantly lower the cost of care."  In other words, half of us believe value-based contracts are great for quality and half of us believe that they're very bad for quality. Perhaps not surprisingly, healthcare providers tend to be more skeptical about the model than executives and administrators.

Also, many, across organizations and despite their roles, don't know their organization's stance on value-based care. The authors indicate that respondent answers may show a lack of consensus on what value-based care really means. "While there is broad agreement that value in health care is represented by the balance between the patient-centered outcomes of care achieved with the costs to reach those outcomes, many individuals do not completely understand that concept." For instance, one clinician asserts that "value" isn't really a term that is useful or has a broadly understood meaning: "Right now, [value is] a convenient term that means whatever the speaker wants it to mean.”

Payers and providers are not aligned. And the high rate of salaried employment by healthcare systems adds to the confusion. Many clinicians tend to have the starting point that, "I am morally obligated to my patient, but there is no real contract between the patient and myself." 

Regardless of current perceptions, there also remain practical barriers to full adoption of value-based care models. The primary barriers to the proliferation of value-based models are primarily related to infrastructure, including Information Technology. But regulatory issues, data integration, patient engagement, and others all play a role.

Of course, many of these barriers can be addressed by new tools, like iClickCare. But adoption is an interesting challenge when so many providers are ambivalent about whether value-based care is the right direction... or even how their organization is currently reimbursed.

To me, these shifts emphasize the crucial importance of healthcare collaboration. Wherever you or your organization falls regarding reimbursement, healthcare collaboration has become increasingly critical for doing the care coordination and achieving the outcomes that reimbursement shifts demand. I thought that an executive at a large nonprofit hospital in the South articulated the challenge -- and the opportunity -- of healthcare collaboration well: 

"Physicians had been taught for decades that they were the final arbiter of everything that happens to their patient. When, and until, we change the culture to one of team-based care where the patient belongs to the team, we will continue to struggle with adopting value-based care. As an example, a physician with a length of stay that is 10 days longer than his peer average once told me that the hospital has a length of stay problem because the hospital gets paid a single fee for the entirety of care.”

Clinicians are decreasingly able to bury their heads in the sand when it comes to the big picture of reimbursement. But rising to the challenge of what's to come in healthcare doesn't have to be complicated. Simply working effectively with your colleagues to provide the best, most coordinated, most efficient care possible will ultimately be the best approach -- now, and in the future. 

To learn more about how telemedicine can support value-based payment models, download our free Quick Guide: 

Stories are sewn into every part of medicine. 

The way we are trained to talk to patients is about drawing their story out of them. The way we share cases with colleagues is about describing the narrative of a patient. 

But modern medicine, especially in this age of EHRs and silos, tends to reduce patients to treatments and boils stories down to a series of interventions. And this weakness might feel more "efficient" at first but does tend to erode the quality of care our patients receive -- as well as the results they may experience from that care. 

That said, there are programs and tools that intend to reintegrate patient stories into our work. A recent article in the New York Times told of a program at Weill Cornell Medicine in New York. To combat ageist biases and practices, the program brings in older people to speak to medical students about their experience. Like all people, older patients have a diversity of experiences, strengths, and challenges. And for doctors to care for them well, they need to be able to understand this diversity, and create a care plan within that knowledge. 

As Dr. Adelman, the coordinator of the program, says, "Unfortunately, most education takes place within the hospital. If you’re only seeing the hospitalized elderly, you’re seeing the debilitated, the physically deteriorating, the demented. It’s easy to pick up ageist stereotypes.”  This program aims to complement this more hospital-based perspective with the other facets of patients' experiences. 

Unfortunately, this type of program is still rare. And rarer still are tools that support the full, holistic story of patients as the center of care -- especially once healthcare providers are outside of an academic setting and in the flow of practice. 

Electronic Medical Records, text messaging, and other intervention-focused tools only serve to create a further lack of "story" in patient care. But when you don't have the full story of a patient -- including their dreams, goals, daily habits, health goals and other "ancillary" aspects -- you don't necessarily have the full picture of how best to treat them. 

Certainly, many aspects of medicine pull us, as providers, away from stories and towards interventions. But when we use a telemedicine-based medical collaboration tool -- like iClickCare -- to have fulsome conversations with other providers about patients and share the holistic picture of whom the patient is, we provide better care and experience more satisfaction. So whatever our medical education provided or did not provide in this way, we always have the choice to use tools to practice medicine in the way that best fits our values. And for me, that has meant a tool that helps me do medical collaboration and see patients as full people. 

Frequently, “power users” of healthcare are seen negatively.

Whether because they are seen as more “demanding” patients or because of their relatively larger “burden” on the healthcare system, there is often a bias against these patients.

But a recent study — a collaboration among the New York Times, The Commonwealth Fund, and the Harvard TH Chan School of Public Health — looked in depth at these patients, both putting a spotlight on their behavior and experience, as well as sharing the wisdom they have about how to interact effectively with the healthcare system. Interestingly, much of what they shared advocated for a more collaborative, connective way of doing medicine.

In this study, “power users” of healthcare are defined as “people who have been hospitalized multiple times and are seeing multiple physicians, related to a serious illness, medical condition, injury, or disability.”

Of course, their perspective holds a lot of important insights for healthcare providers, for a few reasons. They: 

• Have experienced more facets of the healthcare system. 
• Necessarily developed skills and habits to deal with the shortcomings and strengths of the system. 
• Are sicker and so may tax the system more, revealing faults that go less noticed otherwise. 

So this study of their experience, problems, and advice is enlightening. Among the findings: 

• 30% say they were sent for duplicate tests by different healthcare providers.
• 23% have had to wait too long for appointments, treatments, and tests.
• Overall, they offer the following advice for navigating the medical system:
  • Show your doctor a list of medications you are taking (78%)
  • Bring a list of things to discuss with your doctor (70%)
  • Bring a family member, friend or someone else to all of your medical appointments to serve as a coordinator (55%)
  • Seek advice or help from a family member or friend who is a doctor, nurse or other health professional (34%)
  • Seek advice or help from a former patient who had a similar health condition (23%)

Our take on these results? People who use the medical system a lot experience the delays, confusion, and duplication caused by healthcare providers that aren't able to coordinate care or do healthcare collaboration. For that reason, the advice these patients offer tends to revolve around creating their own solutions to ensure care coordination on their behalf.  

Instead of patients trusting doctors and other providers to coordinate care, they do it themselves or involve friends or relatives to support them in doing it. This behavior certainly makes sense. And it's a wise way to approach a well-intentioned system that doesn't always work. But it does concern us, since patients have only a limited ability to truly coordinate care on their own behalf. For instance, a patient can bring a list of medications they are taking, but they can't bring a list of providers who should collaborate on a case. They can ask a friend to offer advice, but they can't necessarily facilitate meaningful conversations among all of the members of their care team. 

That's why we believe it's necessary for healthcare providers to have the tools they need to truly effect care coordination and healthcare collaboration. Sure, patients may fill in the gaps. But their ability to identify all of the possible gaps and truly fill them effectively is limited.