As a surgeon, I was certainly trained in a culture of respect for high-impact, high-sophistication interventions, like specialized surgeries.
That said, I was also taught that prepping your own patient for surgery, even down to preparing the surgical area with drapes, and checking on your patient frequently in the hours and days after surgery, are equally important. I was taught, too, that every single person on the care team is equally important — and each person on the team may mean the difference between life and death.
I think that the concept of specialized surgery being lauded above all, was winning for a couple of decades. It’s the concept of “only the best for my loved one” and “we took him to the Mayo Clinic” along with respect for research institutions (rather than community hospitals.) The fee-for-service approach certainly played into this swing. If hospitals are paid most for the most sophisticated, high-intervention care, it’s likely that the trend will be toward that approach.
A further consequence of this previous focus is that when specialized interventions are what matters, it’s the specialist who is valued above all. In that context, the team only exists to support the specialist.
Recently, however, the focus on outcomes-based or value-based care has meant that this high-intervention approach is being called into question.
For instance, two new programs spotlight simple, holistic approaches. This program created a teaching kitchen right next door to the pediatrician’s office, showing families how to improve their nutrition through cooking lessons. And this program reduced readmissions by 27%, cut hospital stays by two days, and saved $3800 per patient — all with a simple $36-per-person nutrition program. In a value-based, fee-for-performance, setting, these types of inexpensive, “unsophisticated” programs may have a bigger effect — and certainly a higher ROI — than the dramatic interventions.
In this context, and with programs like this, medical collaboration becomes the lynchpin. When we are looking at slightly “softer” interventions — like nutrition — everyone from the teacher to the aide to the specialist to the pediatrician to the nutritionist are equally important in the care plan. And those individuals must have the tools to collaborate or the interventions won’t be orchestrated among the providers.
iClickCare has always been oriented toward this kind of holistic, value-based approach. In fact, we started in a school-based health center setting, in which what mattered most was getting students healthy and back to class as efficiently as possible. We created the app to facilitate collaboration among specialists, a pediatrician, and the school-based nurses caring for students. It was holistic, it was team-based, and it was focused on outcomes. In other words -- we had the same values that the future of medicine will.
If medical collaboration is part of your value-based care strategy, download our free medical collaboration quick guide:
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