By Greg Miller
Traditional care coordination is broken. The breakdown is already evident on the frontlines of healthcare in ORs and emergency departments, and its financial impacts are increasingly bothersome to the C-suite as well. It is possible for health systems to address care coordination challenges to cut costs and ease burden on personnel, even in the midst of staffing shortages.
Fixing the problem, however, requires healthcare leaders to acknowledge that current methods for coordinating, verifying and advancing steps in a patient’s clinical journey are manual, variable and unscalable – and need to be changed.
Let me explain what I mean.
Manual. Most care coordination tasks — scheduling appointments, following up with patients, or tracking down lab orders — are done by people. Healthcare systems either hire employees to perform these activities or add responsibilities to existing personnel. Unfortunately, in many cases, the burden of administrative functions is placed on clinical personnel, which removes them from direct patient care. Care coordination is time-consuming, sometimes tedious and often delayed by the inability of personnel to complete required tasks in a timely manner. And, because it requires human labor, care coordination is quite expensive.
Variable. The many individual steps of care coordination tend to get dispersed among different care providers, both within the same organization and between care sites. Individual care teams and care sites execute the same tasks differently. Not only can this create an inconsistent care experience for patients, but the lack of integration between siloed health information systems makes it easy for steps to be overlooked or uncommunicated. Considering that patients with multiple chronic conditions can see as many as 14 different physicians annually, the extent of this variability becomes a problem.
Unscalable. Historically, health systems have met care coordination demands by throwing more bodies at the problem. In today’s environment of healthcare labor shortages and burnout, additional staff simply isn’t available. Furthermore, financial pressures are causing many health systems to restrict hiring. How can a health system scale its care coordination efforts when more people aren’t available?
The answer is automation.
The promise of automation
Automation isn’t new. In fact, we trust it implicitly in other aspects of our lives, whether it’s automating an electronic bill payment or relying on an airplane’s autopilot navigation system. However, the technology has yet to be widely adopted in healthcare, particularly when it applies to patient interactions. There is a reluctance to remove the human touch from medical interactions for fear of weakening the patient-provider connection or introducing potential risk. The fact is that is more likely without automation. Forcing clinicians to spend countless hours performing mundane and repetitive administrative tasks does more to undermine personal care than does automating these functions.
Clinicians are weary of the administrative burdens of care coordination but most don’t know there is a better alternative. Manual execution of these tasks is all they’ve ever known, and they’re often too far removed from health system IT departments to realize technology can deliver much-needed relief. It’s time to bridge this divide.
The power of automated care orchestration
Mentioning automating care coordination processes can conjure up images of a complex artificial intelligence algorithm making predictions based on trained data models. The reality is simpler and more elegant. It’s deterministic care orchestration where known information is automatically identified in an electronic health record or other data source (e.g., the existence or absence of lab results in a patient chart, the lab results, etc.) and then next-best actions are initiated for each patient (e.g., flagging a patient for a doctor consultation or automating surgery scheduling).
This deterministic care orchestration requires real-time patient data and clinical intelligence to algorithmically identify patient risk and triage patients appropriately. Automating care coordination across large volumes of patients saves clinicians time while proper triage lets them focus on high-risk patients who need more interaction. Automation increases efficiency by freeing clinicians from the minutiae of repetitive care coordination tasks and letting them operate at the top of their licenses.
Automated care orchestration also helps create consistency across different sites of care and ensures all providers are aligned and informed on care coordination updates and responsibilities. This information sharing should extend to patients. For example, by prompting patients to confirm or update information in their charts or medication lists, health systems can identify and address new conditions, comorbidities or medications before they derail a scheduled clinical event, such as surgery.
Innovative healthcare providers are already benefiting from automated care orchestration. For example, one healthcare system used to require every preoperative patient, regardless of overall health or type of surgery, to visit a clinician. This visit largely consisted of vital sign collection, order scheduling, and lab reviews — steps that have since been automated. Now, 67% of the health system’s patients bypass this in-person visit, resulting in a 20% reduction in cost per case and increased patient satisfaction.
This is just one example of the efficiency that can be realized in all types of care coordination efforts, from care transitions and discharge readiness to chronic disease management. All health systems must do is remove the stigma often associated with automation and let technology handle the care coordination grunt work overwhelming their valued clinicians.