By Cindy Gaines, Chief Clinical Transformation Officer

Improve the Quality of Care Despite Ongoing Labor Shortages

Quality of care depends on many factors, starting with skilled clinicians, laser focused on delivering care to their patients. Sadly, this is a challenge in today’s healthcare environment, in part because the burden of administrative tasks associated with care delivery represents a major “distraction” for clinicians. It’s these administrative tasks and processes that often take clinicians’ time and attention away from their primary mission: delivering quality patient care.

All six domains of healthcare quality enumerated in the Institute of Medicine (IOM) framework can be positively impacted by the strategic use of automation to ease the administrative burden on care teams. In this discussion, we’ll focus on three of them. According to IOM, quality care is:

  • Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).
  • Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.
  • Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

The application of automation to support these three quality-related aims may vary based on the clinical use case and setting. However, one universal application is “care coordination”: the organization of a patient’s care across multiple healthcare providers. By thoughtfully adding intelligent automation, traditional care coordination – largely manual, often inefficient, with multiple redundancies – can become “care orchestration”: the ability to harmonize the patient and the care team into a unified, coherent journey through the care delivery process, personalized to each patient, at scale.

Consider the preop workflow.  When a patient is scheduled for surgery, there is a series of things that need to be done, quickly and efficiently. This pre-operative process is a critical part of the surgical journey; if patients aren’t ready for surgery, this can lead to cancellations and this is bad for both the patient and the hospital. 

As an example, in a typical preop workflow, the process begins with the care team completing a lengthy intake with the patient either on the phone or in person.  In addition, risk stratification needs to be completed and labs need to be drawn, making sure they haven’t already been taken.  Patient instructions need to be given at key times in the journey, but what has already been done? All these different pieces of data about (and needed for) the patient reside in different systems, in various locations; assembling them is not a trivial task.

Another challenge is that it’s a one size fits all approach.  Clinicians and staff put all the patients, regardless of their complexity, through the same process, giving them all the same amount of time.  In most cases, the preop work up will yield a result that the patient is “clear for surgery, no issue raised.” But if you were to go back and look at the guidelines and what was on file for that patient, you’d say, “for this patient, given these risks, given the procedure they are coming in for, we don’t need to do half of these things.” And the few things we must do, we’ve already got on file.” So, the entire preop encounter was effectively a poor use of the team’s time — it wasted the patient’s time and took valuable care team effort away from other patients that may have warranted more attention because their cases were more complex.

Employing care orchestration pre-empts this wasted time and effort by enabling the patient’s care journey to be redesigned, in real-time. And the saving is significant: depending on the case mix, between 50%-60% of the cases the care team would otherwise see on the phone or in person will be fully managed by the care orchestration system. The system is pulling data from multiple systems, looking at the patient and their record, engaging the patient, and risk stratifying them based on what it sees and what information may not exist. The system is also looking at the procedure and the process and, for those patients that fit the criteria, managing them entirely digitally — they don’t need to be seen at all. Without automation, it’s impossible to choreograph individualized patient journeys at scale so that each patient progresses down the exact right care path for him or her, safely and efficiently.

In summary, care orchestration in this case:

  • Unburdens the care team with unnecessary preop visits and unnecessary tests for many patients;
  • Creates a deeply personalized experience for the patient; and
  • Substantially reduces the cost of optimizing the patient because everything’s done automatically.

So, how are the three quality domains highlighted earlier positively impacted by the automation described in this preop scenario? Let’s revisit them:

  • Effective: By reducing clinically unnecessary interactions between care team members and patients, the care team is freed up to focus more time on those patients that, based on their medical situation, need extra attention.
  • Timely: The system’s ability to trigger automatic reminders and notifications to patients helps keep each care plan on schedule and improves patient adherence to protocols.
  • Efficient: Providers can effectively more than double the capacity of the care team. And in a healthcare environment where staff resources are at a premium, that’s invaluable from both a care delivery and financial perspective.

Ensuring quality of care must always be a priority for every healthcare provider organization. Utilizing automation in creative ways, such as care orchestration, can contribute significantly to quality of care in a range of ways, including by more effectively leveraging healthcare’s most precious and limited resource: skilled, knowledgeable clinicians.