Every Successful Relationship is a Two-Way Street
As was typical, I was mapping out my upcoming week based on my husband’s travel schedule. Most parents will know what I mean by coordinating child care. Who picks up the kids, where to pick them up, when to pick them up, where to take them, when to feed them, what to feed them, when to bathe them – and that’s just your average Tuesday. It becomes that much more complex when I’m sharing those tasks since I work. Juggling work priorities with the critical Mom priorities is a balancing act. In addition to my husband, I collaborate with the nanny, other moms, the kids’ grandparents, Amazon Prime, and many, many others to keep all the balls in the air. So, this past Valentine’s day, I was thankful for all my partners and for the technology that enables seamless two-way communication such as shared to do lists, shared calendars, texts, and emails. Not to mention the aligned incentives in doing a good job, some financial but mostly love!
Now comes the kicker. Even siblings are very different from each other! Each child has their own preferences around what they eat, how they like to be held, and which specific items they need – such as the green pacifier or Winnie the Pooh for sleep. It takes time to learn these differences and to personalize the care we provide them.
Imagine that situation but with 200 children who have many different partners and needs. That is what care coordination is like for the care coordinators at the forefront of patient care. With the slow but steady transition to alternative payment models such as bundled payments and accountable care organizations, care coordination has become a pressing issue. What happens to the patient outside the four walls of your hospital has now become vital information, since care unravels once the patient leaves the hospital. Care unravels not because other providers do not care for the patient, but because of a lack of awareness or communication. Imagine that you don’t know that a patient is coming to your skilled nursing facility or that you’re missing critical information about the patient’s progress due to the sheer effort it takes to call or email other members to keep them posted.
Electronic medical records could be the solution IF (a big if) the same EMR was used by every single care provider – hospital, skilled nursing facility, home health clinic, etc. But EMRs have become a billing and documentation system (which is a topic for another day). Outsourcing the entire care coordination to other organizations is an option but one we’d caution you of – do you REALLY want to source away the capabilities you need to succeed in an alternative payment world? Is it not better to engage providers across the continuum as your partners? Give them the tools to enable seamless two-way communication? Financial incentives can be aligned, either direct (gainsharing) or indirect (promise of additional revenue) – but we all need to start thinking about HOW to coordinate care since it takes a village to get this done right.