More than a decade ago when the healthcare industry began transitioning from paper charts to electronic medical records (EMRs), leaders of large hospitals and health systems, including me, expected to see at least some return on investment. Yet over the years, it has become apparent EMRs alone cannot produce the clinical and financial returns once anticipated. Today’s EMRs need a technology booster shot to take them from electronic repositories of patient data to a vehicle that supports the free exchange of protected patient health information among care providers and even with patients themselves. If they get the boost they need, I believe EMRs will be the lone platform needed to fundamentally transform fee-for-service medicine to fully coordinated patient care.
So where do we start? First, leaders should accept that their EMR system is a living, breathing infrastructure platform which will require regular updates and investments to effectively manage healthcare information in a complex, constantly changing healthcare environment. Perhaps the biggest challenge is that our idea of care coordination is changing. Today, providers and payors are thinking and talking about “episodes of care” instead of discrete procedures. The data sharing that’s necessary to ensure continuity of care requires interoperability, and unfortunately post-acute facilities rarely use the same EMR system as the referring hospital. Bottom line, not everyone can read or access the information they need to fulfill their role.
That “everyone” includes patients who are released home after a stay in the hospital. Even though many patients need further care such as occupational or physical therapy, monitoring of biometric data, medication refills, transportation to appointments and so on, most hospital EMRs can’t truly support care coordination. This lack of access hinders the community-based service providers and non-clinical caregivers who play a role in achieving a positive patient outcome. Healthcare providers can and should look for connecting technologies that address the interoperability elephant in the room. Connecting technology solutions will allow providers to facilitate efficient and effective information-sharing across engaged, yet disparate, parties.
Using the foundational base of the EMR investment, hospitals can integrate the next layer of technology designed specifically to improve care. The result is a robust care coordination machine with capabilities to:
- Manage a network of post-acute facilities with no charge for participation
- Train and engage the post-acute network on referrals
- Provide analytics about referral activities to support Meaningful Use requirements
- Connect with non-clinical and community based social services providers
- Provide remote patient monitoring post discharge
- Monitor readmission risk levels and send proactive alerts
- Receive data from wearables, health apps and other mobile devices
- Allow multi-directional communication for the care team including patient, family and other caregivers
- Analyze data surrounding patient adherence and patterns of readmissions
- Provide 24/7 customer service support to hospitals and post-acute facilities
The investment in EMRs was merely one step in effectively managing healthcare information, creating the infrastructure and electronic foundation necessary for further advancements. Now it’s up to us to leverage EMRs to fundamentally transform care coordination.
Learn more about how care coordination technology simplifies and streamlines the processes surrounding transitions of care.