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Hospitals, physicians, and payers will connect like never before.

 

Effectively managing across the care continuum requires a whole new way of thinking and a whole new set of data to think about. Providers at the head of the pack are already working to systematically coordinate patient care with new approaches and new data. Although not so very long ago, many providers hardly thought about coordinating care with entities outside their own walls, it’s increasingly clear that doing this—and doing it well—will be crucial going forward.

Despite progress by a few at the leading edge, we are still largely operating in an overly fragmented environment, touching all aspects of our industry. This fragmentation plays out particularly in the revenue cycle, creating confusion for patients and frustration for payers and providers alike. Fragmentation is perhaps most devastating when it impacts the clinical setting, creating situations where data, and therefore health information, are not linked. Thus, vital information is too often not tied to the patient, the one who really matters.

We are just now starting to hear about tools to correct the payment environment in multiprovider settings. I recently attended the board retreat of the American Health Information Management Association (AHIMA) as a guest and found that AHIMA is laser focused on providing solutions to address the health data aspect of this fragmentation. I’m excited by what I saw. Real progress is being made in creating incentives for care coordination, quality, and efficiency. Even more encouraging, AHIMA is but one leading organization among many now working on unifying data around the patient.

However, I must point out that huge barriers still remain. We will have to work together to address them. We need to coordinate across many aspects of the patient care cycle, from improving efficiency, to creating virtual communication pathways, to focusing on how care transitions between providers impact overall population health. As a former CIO colleague of mine used to tell me, "We can do pretty much anything; it’s only a matter of time and money."

New risk arrangements may help us in this task. Few things motivate us better than the threat of a hit to our own wallets and purses. Tying together multiple providers—and the payers—may be what it takes to pierce the veil of fragmentation, get and improve data across the continuum, and focus on the patient at the center of it all.

Given the current industry environment, working to close the fragmentation gap should be a key success strategy for all healthcare providers. Highly coordinated care has long been found to promote better patient outcomes and reduce cost per patient encounter. It is vital that we break down the barriers to optimal industry coordination. If we can do it, everybody wins!

Publication Date: Monday, April 01, 2013

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