In order for an accountable care organization to succeed, there must be a workable method for collaboration among the providers. How do providers of care effectively communicate amongst one other? What is the optimum means of memorializing a patient’s medical history and present health status so that all providers of care are basing their decisions on the same data? And how do, for example, a surgeon and cardiologist communicate best to ensure a patient’s risks of undergoing surgery are fully assessed and yet not one day extra is spent as an inpatient than absolutely necessary?
These very issues confront providers each and every day in their offices, surgery centers, clinics and hospitals. When a patient is admitted to a hospital because a colonoscopy indicates that a cancerous section of the colon should be removed, how is the process of caring for that patient met and coordinated from admission to discharge? A recent experience of mine exposed the communication barriers among the various providers of care in the inpatient setting causing inefficiencies, avoidable delays and unnecessary days in the hospital.
Importance of Information Technology
Having a single provider coordinate all of the care will help increase the quality of the care and decrease wasted resources. An invaluable tool to accomplish this coordination of efforts is to make all of the medical information concerning a patient readily available to all of the caregivers. The manner in which the health data is organized and presented should be standardized so all providers can zero in on the information sought at any moment. Every provider should be able to view a screen or screens of data that capture an individual’s medical history, current and history of medications as well as their present physical condition, both subjectively and objectively. Thick and unruly medical charts must be made a thing of the past.
Kaiser Permanente physicians, for example, follow patients closely because their performance with regard to quality of care and patient satisfaction are determining factors in whether or not they receive a bonus. Financial incentives are not new, but they work. Physicians within the Kaiser Permanente system use a comprehensive health information process that coordinates medical records in and out patient, scheduling appointments, registration, all of which yield efficiency and effectiveness. Elimination of wasted resources is the goal.
Perhaps we will have to accept that it will be a slow process until physicians and their staffs are able to fully adopt health information technology and learn to use it effectively. Doing so in a standardized fashion will assist with the delivery of high quality and effective care while eliminating wasted resources. Too much time is currently wasted waiting for diagnostic test results or communication between health care providers. The by-product of unnecessary waiting and communication gaps is wasted resources. With a growing population and people living longer, health care resources will become precious. This will drive the need to become frugal and efficient when using health care resources because they are not limitless.