Canada Health Infoway has designated November 13-17 national Digital Health Week. In recognition of this week, I’ll share examples of ways in which poor care coordination causes inefficient and ineffective care, and why IT is an essential part of the solution.
- Poor care coordination: If a patient is seen by a provider that is not a specialist in the area of care need, the results are costly and wasteful. Technology can help rectify this type of error. First, a health services catalog provides a map of specialists and other healthcare providers, including their areas of interest and specialization. This allows providers to refer patients to care partners who can see them in a timely fashion. Second, through the “referral for advice” model, providers can reach out to the appropriate specialist to review the patient’s case, provide appropriate advice to the referring clinician, and determine if the patient needs to see the specialist, or whether the advice is sufficient. Studies have shown that this capability can reduce waiting lists by as much as 40% by eliminating unnecessary appointments.
- Information gaps about patients: Patients can easily fall victim to blind spots within the health system, due to multiple streams of care and too many touch points between providers. But with access to complete patient information, treatment is based on the full context of patients’ clinical situation. Complete information can reduce the need for unnecessary care such as duplicate consultations with other specialists or unnecessary investigations and follow ups. This is something we’ve worked hard to achieve with Orion’s Clinical Portal, which is now available in the majority of Canadian provinces.
- Lack of robust, coordinated care plans: When patients are seen by many different specialists and community clinicians, it is common for each provider to generate a unique care plan for their area of specialization. However, there’s potential for the multiple care plans to conflict. While it is best practice to only manage a patient with full knowledge of their clinical case details, including their comprehensive care plan, this can be a counsel of perfection. In real-world situations, clinicians frequently cannot access up-to-date, comprehensive care plans. A readily accessible electronic version of the care plan, made available in all care settings and that enables all appropriate providers to update it, is key to solving this puzzle.
- Patient Participation: When patients and their caregivers are engaged as equal members of the care team, patient outcomes are improved, and unnecessary care is reduced. In fact, by becoming active partners in their own care, patients are making the health care delivery system more responsive to their needs and preferences. As physicians, we have been slow to realize that a patient’s desired outcome and a physician’s preferred outcome may not always be the same. One application of patient participation is through Remote Patient Monitoring (RPM). RPM collects patient data such as BP, glucose or peak expiratory flow rates and transmits information electronically to the patient and provider clinical record. The solution also recommends ways in which the patient can improve their health based on the data at hand.
- Uncertainty relating to accountability: Digitizing health information can improve clinicians' understanding and accountability for items such as following up on tests, procedures and necessary treatments. Additionally, when a report has been sent to just one member of the patient’s care team, others may be in a better position to deal with it. In a recent example in Edmonton, a patient was found to have a pulmonary embolus (“clot on the lung”) and treated appropriately. However, there was also an indication of a small lung tumor that was not properly realized until a few days later. The radiology report detailing the lung tumor was inexplicably sent to the patient’s gastroenterologist. Fortunately, his PCP was able to access the result via the provincial EHR and institute appropriate management. Without the ability to see that report, the patient’s lung tumor would not have been treated until much later.
Throughout Digital Health Week, we’ll be sharing more stories of how Orion Health solutions have improved the healthcare offered to Canadians. Please check back to our social sites and our website for updates on Digital Health Week and Orion Health’s work in the field.