Comprehensive care coordination solutions are rapidly becoming an important way for disparate clinicians across multiple organisations to collaborate at a patient and panel level.
What can and should a general-purpose care coordination solution for providers look like? The broad outlines of such a solution are emerging from many HIE vendors. In fact, it seems like the HIE as a “product category” has always awaited a comprehensive care coordination solution to truly unlock the value of cross-HCO data exchange.
Care Planning Applications
Care planning by providers, rather than payers, is in its infancy and HIE vendors are contributing in a variety of ways. The key requirement for a care planning application is that it support multi-entity access. Most HIE vendors provide a single application that bears some resemblance to a project management or CRM application. The reality is that many clinicians are reachable only with messaging applications.
This is particularly true for some long term and post-acute (LTPAC) providers. For the foreseeable future, Direct-based messages with attached care plans and other documentation will have a place in provider-driven care planning efforts. Most vendors recognise that this hybrid approach, while not optimal, will be needed to support diverse clinical populations. Where messaging plays a role in care planning, care plans circulate as structured documents (CCD, C-CDA or PDF). This cumbersome form of exchange will give way over time to the single, most likely hosted (SaaS), application approach.
Patient Portals are New Again
Care plans require the active participation of patients. One consequence of the focus on care coordination is fresh attention to the problem of engaging patients in the care planning process. One year ago, HIE vendors backed away from their patient portals. Today, all HIE vendors are putting renewed focus on their patient engagement solution(s), which are, by and large, merely patient portals
A Sample of Vendor Solutions
Our forthcoming 2014 HIE Market Trends Report will provide detailed information about the care coordination capabilities of each vendor. However, we want to share some preliminary results from our recent research for this report with a representative sample of HIE vendors and their care coordination efforts.
HIE vendors are chasing the care coordination opportunity in earnest. This dramatic change in one year is being driven by provider’s awakening realisation of the demands of VBR. Provider organisations should be familiar with the general outlines of these solutions and begin asking both their EHR and HIE vendors to sketch out their solutions’ capabilities to support such care coordination processes. It is important to plan for the long term with a focus on general-purpose care coordination based on the requirement of your total provider community. Solutions need to support an organic, constantly changing care plan at the individual level as well as the ability to monitor progress of care activities at the panel level.
There are essentially three enablers:
- first, the creation of the vision
- second, a sustained investment in providing staff and contractors with the skills needed to innovate, and supporting them when they do
- and third, new forms of contracting.