Care Coordination as a Business Opportunity

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By Jamie Gier, CMO, SCI Solutions

Care coordination. In health care, it’s a term that’s often used, but rarely understood. AHRQ defines care coordination as deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient’s care to achieve safer and more effective care. In this context, care coordination is about much more than the clinical delivery of care – and though most people consider it a clinical term, it also encompasses the critical business mechanisms that facilitate and pay for this care delivery, such as orders and referrals, insurance verifications and scheduling.

Understanding this care coordination paradigm is critical because in order to grow, health systems must exploit all their channels – not just employed physicians but also independent providers and other stakeholders – in order to tap into new referral sources, effectively coordinate patient care and reduce costs. Electronic health records (EHRs) have their use cases within the four walls of the hospital or the clinic – including clinical documentation, intelligent alerting, retrieval of patient data and order entry/results return – but their deficiencies are exposed when care teams need to coordinate across not just physical settings but differing organizational boundaries. As the migration to value-based care accelerates, health system business objectives require supplementary tools to bridge these functionality gaps.

My colleague Bill Reid recently contributed an article to Health IT Outcomes on this very topic. I encourage you to read Bill’s insights, and consider the importance of technologies that integrate electronically and economically with disparate market trading partners, and their criticality in today’s value-based system of care.

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