Dr. Larry Weed, many years ago, postulated a “Problem Oriented Record” that would focus primarily on the Patient and Patients Problem list. Over the year with much specialization, Medicine had become Compartmentalized to the point that sometimes one had to ask the question, “Who is managing the patient” and how are the various clinicians responding to the Problem list”?
With the introduction of Electronic Records, it is now possible to share information about the patients and have clinical team members focus in a much more “Integrated fashion”, so that there is a Management Plan and each of the clinical team tell us what they have addressed. It is unfortunate that the Progress of integrating information is both slow and therefore Patient Care Coordination suffers. A survey sponsored by the Council of Accountable Physician Practices indicated that patients with several chronic conditions received only slightly more coordination than other patients. This finding is contained in detail in an article by Ken Terry/ June 23rd in Medscape. (Progress Remains Slow on Physician/Patient Care Coordination).
The article is well done, but the parallel problem of Coordination of clinical information affects the actual coordination of Care. This has a very measurable impact on The Revenue Cycle and the ultimate claim for services. While much has been written about reimbursing outcomes and quality and the proposal to introduce such a system in 2019 by CMS, there is still huge gap in both the technology and philosophy of care. Health Systems Management has been working with hospitals and physician’s practices for many years to introduce the idea of coordinated care, through the magic of real communications among and between the clinicians. The technology will help convey the information only if it is documented in a way that allows all of the clinical team to understand how the patients’ problems have been addressed.
Similarly, we urge that the Revenue Cycle staff be taken out of their Silo’s and integrated in, much the same way that that we expect clinicians to communicate. Often this means knowing the clinicians, understanding what they do in each discipline and supporting the clinical team as consultants to make sure that each encounter/procedure is properly documented, and made ready for claims.
For over 30 years HSMN has provided models and helped to implement programs that have helped both patient and revenue. Depending on Technology alone will not provide better coordination unless it is universally present and used for communication. Please contact us if we can be helpful.