What is Care Coordination? Exploring a Dynamic Concept in Health IT

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A doctor viewing patient records on her computer.Medical errors can be quite detrimental to a healthcare organization. It was reported that 80% of clinical errors were a direct result of the inadequacy of “coordinated communication during care transition,” according to the market report provider Research and Markets.

Care coordination is an essential aspect of healthcare as it correlates with health data and the optimization of patient care. Professionals with an advanced degree in health information management can aid an organization in developing effective care coordination strategies.

Defining Care Coordination

What is care coordination? Research and Markets defines care coordination as the process of delivering and interchanging patient data across “the care continuum via a centralized, yet interoperable IT platform that facilitates real-time communication between specific care team members.” The goal of care coordination is to create synergies among medical professionals to develop optimal patient care.

Care coordination enables patient data and electronic health records (EHRs) to be shared with different sectors of the healthcare industry, such as hospitals, laboratories, and doctor’s offices. This helps to ensure a comprehensive care strategy. For example, a patient can have a massive heart attack and be sent to the emergency room. Through coordinated care, that individual’s medical history and medications can be accessed by the medical team in the emergency room.

Patient health information provides medical institutions and personnel with important information about a patient’s specific medical needs and preferences. When care coordination is effectively implemented, it can provide patients with lower healthcare costs as a result of fewer redundant lab tests and medical procedures.

A variety of care coordination models exist that guide a patient through various steps of care administration: Acute Care, Primary Care, and Post-Acute.

Primary Care

Primary care coordination assigns a registered nurse (RN) to a patient who has a chronic condition. This RN communicates with the patient’s doctors to develop a care plan. Primary care coordination is a perfect example of why health information managers are essential in developing care coordination processes and procedures.

Acute Care

Acute care coordination involves every step of critical or emergency patient care, from the initial incident—heart attack or stroke, for example—to days after the patient is released from the hospital. Professionals who are responsible for acute care coordination ensure patients receive the properly prescribed medications, educate patients and families on care instructions and usually follow up with patients. The goal of acute care coordination is to reduce the number of patients who return to the hospital.

Post-Acute Care

Post-acute care coordination revolves around patients that are cared for in post-acute care facilities. In many cases, these patients must receive further medical care in hospitals, which makes it important that care coordination between facilities is a priority.

The Role of Health Information Management in Care Coordination

Health information managers need to ensure they have an effective IT strategy in place, because such a strategy is crucial to care coordination. These professionals oversee EHR and patient health information, which requires them to make sure the data is both secure and easily accessed by medical professionals. These systems must be safe from cyberattacks and misuse. To achieve this, health information managers need to train employees who are handling and using patient data.

Healthcare employees must understand that all processes and procedures relating to patient data demand compliance with HIPAA (the Health Insurance Portability and Accountability Act). This is another role of the health information manager. HIPAA is the federal law that created national standards for the protection of sensitive patient health information.

Health information managers must also require all employees who access patient data to have a secure passcode and an employee-specific ID number. If there is a breach in the EHR system, it is important that the health information manager have access to every employee’s ID number to track who may have caused the breach. Lastly, it is crucial that the manager develop a system in case EHRs become susceptible to a cyberattack. In most cases, this requires working closely with the IT department.

Health information managers must communicate the need for all patient data to be encrypted, especially throughout the transferring process between health institutions. Health information managers must also develop a level of business acumen when dealing with relevant contractors who are hired by the healthcare facility. Lastly, all patient data must be accessible at all times through EHRs. The information must also be updated and accurate to provide patients with optimal care.

Trends in Care Coordination

Many emerging trends continue to shape what care coordination is. These include value-based healthcare, mHealth, telemedicine and beyond. Health information managers must make sure they stay up-to-date on these and other trends.

Value-Based Healthcare

Value-based care coordination allows primary care physicians to have access to all their patient’s doctors, including information about the medications and lab tests that have been prescribed. This is important because it enables primary care physicians to develop care plans that can improve their patients’ health and potentially save them money. Medical professionals who participate in value-based care are rewarded with bonuses when they meet particular healthcare goals. This is advantageous for patients, because this healthcare model focuses on quality of care, as opposed to doctors working to acquire more patients.

mHealth

Another trend in care coordination is mHealth, which enables both patients and doctors to access healthcare information and medical records via mobile devices. Mobile applications can help relay information about health conditions and diseases and can even monitor a patient’s health in real time (an app connected to a wearable device to monitor heart rate, for example). Additionally, mobile health apps can help change patient behaviors (apps that feature goal setting and activity logs for weight loss, for example). mHealth also allows patients to access web portals to make appointments with their doctors, refill prescriptions, request lab results and message their physicians.

Telemedicine

Related to mHealth, telemedicine is real-time communication between a doctor and patient, enabled by video and audio. It is considered a cost-effective alternative to seeing patients in an office setting. It also saves money for patients since they are not required to travel to a doctor’s office for routine or follow-up appointments. Perhaps the most important benefit of telemedicine, however, is access. It is especially important to individuals who live in rural areas where healthcare is not easily accessible.

Explore a Career in Health Information Management

Students can learn more about what care coordination is and the role a health information manager plays by pursuing an advanced degree in health information management.

The Master of Science in Health Information Management program offered by the University of Illinois at Chicago provides a comprehensive curriculum taught by professors who have direct experience in the field.

Students are able to take a variety of classes in subjects such as Health Information Technology and Systems, Quality Management and Data Analysis, Executive Healthcare Financial Management, Legal Aspects, Risk Management and Security of Health Information.

Explore how the University of Illinois at Chicago’s online Master of Science in Health Information Management empowers students to develop effective health information management skills that can prepare them for rewarding careers.

Recommended Readings

How to Become an EHR Consultant and Pursue a Career in Health Information Management
What is Health Information Management? Comparing HIM vs. Health Informatics
What Is Patient Information, and How Is It Protected?

Sources:

EHR Intelligence, “Telehealth EHR Integration Key to Meet COVID-19 Demand”
HIPAA Journal, Healthcare Data Breach Statistics
Nature, “What is the Clinical Value of mHealth for Patients?”
NEJM Catalyst, “What Is Care Coordination?”
Perspectives in Health Information Management, “Using Health Information Exchange to Support Community-based Innovations”
Research and Markets, US Care Coordination Software Market, Forecast to 2023
U.S. Department of Health & Human Services, HIPAA and Health Plans – Uses and Disclosures for Care Coordination and Continuity of Care