Technology and Coordinated Care: Overcoming Real and Perceived Barriers
Melissa Fox, MHA, FACMPE, FACHE | Chief Operating Officer, Acenda
The ongoing pandemic and the devastating impact it’s had on the health and economy of our communities has revealed the need for technology as a critical component of care management. The flexibility and safe access of tech allows for efficient care coordination without jeopardizing outcomes.
However, operational barriers — both real and perceived — interfere with the ability of many organizations to successfully implement technology-driven care coordination models. Whether during a pandemic or not, using technology can help to expedite care provision and more efficiently target the care population, but it is important for providers to fully consider operational logistics when selecting the appropriate technology to support their care management processes. Key processes should be considered such as expediency in care connections, visibility of patient care data, patient consents, and meaningful referral management, so as not to interfere with care delivery.
One of the most common barriers to using technology for care coordination is related to the management of patient data. Many providers are reticent to fully coordinate and share data due to concerns about HIPAA, but this can typically be addressed with the proper patient consents and with proactive patient communications regarding how their information will be used. It’s important to note that some states have very stringent and specific laws regarding which data can or cannot be shared, so knowledge of those restrictions is important.
In addition, technology can provide more security related to protecting health information than paper documentation. This may seem like an obvious point, but many organizations still utilize paper to facilitate referral management because they haven’t full transitioned to electronic record management. However, by more fully utilizing technology as part of their care management, they will not only better align with the larger healthcare ecosystem, but they can also help reduce the risk of wrongful identity and preventable medical errors. The advances in healthcare technology can offer organizations the confidence that their data is secure if access is managed properly, but oversight regarding compliance is always a good practice to ensure security measures are being met.
Another perceived barrier is resistance to virtual patient care. The pandemic has helped to expedite acceptance and usage of telehealth, but this approach still causes hesitation — especially as it relates to care transitions among providers. Technologies that connect health care professionals with patients, no matter where they’re located, can expedite diagnosis and treatment. Studies have shown that outcomes are not adversely affected by virtual patient visits, and this is especially important during crises like the pandemic, when telehealth becomes the primary method by which patients are able to see their physicians.
During the pandemic, the Centers for Disease Control and Prevention have encouraged the use of telemedicine “to decrease your contact with healthcare facilities, other patients, and healthcare staff in order to reduce the risk of COVID-19 and keep you and your family healthy.”
The FAIR Health’s Monthly Telehealth Regional Tracker, a free service launched in May 2020 that uses over 31 billion private health care claim records to track the growth of telehealth, found that “telehealth claim lines increased 4,347% nationally, from 0.17% of medical claim lines in March 2019 to 7.52% in March 2020.
In mental health, there are still many who believe that discussing deeply personal topics in a conversation over the phone or through teleconferencing is not therapeutic or supportive of an appropriate level of connection with their patient. While virtual visits may not be suitable for patients with higher levels of acuity or psychiatric diagnoses which may not be conducive to remote support, there is evidence that telemedicine does provide positive outcomes for many individuals who require counseling support. Closing a gap between the care professional and the patient and removing obstacles like ability to travel to appointments due to location and distance, transportation and having to leave work or responsibilities at home to get to an appointment, can all be alleviated with telemedicine.
However, even with the effectiveness of telehealth, there are potential barriers which should be addressed. Many segments of the population may have limited access to the proper equipment, or who may have issues with internet connectivity and smartphone data availability, which can obviously affect their ability to benefit from this as a care option. Organizations considering using remote technology to support care coordination should be sure to conduct an analysis of the potential gaps in access and incorporate a response into their planning. Solutions can include securing funding for phones/devices or even innovative partnerships with internet providers.
Though there are both real and perceived barriers to utilizing technology in support of effective care coordination, proactive planning and input from key stakeholders can help ensure operational and care success.
Melissa Fox, MHA, FACMPE, FACHE, has a distinguished 20+ year career leading operations management, innovation, strategic growth, partnerships, and development for various types of Health and Human Services organizations including Federally Qualified Health Centers, Healthcare for the Homeless, Behavioral Health, HIV/AIDS care, Homeless Shelter Outreach, Prevention Programming, Home Care and Hospice.
Melissa is a 2014 LEADERSHIP Philadelphia alum, a member of the American College of Healthcare Executives, the National Association of Health Services Executives, the Medical Group Management Association and is a Fellow in the American College of Medical Practice Executives as well as the American College of Healthcare Executives. Fox has served as an expert speaker for organizations including the National Healthcare for the Homeless Council, National Nursing Centers Consortium, Philadelphia Social Innovations Journal, Philadelphia Housing Authority, and the Health Center and Public Housing Symposium.
