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Originally published on the Jive Software site on May 3, 2017 by Bill Klco.


Care coordination has long been an Achilles heel of the American healthcare industry. Gone are the days when personal relationships among practitioners and organizations were enough to ensure clear communications and hand-offs as patients made their way through the system. These days, the process is fraught with miscues, crossed signals and inefficiencies. It leaves patients struggling to understand their conditions, their treatment options, their care instructions and their payment responsibilities. It drives up costs for providers and payers. It increases the risk of medical mistakes and compromises the quality of care.


As the Improving Chronic Illness Care (ICIC) organization puts it, "Across U.S. health care, fragmented systems and communication breakdowns contribute to widespread failures in care coordination that have devastating consequences for patients (Reducing Care Fragmentation: Executive Summary).


Need further confirmation? Just ask the patients themselves, as the Commonwealth Fund did in this survey:


Those experiences ring just as true now as they did when the survey was conducted in 2008. The situation is unsustainable, especially with the industry's current shift to value-based reimbursement models that emphasize better outcomes at lower cost. Poor care coordination is a big obstacle standing in the way of those efforts. Clearly, something's got to give.


Teamwork: The Missing Ingredient

Care coordination has been defined as "the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services." In other words, it's all about cross-functional connections and teamwork, and that's where the system so often falls short. While individual healthcare professionals may do an admirable job attending to their separate areas of responsibility, the cracks between them are wide enough for all sorts of important details to fall through. That's true even within single practices and clinical settings, and it gets much worse when a patient's care spans multiple organizations and environments (acute, ambulatory, out-patient, home care and aftercare).

Several factors in particular contribute to the problem:


  • Current healthcare systems are often disjointed, and processes vary among and between primary care practices (PCPs) and specialty sites.
  • There is often no central point of responsibility for the entire cycle of care.
  • Many organizations don't have sufficient people or systems dedicated to care coordination.
  • Much of the time and labor that goes into care coordination is not reimbursed.


Why New Collaborative Solutions Are Needed

It's critical for healthcare organizations to invest in new solutions that bridge the gaps and support better coordination. Electronic Health Records (EHR) systems being adopted by major healthcare institutions are a start, but they're not nearly enough, as a recent report by Frost and Sullivan made clear (Analysis of Care Coordination Software: Overview and Outlook, 2014-2020). Though EHRs are helping to eliminate disconnects and discrepancies in patient records, they don't provide the dynamic collaboration and communication capabilities needed to make collective decisions, fully orchestrate care and make sure all participants are informed and on the same page. They capture records of clinical decisions that were made, but they're missing a lot of the essential context around those decisions – the conversations and communications that are such an important piece of the process. Decisions made by different care teams can conflict, and without robust information on why decisions were made, physicians can be left guessing.What's really needed is a digital collaboration platform where all stakeholders can come together to share information, make care decisions, track progress and make adjustments as necessary. Such a platform serves as a hub for coordinated care, solving many of the issues described above. A clinical hub:


  • Creates accountability by bringing the entire care team into a collaborative environment.
  • Provides clinical alerts, reminders and messaging to the entire care team.
  • Bridges the gap between care providers and makes it easier to consider all aspects of a patient's condition beyond the EHR.
  • Provides a way to easily manage the conversations associated with transitions of care, keeping all caregivers on the same page. Specialists consistently receive clear reasons for the referral or adequate information on tests that have already been done.
  • Helps scale your existing care coordination resources to provide increased service to more patients, improving aggregation, analysis, and communication of patient information.


Of course, the collaborative platform has must comply with all rules and regulations (such as HIPAA and HITECH), and it must be secure. It should be easy for people to access and use via mobile devices, not just computers, since clinicians spend much of their time away from their desks. And it should tightly integrate with other essential tools and systems, such as secure texting and clinical communication systems, learning management tools and IT ticketing systems.


A successful clinical collaboration hub can dramatically improve care transitions and make the process better for everyone involved. By powering better collaboration, a hub reduces costly missteps, enables more timely decisions and actions, and cuts down on duplication and confusion. It eliminates many of the frustrations of disconnected processes and increases satisfaction not only for patients but also the caregivers themselves. It drives greater value across the entire spectrum of care. And most importantly it leads to healthier patient outcomes and the best care experience possible.

Learn how a clinical collaboration hub can improve care coordination for your organization.

Originally published on the Jive Software site on April 19, 2017 by Bill Klco.


The adoption of Electronic Health Record (EHR) systems by the healthcare industry has led to real improvements in medical record-keeping, but those gains have come at an enormous price. Hospitals and other institutions routinely spend hundreds of millions of dollars on their EHRs (also known as EMRs, for "Electronic Medical Record" systems), with some implementations topping $1 billion (8 Epic EHR implementations with the biggest price tags in 2015, 8 hospitals' finances hurt by EHR costs). The costs continue to rise as the implementations get bigger and complex.


And it doesn't end there. Even after rollout, the costs continue to pile up due to ongoing upgrades and optimization processes. On top of all that, clinicians often have trouble using the systems and incur expensive penalties for incorrect use.


Not surprisingly, EHR systems are a putting a serious financial strain on the healthcare industry, and can take a hefty toll on the bottom line. For instance, EHR costs contributed to a 15% drop in net income at one major health system in 2012, and forced another to lay off 130 people at three hospitals in 2015 (Unpacking hospitals' EHR implementation costs: What's behind the million-dollar price tags?). This comes at a time when healthcare providers are under intense pressure to trim costs and become more efficient.


The problem isn't simply that EHRs are expensive; it's the inability of healthcare organizations to fully reckon with and plan for all the elements a successful implementation entails. Nearly every EHR rollout is plagued by major cost overruns due to unanticipated expenses in areas such as training, additional hardware purchases, operational costs, consulting fees, and change requests and fixes required because of miscommunications and difficulty gathering and implementing feedback. It's these overruns – not simply the intrinsic price of the systems themselves – that are really hurting the healthcare industry.


Why do so many EHR implementations exceed their budgets? One big reason is a failure to fully address some key questions up front:

  • How do you effectively manage communications within the EHR selection committee?
  • How do you capture all the design and build decisions as well as validation test results, and how do you communicate progress?
  • How do you work with diverse stakeholders across a large health system to communicate and coordinate the rollout?
  • As EHR champions are identified, how do bring them together to share best practices and support each other?
  • How do you train users and administrators during the rollout and provide ongoing education on upgrades and new features?
  • How do you gather feedback and process improvement suggestions from clinicians after rollout?
  • How do you provide ongoing support to clinical and administrative users (on current and previous builds at the same time)?


These are critical considerations, but they're often overlooked because they involve communication technologies beyond the EHR system itself. Many organizations make the mistake of assuming that existing tools like email and support tickets will suffice, but none provides the kind of powerful conversational and cross-functional collaborative capabilities needed to connect all stakeholders, share information, gather feedback and work together in a timely way. Given that even simple changes within an EHR can cause major issues with interfaces, clinical workflows and training, it's not surprising that the lack of a suitable communication and collaboration platform can lead to all sorts of mistakes, inefficiencies and extra costs.


That's where new-generation clinical collaboration hubs come in. These systems provide a single destination for organizing, informing and connecting all parties involved in EHR usage, including clinicians, care teams, administrators, IT and other staff. State-of-the-art platforms provide a broad array of capabilities, including news and announcements; departmental portals; team collaboration spaces; individual and group communications; document collaboration; people directories; rapid search for people and content; and support spaces.


These functions provide a comprehensive answer to all of the issues listed above:

  • The EHR selection committee can manage all communications, documentation and decision-making around each phase of the EHR lifecycle in a single, private collaboration space.
  • The design and build process can have its own space, where all decisions and test results are captured and shared, and where updates can be pushed out to clinical staff.
  • Targeted blogs and tailored news feeds keep all stakeholders informed on the EHR rollout.
  • EHR champions can have their own spaces for education and knowledge-sharing.
  • Training spaces provide all the resources – including discussions, Q&A, documents and videos – needed to educate users and administrators on EHR use, upgrades and new features.
  • Collaborative hubs enable a wide array of two-way communications and feedback channels, such as the ability to comment and reply to communications and content.
  • Hubs offer a very efficient combination of self-service, peer-to-peer and staff-assisted support. For instance, users can quickly find answers by searching existing content, or submit their questions to be answered by knowledgeable colleagues. Staff can jump in to field or clarify any unanswered issues.


Whether you're implementing a new EHR, upgrading your existing system, or optimizing processes, a secure collaboration hub can save you substantial time, resources and money. It also improves clinician productivity with support through all aspects of EHR lifecycle, from selection through ongoing optimization efforts. Major health systems have saved millions of dollars in their EHR optimization efforts by streamlining project communication and clinician feedback using a collaboration hub. One Midwestern health system reduced their backlog of clinical change requests from over 8 months to 3 weeks simply by moving to a hub.


Creating a successful EHR system requires the expertise, understanding and contributions of many participants. A well-designed collaboration hub provides a place for all of that to happen. In doing so, it reduces risks, reins in expenditures, helps organizations reap much greater ROI from their EHR investments, and brings a new predictability to fiscal planning.

Want to end cost overruns on your EHR/EMR project? Learn more: HIPAA-Compliant Healthcare Communication | Jive Software

For fun, I typed “digital transformation” into Google and scoured a few of the 58 million results. It didn’t take long before I noticed a pattern: most of the discussion is centered on technology. Countless articles cover the social, mobile, analytics and cloud technologies you need to pull off a successful transformation initiative.


But digital transformation is not just an IT project. If done well, it drives a massive shift in human behavior that reshapes the way we live, work and what we expect from our daily interactions with friends and colleagues. A battle that big can’t be won by infrastructure and process improvements alone. It also requires companies to fundamentally rethink how they attract, engage and retain top talent to remain competitive. So what is the missing link, you ask?


Read the article here!

The Missing Link for Digital Transformation Success Is? | Jive Software

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