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FCW : October 2016
S-43 S-43 S-42 Collaboration has always been an integral component of U.S. healthcare, contained only by the ability of patients, doctors and other providers to communicate. In the digital era though, it’s at the center of an increasingly popular practice model that promises to improve clinical outcomes while cutting costs. The collaborative care model positions the primary physician as the quarterback in the middle of a line of healthcare participants. The patient is at one end and all the relevant specialists are at the other. They all work together to provide care, and monitor the patient’s progress. They rely on video, voice and data technologies to communicate and collaborate. Patients themselves are active participants in the process, with full access to all the available information. The result should be more timely and effective delivery of care. A report developed several years ago for the Centers for Medicare and Medicaid Services (CMS) concluded a collaborative care model could have significant impact on particularly difficult treatments, such as mental illness. More than 70 random trials, conducted across diverse practice settings and patient settings, showed collaborative care for common mental disorders to be more cost effective than traditional care. In July 2016, CMS proposed several changes to many of its Medicare fee schedules, including payment for specific behavioral and mental health services that use the collaborative care model. The Affordable Care Act also contains a specific provision for states to establish what it calls Health Homes, for people on Medicaid who have serious and chronic physical and mental health problems. Patients in these cases receive coordinated, collaborative care. Technologically, most healthcare organizations are half way there, having the necessary network connectivity. Now it is just a matter of investing in middleware—software that lets various health systems communicate and understand each other. In its broadest terms, mobility has been a part of healthcare for decades. Think of computers on wheeled platforms, beepers, personal digital assistants (PDAs) and various other devices. The new era of powerful mobile systems, however, takes the idea of clinical mobility to another level. The Healthcare Information and Management Systems Society (HIMSS) noted several years ago in its Clinical Mobility Report the newer generation of mobile devices had begun to change patient care delivery. In early-stage tele-monitoring, for example, alerts regarding patients’ vital signs once triggered immediate home visits by care nurses. Now nurses first respond by calling the patient. In its 2015 Mobile Technology Study, HIMSS found that close to 40 percent of the healthcare organizations said implementing mobile services for healthcare data access was a high priority. However, only 18 percent indicated their mobile environment was “highly mature.” There have been some notable successes. New York Presbyterian Hospital is one of the largest health systems in the country. It started developing a clinical mobility platform in 2012. This was intended as a “five-year journey to iterate on the right form factor, right integration, right infrastructure setting, and right use cases,” says Rosemary Ventura, director of nursing informatics, in a recent blog post. The hospital now has nearly 2,000 Apple iOS devices deployed, and all hospital clinicians use the system. It supports continuous improvement in eliminating harm, reducing waste and improving productivity, as well as providing real-time messaging and cooperation between clinicians. Collaboration is Key to Effective Care Mobility Gains Momentum FCW.COM/2016HealthITGuide S-43 A GUIDE TO HEALTH IT SPONSORED REPORT
September 30, 2016
November and December 2016