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New Survey: Clinician Leaders Reveal their Care Coordination Priorities, Challenges

April 25, 2016
by Mark Hagland
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A survey of patient care leaders reveals the main areas of focus of care coordination efforts

A survey conducted by the Wellesley, Massachusetts-based Digital Collaboration Solutions, LLC (DCS), and released last week, reveals the top priorities that clinical and operational leaders in organizations spanning the care continuum are focusing on right now with regard to care coordination efforts at a time of intense change in U.S. healthcare.

The top-line results from the survey of 75 healthcare executives found that over 70 percent of healthcare leaders surveyed reported that “improving patient outcomes” is their top goal in implementing care coordination right now, while 20 percent reported that “improving patient experience” is their top goal. Meanwhile, while 86 percent of respondents stated that coordinated care improvement efforts are a top-five priority in 2016, fully 55 percent acknowledged that they do not have a dedicated budget to support such efforts. And while 77 percent are treating care coordination efforts as process improvement, 40 percent have no defined process to review, approve and prioritize care coordination improvement projects.

The survey encompassed responses from across the care continuum. Among survey respondents, 39.4 percent were leaders in individual acute-care hospitals; 22.5 percent worked in skilled nursing facilities; 15.5 percent were in integrated delivery networks; 15.5 percent worked in primary care physician offices; 11.3 percent in physical or occupational therapy services; 9.9 percent in specialist physician offices; 9.9 percent in home healthcare services; 8.5 percent in accountable care organizations (ACOs); 7.0 percent in rehabilitation facilities; 5.6 percent in behavioral health facilities; 2.8 percent in health clinics; and 21.1 percent in “other” organizations.

With regard to the professional titles of survey respondents, there was a vast range of titles involved, with fully 66.2 percent of respondents choosing the “other” category. The most common titles identified by respondents were chief nursing officer (9.9 percent), director of case management (8.5 percent), chief medical officer (4.2 percent), chief executive or operating officer (2.8 percent), chief information officer (2.8 percent), service line director (2.8 percent), and chief financial officer (1.4 percent).  Among the 30-plus titles in the “other” category were administrator, assistant administrator, business services manager, director of nursing, care manager, case management supervisor, medical director, and a wide range of quality management-related titles.

With regard to the importance of coordinated care improvement efforts, fully 85.9 percent of survey respondents affirmed that coordinated care improvement efforts will be important to their organizations’ 2016 goals, with only 4.2 percent saying they would not be important to those goals (and 9.9 percent saying that they didn’t know).

Meanwhile, survey respondents indicated a very broad range of care coordination efforts. Among those: improving transitions of care with patients and their families (60.6 percent); reducing 30-day readmission rates (60.6 percent); improving patient experience measures (57.7 percent); improving transitions of care between facilities (54.9 percent); coordinating post-acute care across home health, etc. (45.1 percent); implementing chronic care management strategies (43.7 percent); improving medication adherence initiatives (42.3 percent); enhancing the referrals process (35.2 percent); telehealth initiatives (31 percent); implementing population health (25.4 percent); minimizing network patient leakage (19.7 percent); expanding a secure communications infrastructure (18.3 percent); advancing physician/provider/payer alignment (14.1 percent); and getting more out of their existing population health investment (11.3 percent).

In engaging efforts, 70.4 percent wanted to improve patient outcomes; 19.7 percent wanted to improve the patient experience; 5.6 percent wanted to increase revenues; and 2.8 percent wanted to decrease costs.

The scope of these efforts is often quite broad. Asked how wide the scope of their typical care coordination efforts were, 40.8 percent said those efforts were spanning their entire care network; 21.1 percent said, “between a small number of defined entities within my care network”; while 25.4 percent said their efforts were limited to being only inside their own organizations.

Interestingly also, the percentages of those leaders with dedicated budgets are smaller than one might expect. Fully 54.9 percent of survey respondents said that they have no dedicated budget for care coordination efforts, and pursue those projects with existing resources, while only 12.7 percent stated that they do have dedicated budgets to support these initiatives. Another 26.8 percent have budgets for different initiatives spread across multiple departments, while 5.6 percent find money on an ad hoc or case-by-case basis, for these initiatives.

Given how important all these initiatives are to these patient care organization leaders, what are the implications of the results of this survey, for healthcare IT leaders? Timothy Perkins, a partner at DCS, says, “That is a good question. We found that this [care coordination work] is mostly clinically driven. So the implications of course, is that IT has to support this work in some form. And our belief is that IT leaders should have a seat at the table, because the clinical folks are asking for process improvement; and there is a clear IT component in creating, maintaining, and extracting results from, the data involved.”