OBJECTIVES: Complex patients incur a majority of healthcare costs in the United States, in part, because their care is poorly coordinated. We sought to determine the leading edge of health information technology (IT) tools for care coordination of complex patients. STUDY DESIGN: Qualitative discussions and technical expert panels. METHODS: We conducted 35 discussions with clinical leaders, technology and startup executives, government officials, academic researchers, and 2 technical expert panels. RESULTS: Although health IT has the potential to improve care coordination, the types of IT tools available to clinicians and patients are currently limited. We found substantial barriers to developing technical capabilities for improving care coordination, including lack of knowledge of users' needs; lack of standardized roles, responsibilities, and protocols; required changes in providers' work activities to achieve coordination; and an unclear value proposition. CONCLUSIONS: We found several innovative tools, but existing efforts suffer from important limitations, including minimal engagement by physicians, lack of standardized definitions of what the tools do, and challenges integrating with clinical workflows. For health IT to facilitate coordination of care for complex patients, user needs and workflows must be better understood and used to guide the development of technology and policy.
OBJECTIVES: Complex patients incur a majority of healthcare costs in the United States, in part, because their care is poorly coordinated. We sought to determine the leading edge of health information technology (IT) tools for care coordination of complex patients. STUDY DESIGN: Qualitative discussions and technical expert panels. METHODS: We conducted 35 discussions with clinical leaders, technology and startup executives, government officials, academic researchers, and 2 technical expert panels. RESULTS: Although health IT has the potential to improve care coordination, the types of IT tools available to clinicians and patients are currently limited. We found substantial barriers to developing technical capabilities for improving care coordination, including lack of knowledge of users' needs; lack of standardized roles, responsibilities, and protocols; required changes in providers' work activities to achieve coordination; and an unclear value proposition. CONCLUSIONS: We found several innovative tools, but existing efforts suffer from important limitations, including minimal engagement by physicians, lack of standardized definitions of what the tools do, and challenges integrating with clinical workflows. For health IT to facilitate coordination of care for complex patients, user needs and workflows must be better understood and used to guide the development of technology and policy.
Authors: Emily Gill; Patricia C Dykes; Robert S Rudin; Marianne Storm; Kelly McGrath; David W Bates Journal: Int J Med Inform Date: 2020-02-19 Impact factor: 4.046