Altering Attitudes and Technology to Achieve Patient-Centered, Collaborative Care

By Allan Finkelstein
08:30 AM

The association between mental health and physical health has a long history, yet the two disciplines often are viewed as disparate pieces of patient care. Making this link between a patient’s physical and mental well-being is becoming paramount in terms of streamlining a patient’s medical lifecycle. Bridging the gap is essential for creating a smarter roadmap to understand these cause-and-effect relationships and ending this false duality.

Take, for example, a behavioral health therapist who documents a patient’s lack of transportation. Although this factor may seem irrelevant to physical health, the cardiologist who accesses this information might finally understand the real reason for a patient’s subpar pharmacotherapy results: He has not been compliant with his medication regimen not due to cost, but because he has no way to get to the pharmacy regularly.

With new care models like accountable care organizations (ACOs) and an increased focus on the holistic patient experience, this level of collaboration is going to be increasingly necessary moving forward. However, it will require shifts in both technology and provider mindset to achieve true patient-centered care.

Technology Makes Interdisciplinary Care Possible

ACOs, bundled payments and pay-for-performance are more than just buzzwords — they are the future of medicine. As healthcare organizations grapple with bringing information systems into compliance with federal mandates, they must also consider how any new technology will impact patient care and clinical workflows.

All indications are that technology can — and will — play a central role in the delivery of patient-centered and collaborative care. However, while electronic health records (EHRs) are a basic pre-requisite, they cannot enable a seamless exchange of patient data on their own. Achieving this industry goal also calls for data repositories and analytics tools, as well as the incorporation of supportive technologies such as kiosks, web portals and mobile applications.

Consider the need for centralized data repositories, for instance. They support the aggregation, manipulation and analysis of data providers collect, which in turn enables scientists and providers to leverage data for a better understanding of disease processes. The ultimate result? More effective and less costly care.

To do this, however, organizations need to look beyond the EHR to ensure that the disparate systems used by disparate clinical disciplines have the interoperability needed to securely exchange critical patient data. This includes data that encompasses both mental health and physical health.

The availability of an electronic, longitudinal health record accessible from multiple devices allows all providers involved in the care of a patient to consult and make informed decisions based on a complete medical history. Although a primary care provider might apply patient information differently than a psychiatrist or a cardiologist, all of these physicians can use the patient record as platform for real-time care coordination. Treatments can be administered in parallel, and care collaboration can be further facilitated through web-based services such as instant messaging and video-conferencing — whether before, during or after in-person care.

Meaningful Use criteria will factor significantly in how healthcare organizations approach technology deployment. However, at the heart of collaborative care, providers must find technology that enables easy access to interdisciplinary data. That is how they will be able to provide the best possible health outcomes for their patients.

Changing the Provider View

As large as the technology challenges posed by collaborative and patient-centered care may be, they pale in comparison to the larger hurdle of altering provider viewpoints. This is due, in part, to the fact that enormous changes are occurring throughout healthcare at a rapid pace. For providers already squeezed for time, it is difficult to embrace any new process or initiative that requires a time-consuming learning curve.

One of the best ways to overcome this obstacle is simply to allow those most affected by any new process or technology to help shape its use. In a word: empowerment. Providers — especially those who remember the demands imposed by the managed care organizations of the past — are unlikely to uphold top-down mandates. Yet many are willing to champion those changes in which they have both a vested interest and a voice.

To make patient-centered and fully collaborative care a reality, the industry as a whole must advocate for both technology and a new way of thinking about patient care. One important way health IT stakeholders can work toward this end is by clearly outlining how innovations can streamline business operations at the same time that they encourage patient engagement, raise patient satisfaction and enhance the quality of patient care.