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Care Coordination and the Role of the Patient

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Care coordination is a primary focus of healthcare organizations these days.  There is an urgent need to better coordinate care as a patient moves from provider to provider and service line to service line. Poor coordination is one of the fundamental causes of diminished safety, increasing costs, and less than stellar patient satisfaction scores.  In fact, care coordination is arguably the basis of Patient-Centered Medical Homes, Accountable Care Organizations, and the long-standing Managed Care Organization.

Having providers work in partnership with patients is a key factor in achieving true care coordination. What this means is that patients themselves – directly or through their trusted advocates – need to be directly engaged in the process as a partner in their care; in other words, patients need to be truly activated.

This represents an opportunity for provider organizations because what resource has a more vested interest in improving outcomes with the greatest efficiency than the patient?  Oh, and the resource costs nothing!  Furthermore, the resource has already established a team of informal caregivers of family, friends, and advocates they trust and rely upon to help them, whose services are also free (at least to the healthcare delivery organization).  Why not take advantage of that?

This is the foundation of a people-centered model of health, and it is being proven to improve outcomes and lower costs through controlled clinical studies in multiple locations.  Early data from Beth Israel Deaconess Medical Center demonstrates this works, and can – dare I say, should – be the basis of any trans-formative effort in healthcare delivery.

So how is your organization embracing this new opportunity?