Health information technology (HIT) holds enormous promise for improving the coordination of care delivered to high-need patients and producing savings for the U.S. health system. The types of HIT tools available, however, are limited, and obstacles hinder the development of new ones. A research team including The Commonwealth Fund’s Eric C. Schneider, M.D., interviewed experts, government officials, academics, and clinicians to define these obstacles and determine a path forward.
What the Study Found
Researchers identified four main barriers to creating HIT tools for care coordination:
- Lack of clarity around what “coordination” means. Since the issues surrounding coordination of complex care are poorly understood, HIT designers are substantially handicapped when attempting to come up ways to address them. For instance, experts remain divided on the kinds of activities and the types of care providers that should be factored into care coordination initiatives.
- Diverse practice patterns, workflows, and job definitions. There is enormous variation from one practice to the next in terms of team members’ roles, responsibilities, and workflow patterns. Among experts interviewed for the study, there was no consensus on how to meet even basic requirements such as defining the care coordinator’s role.
- Resistance to change. Incorporating new HIT solutions to will involve substantial changes to the processes physician practices have in place. This will require training and an organizational commitment to prioritizing coordination.
- The missing business case. The shift toward accountable care organizations and other newer payment models that provide incentives to coordinate care has been a slow one. At the same time, there is no guarantee that adopting expensive HIT tools and changing up work patterns will pay for themselves, let alone increase practices’ compensation.
These obstacles aside, the researchers did identify five types of HIT tools that help facilitate coordination: care plans, dashboards, patient-relationship managers, event alerts, and referral tracking.
To develop solutions to inadequate coordination in the care of complex patients, HIT developers should engage physicians in the design and functionality of their products.