- With the transition to value-based care,
healthcare providers are facing new challenges
to meet specific performance metrics
and bring value to the care they provide.
They're turning to integrated care coordination
as a holistic solution to answer these challenges.
But what exactly does that entail?
In this video
we're going to discuss care coordination
and walk through its four components so
that you can get a better understanding
of how it can improve the value based care that you provide.
(upbeat music)
Hey, this is Dan from ThoroughCare.
At ThoroughCare, we've assisted clinics
and physician practices across the United States.
As they transition to value based care
through an overall focus on care coordination.
Care coordination offers a broad response
to the challenges inherent to value based care.
We're going to discuss four core features
of care coordination to give you an understanding
of its goals and some of its practical applications
for you and your patients.
But first, let's talk a little
about what care coordination is.
Care coordination is a means to help engage your patients
and streamline their care activities.
It involves organizing your patient's various needs
as they go between multiple providers.
The overall goal
of care coordination is to enable a more holistic
personalized approach to healthcare
while reducing costs and negative outcomes
through increased efficiency.
Care coordination consists of four core components.
As we see them.
The first component is a holistic understanding
of a patient's health needs.
To provide effective care coordination,
you'll need thorough information
about your patient's conditions, health goals
and the interventions or activities they're undertaking.
All coordination efforts will be based
on information, which makes this an opportunity to
tailor your patient's care experience.
A patient-centered care plan can help gather
all pertinent health information.
A care plan allows you to assess a patient's priorities
and then personalize treatment
by having a patient answer a series of questions
and provide medical history through a simple assessment.
The result is a concise report that helps isolate
a patient's primary concerns or goals.
A patient centered care plan is ultimately the backbone
of integrated coordinated care.
The second component is streamlined access
to care services and providers.
Once a care plan is established
it will help guide the next best actions
and streamline access to care services and providers.
Services will vary based on patient needs
but ideally access to specific programs
or specialists should be streamlined.
A patient-centered care plan can help focus specific care
goals and promote preventive health program participation.
In doing so care coordination should promote a continuum
of care outside of practice office
or hospital and into the home.
One such home health solution is remote patient monitoring
or RPM.
This is a value based care program that enables
remote vital capture through various digital devices.
This program can benefit a patient's health
by capturing patient data in real time.
Providers can then analyze this information
to help inform targeted interventions or care decisions.
RPM and other preventive care programs work
with and support the core objectives of care coordination.
These programs can inform a personalized care experience
while helping to improve efficiency
for both the practice and the patient.
The third component is concise,
actionable information to support patient engagement.
Patient engagement is a key performance metric
for value-based care
and it's an integral part of care coordination.
Engaged patients are more likely to track their progress
and maintain their treatments
which can lead to improved health outcomes
especially for chronic disease management.
As a provider, you are now tasked
with making care services more transparent, more useful
and ultimately more valuable for your patients.
Communicating clear, useful information is one way to do so.
Including information about care interventions,
tasks and medications.
This invites your patients into the overall process
while ensuring you and those you serve are on the same page.
It builds trust and it promotes efficiency.
It can encourage additional effort
from your patient as well as reduced potential confusion.
Some providers utilize mobile patient apps to
engage and inform.
Whereas other practices rely
on care managers to conduct direct outreach
by phone or through digital chat tools.
The fourth and last component is strong communication
to help coordinate care transitions.
Care coordination aims to support a continuum of care.
This can encompass primary, acute
and long-term health services that occur
in various settings, whether in a hospital, your office
or even the patient's home.
No matter where a patient is in the continuum of care
care coordination helps to ensure quality, efficacy
and efficiency throughout their care.
This can support improved outcomes while reducing cost
which are key aims of value-based care.
One way that you can apply the concepts to
drive care coordination is another program
called transitional care management or TCM
as we'll refer it to.
The program places emphasis on a strict timeline
in which you or your care team are expected
to inform and connect with patients
by specific follow updates,
as well as coordinating services
between providers and specialists.
Strong communication enables
effective coordination and engagement.
So those are the four core elements of care coordination.
And as you can see, care coordination shows promise
in addressing the goals of value-based care.
It's most effective to implement care coordination
with actual programs
and services that incorporate the four components
that we've detailed, including programs that we mentioned
in this video, as well as other value based care programs
like chronic care management.
If you'd like to learn more about these programs
watch the videos on our channel
or visit our learning center
or you can find out more information
about these programs as well as care coordination.
If you're interested in how a care coordination
software solution can help you to implement these solutions,
contact us at the link below.
A ThoroughCare rep can answer any of your questions.
If you liked this video,
be sure to like it below and subscribe.
Thanks for watching.
Bye.