The need for better coordinated care is almost overwhelming. Of the estimated 400,000 preventable deaths in the US every year, it is estimated 20 percent are caused by lack of information at the point of care, said Humetrix CEO Bettina Experton, and while patients see an average of seven doctors during a hospital visit, only 2 percent of physicians and hospitals who have received EHR incentives are able to send electronic summaries most of the time.
The solution, however, may be sitting in many people's pockets.
Speaking at a Monday afternoon mHealth Summit panel on coordinating care with mobile technologies, Experton said the source for her statistics is the CMS report on Meaningful Use published in October 2014.
Experton and other panelists demonstrated ware for improving care coordination.
Humetrix’s Blue Button app, for instance, renders a 300-page text file with a patient’s medical history into a smartphone that provides a view of patient data, organized around summaries of medications, vital signs and lab results.
[See also: Connecting the dots between providers and innovators.]
Siva Subramanian, vice president of mobile products for Zynx Health, showed off another tool. The company's ZynxCarebook is a network application that connects each member of the care team and allows them to communicate securely through desktop and mobile devices as the patient transitions through stages of care.
Subramanian said solutions like Blue Button and ZynxCarebook are urgently needed.
“Communication failures drive 70 (percent) to 80 percent of errors," he said. He described a typical hospital visit in which a patient will experience as many as 30 to 40 providers, each working in a separate silo of care. During each encounter, the provider is likely to ask the patient what the other providers said because they don’t have an easy method to refer to other provider’s notes.
According to Subramanian, in a study of more than 6,000 patient care transitions over an eight-month period, Zynx reported a 13 percent drop in readmissions, a reduction of one-half-day in average length of stay and an increase in clinician productivity by 60 minutes a day through the use of the ZynxCarebook.
At the Atlantic Managed Services Organization, part of the Optimus Healthcare Partners Accountable Care Organization, the 1,700 physicians in the network are using the Imprivata Cortext secure messaging solution to keep in touch.
“Increased communication is a cornerstone of clinical integration,” said Thomas Kloos, MD, executive director of the Atlantic Managed Services Organization. He described the problem of doctors playing phone tag as they try to reach each other throughout the day in between office visits.
Kloos said the biggest hurdle was getting physicians to change their behavior.
“The challenge was to change the mindset of physicians who were forced to adopt a fee-based approach and asking them to care about patients after they’ve left the office,” he said, and noted that the problem was solved as evidence mounted that the coordination improved patient outcomes.
Subramanian explained that the biggest motivation to improve care coordination stems from policy changes at the federal level, including the carrots and sticks of readmission policies.
“Until that happened there was not a clear reason why the hospital would invest,” Subramanian said. “Why would they continue to care about patients after they left the hospital wasn’t clear.”
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