The healthcare system has a disjointed reputation. Surveys have found that only fifty percent of patients have good patient care coordination. Recently, there’s been a push to improve health logistics. Just like FedEx works to deliver packages to the right place at the right time, hospitals and health systems are working to give patients the shortest path to better health.
Disorganized care leads to wasted time and money. Patients and professionals are asking questions: Why did two medical facilities perform duplicate tests? Why doesn’t my new doctor have access to my previous health records? Why are two case managers working with the same individual? This article will explain how mobile integrated healthcare-community paramedicine (MIH-CP) can improve patient care coordination.
MIH-CP programs may be the missing link between the patients and their providers. Often, the community paramedic works as an extension of the primary care physician (PCP), acting as a liaison between multiple facilities.
Paramedics can act like the “cell tower” for patients, answering their questions about chronic treatment decisions while transferring information between providers. As a result, community paramedicine teams have a significant impact on improving patient care coordination.
Let’s start by remembering what happens when patient care coordination breaks down.
Consequences of Bad Patient Care Coordination
We’ll look at patient care coordination on a small scale and a large scale for our two examples. But, as you’ll see – without coordination – patient care breaks down on multiple levels.
Here are some of the downsides to failed patient care communication:
- Wasted time. Untreated chronic illness can have a devastating effect on a patient. Patients who are not or cannot receive chronic care management will call 911 and end up in the ER. Community Paramedicine teams have proven to be a great solution to chronic care management and patient monitoring.
- Lost money. Lapses in patient care coordination can slowly eat away at budgets. Hospitals, EMS, long-term care institutions – if anyone wastes time and resources, it will bite everyone.
- Unsatisfied patients and staff. Patients and staff want to believe they are doing the best for themselves and their patients – wasted resources and disorganized care isn’t part of the plan.
Now, let’s look at several examples of patient care coordination. Then, we can look at who should be spearheading this movement and how community paramedics can help.
Two Types of Patient Care Coordination
Patient care coordination, as defined by the AAACN: is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services.
How this “deliberate organization” looks has two main categories:
- Small-scale coordination. No less critical – however, it’s usually coordination within one or two organizations—for example, an ambulance and an emergency department.
- Large-scale coordination. Patient care coordination between multiple institutions.
In the following two sections, we’ll explain how these relate to each other and how MIH-CP can improve them through the philosophies and tools of community paramedics.
Example of Small-Scale Patient Care Coordination
A community paramedic is assessing a patient who complains of pain in the abdomen. The patient states they just had abdominal surgery two weeks ago, and their physician hasn’t cleared them for normal activity.
The community paramedic must decide: should they transport the patient forty-five minutes to the hospital where the patient had their surgery? Or should they transport the patient to their local ER five minutes away? Maybe it is something completely unrelated to the surgery.
Community paramedics may be able to coordinate with the hospital and offer telehealth to the patient before a transport happens.
Many might say off the bat, transport to the surgery center – this isn’t wrong, but more information would be helpful. For example, the community paramedic could contact that facility and see if the surgeon is working that day.
If the surgeon is working, it might be worth it to transport the patient the extra distance. However, if that physician isn’t working, it may be prudent to transport that patient to the local emergency department.
This is a small-scale example, but coordination can significantly improve seemingly minute daily decisions.
MIH-CP and Large-Scale Patient Care Coordination
Coordination and integration between multiple institutions also improve large-scale decisions. Below, we’ll highlight another example.
A patient needs to be placed in a nursing home for a few months. However, the patient has also recently suffered a heart attack and requires monthly checkups with their cardiologist.
The team coordinating the patient’s housing situation jumps on the first chance to place the patient in a skilled facility. However, there’s a problem – the facility is two hours away from the cardiologist’s office.
Since there was no communication between the team placing the patient, the primary care physician, and the cardiologist, now the patient needs to make an expensive ambulance trip every month for a checkup.
Providers could have avoided this burden if the cardiologist had been aware that the patient needed additional living care.
Situations like this arise all the time. However, they go unnoticed without good patient care coordination, and everybody suffers.
Who Should Spearhead Patient Care Coordination?
Who is responsible for directing good patient care coordination? While there are no more or less critical medical providers, some medical providers will know their patients better. For this reason, the patient’s primary care physician is typically the most appropriate person to handle patient care coordination.
They can work with their nursing staff and their community paramedic partners to consider the patient’s entire health picture before a significant treatment decision.
However, exemplary patient care coordination is a function of teamwork across institutions – not one person’s efforts.
For example, if a primary care physician and a cardiologist have access to the same patient information, they can discuss reasonable solutions for their shared patient.
So how does MIH-CP fit into the equation? Let’s find out.
How Can Community Paramedicine Improve Patient Care Coordination?
Community paramedics are a pivotal cog in patient care coordination. They work closely with primary care physicians, and they are the eyes and ears of the patient’s environment.
Here are several reasons why MIH-CP improves patient care:
- Home evaluations. Some patients may not follow doctors’ orders when subject to certain living situations. For example, if a doctor tells a patient they need daily exercise, but the patient has no ramps to walk outside, community paramedics can coordinate a team to correct the issue.
- Spokesperson. Some patients may not have the ability to communicate their needs. Others might have a disjointed or non-existent family structure. In these cases, the community paramedics can listen to the patient’s needs and become advocates, communicating their desires to other healthcare professionals.
- Transport needs. Many patients don’t have access to reliable transportation. A dedicated community paramedicine unit may coordinate transportation for patients to non-emergency locations, like urgent care or a rehabilitation center. CP units can make sure patients get to their appointments and secure the care they need.
Here is the big question: How?
How can non-connected health programs work together to achieve transparency and integration without compromising patients’ health or privacy?
The following section will discuss some of the critical pieces to successful patient care coordination.
Good Integration is the Key to Patient Care Coordination
There are many healthcare organizations – how in the world do we bring them all together to deliver unified, coordinated patient care? Well, it’s not an easy task, and there’s no reason to pretend there is an easy solution.
However, groups are taking steps to make things better for patients. Once you start rolling the snowball of coordination and integration, the whole movement becomes more manageable.
Here’s how you achieve integration:
- Identify the need. Is there an area of community health that creates a win-win for the two departments? Here’s an example. Community mental health professionals and police departments have partnered, reducing the number of patients encountered by law enforcement and giving mental health professionals an easier treatment path.
- Implement a roadmap. Even if everyone is on the same team, nothing will get done if health professionals don’t understand each other. Documentation and safe sharing of data and patient information give healthcare professionals the ability to work with MIH-CP. Together, reading the same patient information, they can come to a unified treatment plan.
- Julota offers software for better care coordination. In addition, Julota offers software for better patient documentation and safe data sharing. Julota is cloud-based, so no one needs to change their in-house software.
MIH-CP will improve patient care coordination by identifying everyday needs, providing a clear roadmap, and using the right information platform.
Key Takeaway on MIH-CP and Patient Care Coordination
MIH-CP is a growing and dynamic branch of healthcare. All around the world, health systems see the value MIH-CP holds in better patient care coordination.
By using tools like Julota to handle your MIH-CP program, you will reap the benefits of integrated care. What are these benefits? It means reducing waste and growing branches toward better funding for EMS departments.
For hospitals, it means reducing readmission rates and avoiding penalties from Medicaid and clogged ERs. And, for the community, it means that real help is always just around the corner.
Contact Julota now to learn more. We would love to talk with you and offer a free demonstration of our intuitive software.