Post date: Mar 28, 2012 1:29:17 PM
The Journal of the American Board of Family Medicine published in its March-April 2012 issue a mixed method study on care coordination. The authors concluded:
" We demonstrate that the difficulties inherent in collaborative care are independent of the patient population being cared for. Regardless of the patient population and sector of health care, developing collaborative relationships and learning to work collaboratively is difficult and takes time. What many of these teams need is ongoing support and education about how to make these collaborative care practices work."
The real value of this care coordination initiative was that coordination tasks were transferred from family physicians (FP) to nurse practitioners (NP). This transfer and time-savings to FPs took place once trust was established among members of the team. The authors point out that the contributions of various actors were not expected (e.g., pharmacist and NPs).
Interestingly, the EMR contributed little to care coordination. The EMR had been in place for four years but the electronic "To Do" note did not offer a means of adjusting care plans (scanned into system) so current information was not available. Taken together (roles of team members and impact of EMR), this suggests that future EMR/EHR designs should be more chart-based (i.e., coordination artifact) rather than role-based as currently done.
Source:
Legault, F., Humbert, J., Amos, S., Hogg, W., Ward, N., Dahrouge, S. & Ziebell, L. (2012) 'Difficulties Encountered in Collaborative Care: Logistics Trumps Desire', The Journal of the American Board of Family Medicine, Vol. 25, No. 2, pp. 168-176.