As incentives increasingly align between physicians and hospitals for value-based care delivery, health system CMOs face an interesting challenge. The last one to two decades witnessed an extraordinary push to hyper-specialization and compartmentalization of care.
Physicians migrated from round-the-clock response to their personal patients to team call coverage models, and patients were handed over to hospitalists when admitted. Drivers for this shift included financial, efficiency, lifestyle and quality factors. Now, risk-based models are aligning incentives for greater care continuity by physicians for their patients both in and out of the hospital. In many ways, CMOs are asking for an old school approach to meet quality and cost goals. Providing innovative tools can help achieve this – systems can engage physicians for greater continuity while protecting lifestyle and workflow preferences, and mobility solutions will play a key role.
In the shift to risk, a key objective for CMOs is to get physicians and hospitals on the same page – where they are both incentivized for quality and cost efficiency goals. But in practice how does that actually work? Inpatient care teams can benefit from the deep knowledge and context held by primary care physicians, but that’s not happening effectively, resulting in care duplications and inefficiencies. Primary care physicians who still maintain responsibility for their admitted patients only see them for a few minutes after office hours, but are disconnected throughout the day. More often, the pendulum has swung in the opposite direction, where inpatient care is turned over to hospitalists who typically don’t have access to rich outpatient data. That’s not the right solution either.
Something is needed to merge the inpatient and outpatient worlds in real time, and mobility is that bridge. If physicians are incentivized for the total cost of a patient, they need the tools to help them achieve that incentive. An effective mobile strategy enables doctors to operate in multiple environments by getting them the data they need when they need it to make critical decisions.
Physicians need to be engaged in the process change early, so that they understand how the technology is enhancing patient care and their workflow. Physicians don’t want to be inundated with data or unnecessary interruptions to their day. They want to just get the right information on the highest-risk patients and be able to make care decisions on the same device that they were notified on. For example, if a primary care physician gets a notification on their phone that a hospitalist is going down a treatment path for a high-risk patient that has not worked in the past, they should be able to alert the hospital care team with key information from the ambulatory record and start coordinating in a fast, efficient way that makes a difference.
That’s when we will start seeing groundbreaking improvements in cost-savings and quality that will allow hospitals to share risk with physicians and payers more effectively. If CMOs want to make an impact today, they need to stop thinking about mobility as something that will happen in the future, and start thinking about how these innovative approaches can improve care pathways and address challenges like physician engagement that are happening now.
Great post. If you’re interested, my coworker just wrote this piece on continuing medical education and mHealth: http://bit.ly/14Oa5pz. What do you think of it?
Glad you enjoyed the post. I read the piece from your link and it completely resonated with me. That’s the only way I’ve managed to keep up with my hefty California CME requirements the past few years. I now do the majority of my CME on my phone in spare moments. We do so much on mobile devices – banking, shopping, communicating, etc. Clearly medical applications will continue to explode.