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Clinical integration knowledge hub

Learn about the importance of implementing a successful clinical integration strategy, along with some obstacles to avoid along the way.

Advances in health care technology

At the heart of effective clinical integration is health care technology. An effective integrated health care delivery system must be able to manage a vast network of information—collecting, maintaining and providing appropriate access to administrative, clinical and financial data—in order to monitor quality and costs of care.

Health care technology has been evolving to meet these new standards and requirements. Today, health care leaders can look to a variety of health information technology (HIT) tools and platforms to support effective clinical integration and payment reform efforts.

The financial incentives provided by the Centers for Medicare & Medicaid Services (CMS) for the “meaningful use” of EMR and health care technology has provided further reliance on clinical integration efforts, since many independent physicians may be challenged to qualify for these incentives without the involvement of a hospital or health system.

The right HIT platform will support those processes and behaviors necessary for clinical integration, including:

  • Standardization of clinical care: Deliver providers the right protocol data from clinical care guidelines at the point of care, with embedded controls that maximize adherence to these protocols.
  • Care management: Ensure that system-wide data can identify high-risk patients and establish standard protocols and processes for outreach to these patients. Care managers should follow care protocols and support caregivers by alerting them to gaps in care and reduce overutilization of services.
  • Shared measurement: Develop and implement shared clinical quality and integration measures across the network, emphasizing adherence to care guidelines and the delivery of quality care.
  • Workflow optimization: Adopt tools that standardize workflow (and which can be continually updated and innovated) to ensure the right information is captured, the right decisions are considered, and the right recipients get the information they need throughout the system.
  • Clinical integration compliance: Ensure that all stakeholders participate and comply with clinical integration through participation requirements, credentialing criteria, provider education, provider report cards and other trainings.

Ultimately, clinical integration relies on tools and solutions that are flexible, affordable, and provide appropriate access to patient data across various clinical settings, EHRs, and affiliates. Ideally, health care technology should support a continuous process of alignment across the care continuum, bringing the right information tot he right person at the right time, and prompting appropriate care events.

Of course, there are drawbacks to certain HIT options. Some systems require substantial upfront and ongoing costs without a clear return on investment. Others may not support the interoperability necessary for secure, easy, rapid information exchange among different systems. When selecting the right HIT option, it’s important to consider not just the ease of information exchange, but the depth and quality of the information available to providers at the point of care, and how nimble the healthcare technology can be when updates are necessary.

For health system leaders selecting the right HIT to help drive, support and encourage clinical integration, there’s plenty to consider. For the physician, health care technology should help facilitate the practice of medicine by providing access to relevant information for effective decision-making. From an organizational perspective, health care IT should provide clear, actionable insight into financial, clinical and operational measures—all to support better care, lower costs, participation in payment reform and other health care reform initiatives, and an improved patient experience.

A good health care technology solution enables continuous innovation and flexibility as providers’ domains of influence and clinical trading partners rapidly evolve.

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