MedCity Influencers, Artificial Intelligence

The case for automated care coordination

All health systems must do is remove the stigma often associated with automation and let technology do the care coordination grunt work currently overwhelming their valued clinicians.

Traditional care coordination is broken. Registered nurses (RNs), physician assistants (PAs), care managers, physicians, and healthcare administrative personnel are most likely nodding their heads in agreement right now. The current de facto methods for coordinating, verifying, and advancing steps in a patient’s clinical journey are manual, variable, and unscalable, creating a significant challenge for today’s healthcare providers.  Let me explain what I mean by those terms:

Manual – Most care coordination tasks – whether it’s scheduling appointments, following up with patients, or tracking down lab orders – are performed by people. Healthcare providers either hire personnel to perform these activities or alter the roles of existing personnel to satisfy the need. In many cases, the burden of administrative functions is placed on clinical personnel, which takes time away from direct patient care. Care coordination efforts are time-consuming and tedious. Often, coordination tasks are delayed due to the inability of available personnel to complete the required tasks in a timely manner. Also, because of the reliance on human labor, care coordination efforts are extremely expensive.

Variable – Care coordination steps tend to get dispersed among many different care providers – both within the same organization and between sites of care. Individual care teams and sites of care execute the same tasks differently. Not only can this create an inconsistent care experience for patients, but the lack of tight integration between siloed health information systems makes it easy for steps to be overlooked, missed, or uncommunicated. When you consider that patients with multiple chronic conditions can see as many as 14 different physicians annually, the extent of this variability becomes daunting.

Unscalable – Historically, health systems have addressed care coordination demands by throwing more bodies at the problem. In today’s environment of healthcare labor shortages and burnout, additional staff simply isn’t available to dedicate to this effort. Furthermore, financial pressures are causing many health systems to place increased scrutiny on hiring. How is a health system supposed to scale its care coordination efforts when more people aren’t available? The answer is automation.

The inaccurate stigma of automation in patient care

Automation technology isn’t new. In fact, we trust it implicitly in other aspects of our lives – whether it’s automating an electronic bill payment or relying on an airplane’s autopilot navigation system. However, the technology has yet to be heavily adopted in healthcare – particularly when it applies to patient interactions. There is a hesitancy to remove the human touch from medical interactions for fear of weakening the connection between provider and patient or introducing potential risk. The fact is these outcomes are more likely without automation. There is less humanity in continuing to force clinicians to spend countless hours performing mundane and repetitive administrative tasks than there is in automating these functions and allowing clinicians to focus on individualized patient care.

Clinicians are weary of the administrative burden imposed by care coordination, but most don’t know a better alternative is available. Manual execution of these tasks is all they’ve ever known, and these individuals are often too far removed from health system IT departments to realize technology can be applied to deliver much needed relief. It’s time to bridge this divide.

Automated care orchestration provides relief and consistency 

When I talk about automating care coordination processes, I don’t mean a complex artificial intelligence (AI) algorithm that makes predictions based on trained data models. What I’m referring to is much simpler and more elegant. It’s deterministic care orchestration where known information is automatically identified in an EHR or other data source (e.g., the existence or absence of lab results in a patient chart, whether the lab results are normal or abnormal, etc.) and next-best actions are initiated for each patient (e.g., flag a patient for a doctor consultation or automate surgery scheduling).

This type of deterministic care orchestration requires real-time patient data and clinical intelligence to algorithmically identify patient risk and triage these patients appropriately. Automating care coordination steps across large volumes of patients can save clinicians time while proper triage can allow these clinicians to focus on high-risk patients that need more interaction. Automation enables clinicians to operate at the top of their licenses by relieving them from the minutiae of repetitive care coordination tasks.

Automated care orchestration can also help create consistency across different sites of care and ensure all providers are aligned and informed on care coordination updates and responsibilities. This information loop can (and should) extend to patients. For example, by prompting patients to confirm or update information in their patient charts or medication lists, health systems can identify and address new conditions, comorbidities, or medications before they potentially derail a scheduled clinical event, such as surgery.

A select number of innovative healthcare providers are already realizing the measurable benefits automated care orchestration can deliver. For example, one renowned healthcare system is leveraging automation in its preoperative workflows. Historically, this provider required every patient, regardless of overall health or the type of surgery, to have an in-person visit with a clinician. This visit largely consisted of vital sign collection, order scheduling, and lab reviews – steps that have since been automated. Now, 67% of the health system’s patients can bypass this in-person visit, resulting in a 20% reduction in cost per case and increased patient satisfaction.

This is just a small sample of the efficiency that can be realized in all types of care coordination efforts – from care transitions and discharge readiness to chronic disease management. All health systems must do is remove the stigma often associated with automation and let technology do the care coordination grunt work currently overwhelming their valued clinicians.

Greg is the Chief Growth Officer at Lumeon. Greg is passionate about transforming healthcare to deliver better patient and member outcomes. He began his healthcare career at in an academic medical center in Boston and for the more than 35 years since then, has been helping healthcare providers, payers and life sciences companies apply innovative technology to improve clinical and financial operations, with a patient and member-centric approach.

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