Perioperative care is a critical part of the patient journey. Encompassing the time before, during, and after surgery, perioperative care is a collaborative process that allows clinicians to review a patient’s medical history, assess that person’s surgical risk, respond to adverse events, and begin postoperative recovery.
That process, unfortunately, is frequently slow and inefficient. Steps such as checking the patient’s record, gathering information from the patient, ordering lab tests, and confirming identity and health information are essential, but take time and human effort. In a recent survey, four in five (80%) clinical and IT leaders/directors agree that care coordination is currently a manual, tedious and expensive process.
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The Agency for Healthcare Research and Quality (AHRQ) minces no words in its assessment of the current state of technology in perioperative care. “The information technology (IT) sophistication offered to the perioperative environment does not match the requirements of clinicians, administrators, and even clerical staff,” AHRQ writes. “Integrating even well-designed and workflow-enabled software into the perioperative workflow is not easy.”
Views on workflow automation
The survey reveals a disconnect between clinical leaders and CEOs/IT leaders regarding the use of workflow automation to improve care processes. Nearly two-thirds (63%) of nursing and surgical chiefs agree that automation frees up time for better care, versus only 36% of CEOs and financial chiefs.
Although there is agreement that the key challenges for perioperative care coordination include manually intensive tasks, wasteful activities, one-size-fits-all approach, and lack of visibility, there is no alignment on the answer. More than three quarters (78%) of clinical and IT leaders/directors believe that technologies, such as electronic health records (EHRs), should be able to address these challenges. Nearly one-quarter (23%) of respondents said technology could increase efficiency and compensate for chronic understaffing of nurses and other clinicians.
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While EHRs are a foundational technology in our healthcare system, they often don’t have all the information needed for the level of coordination required for perioperative care. A person’s medical information may be spread across multiple EHRs, making it difficult for providers to form a holistic view of the patient.
Asked about the likelihood of the EHR meeting their objectives for perioperative workflow automation, less than one-quarter (22%) of executives say the EHR is well-positioned to meet their perioperative automation goals. More than three-quarters of respondents say the EHR isn’t meeting their needs now (44%), while 33% say the EHR could meet their needs, but would need substantial additional resources to do so.
Care coordination automation as a priority
Though most survey respondents agree that automation enables clinicians to provide better care, only 33% say they consider it “very important.” Roughly two-thirds view care coordination automation as either “important but not on the priority radar yet” (44%) or “not a priority” (22%). Why is that?
Part of the lack of urgency from CIOs and financial leaders to automate care coordination may be traced to cost-cutting pressures. More than one-half (54%) of executives responding to the survey cite IT budget and staff constraints as barriers to selecting and implementing a care coordination solution. On the clinical side, nursing shortages that increase risk to patients are forcing provider organizations to fill the gap by contracting with expensive independent nurse agencies or “doing more with less.” Both options are increasingly untenable.
These different viewpoints and priorities underscore the growing need for stronger collaboration between CIOs and clinical teams that will give CIOs more visibility into the pain points on the clinical side.
Benefits of automation in perioperative care
Automation in healthcare commonly is deployed on a smaller scale and for well-defined tasks before being applied to broader processes. However, point solutions and incremental adoption are a poor match for the holistic approach needed for effective perioperative care. Coordinating data and actions across multiple systems, in contrast, empowers people using that data to better orchestrate the entire process. For example, intelligent automation can:
- Perform many tasks usually done by nurses, thus creating more time for patient interactions and tasks needing human interaction.
- Consolidate all necessary information from the patient, the EHR, and other systems to prevent unnecessary tests and labs.
- Ensure all steps are completed and that patients are prepared in advance. This reduces late cancellations caused by scheduling conflicts or patients misunderstanding instructions on arrival time requirements or NPO (Nothing by Mouth) instructions regarding presurgical eating and drinking limitations.
- Help identify patients who have concerns so care teams can spend extra time with them, answer questions, and guide them through their preparations.
Sharing data and coordinating actions across multiple systems to orchestrate perioperative care can deliver better patient outcomes and experiences. Research from Michigan State University and Rutgers University shows that orchestrated surgery preparation could save hospitals an average of $1,800 per surgery or $28 million per hospital per year.
Conclusion
It is no longer a question of whether we should use automation for care orchestration. The technology for intelligent automation of care coordination is available now and can help providers reduce costs, generate revenue, and overcome understaffing.
Organizations should seek a care orchestration platform that fully meets the needs of perioperative care and serves as the foundational platform for addressing other workflow challenges, such as primary care, discharge optimization, rehabilitation, and follow-up care.
Care orchestration represents an opportunity for the U.S. healthcare system to reverse the course of current trends. Clinical leaders should advocate aggressively with their finance/operations colleagues to adopt clinical automation technology by emphasizing its financial and operational benefits.
Cindy Gaines, MSN, RN, is the chief clinical transformation officer at Lumeon.
