In a system that silos information, especially in systems with multiple providers involved in the care of a single patient, patients have poorer outcomes at higher costs. Poor information flow provides an inaccurate picture of the patient’s health, medication, and treatments. Approximately 80 percent of critical medical errors occur during care transitions between providers.
According to a 2019 survey, half of all primary physicians did not receive information about their patients’ treatment from a specialist, including medication changes. Disease specialization provides patients with medical knowledge tailored to treating complex conditions and diseases, but without care coordination and adequate information flow, patients have risk-averse effects. Coordination with urgent care centers, emergency providers, and social workers was also low compared to other countries.
Patients with fragmented care are more likely to have preventable hospitalizations, more likely to have unwanted medication interactions, and less likely to receive clinical best practice care. Fragmented care also increases medical costs significantly due to duplication of testing and medication, increased number of visits, and preventable hospitalizations.
Too often, providers must rely on patients to inform and update them on recent developments in their healthcare. More than fifty percent of patients do not have adequate healthcare literacy to update their physician correctly, and some may have a medical emergency that prevents them from communicating their medical history.
The Efficient Flow of Information is a High Priority
The efficient flow of information between healthcare providers is the only way to ensure that providers have full access to clinical records, test results, and medications, without relying on patient memory or understanding.
Improving information flow can take many forms. Sharing information through electronic health records, effectively tracking referrals and appointments, implementing care coordination and better protocols, and training for documentation and handoffs are critical strategies for improving information flow.
- An unintended consequence of HIPAA was an overtightening of health information due to a fear of violating HIPAA privacy provisions. This information-blocking circumstance led to overly tight procedures that prevented treating physicians from accessing patients’ medical records. The 21st Century Cures Act, addresses information blocking and promotes health information interoperability. Helping staff understand that information sharing is a priority and providing training to empower them to share while staying compliant with HIPAA and the 21st Century Cures Act is one step toward improving the flow of information.
- For many patients, the primary care practices serve as essential care coordinators. Specialists and after-hours care practices should ensure that primary care physician receives complete records on treatments, medications, and follow-up appointments. When providers hand off from one care provider to another, they should provide thorough clinical documentation that includes all essential information. Properly executed handoffs should include the opportunity for questions and answers.
- Enhancing patients’ understanding of their diagnosis, treatment, and medication also improves information flow. Providers can strengthen discharge communication by assessing patient health literacy and engaging in dialogue to ensure patient understanding. The talk-back method, where the clinician asks the patient questions about follow-up care, provides insights about understanding and allows clinicians to correct misunderstandings.
Moving from fragmented to integrated care will improve patient outcomes and reduce costs. Communication and information sharing are the keys to breaking down the silos.
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