Health IT not meeting practices’ care coordination needs

A new study published in the Annals of Family Medicine shows that healthcare information technology is not helping providers with the aspects of care coordination they need most.

Greater use of information technology (IT) is often seen as the key to improving patient care coordination, and is one of the main goals of the proposed requirements for stage three of the government’s meaningful use (MU) program. But a new study finds that health technology is not helping providers with the aspects of care coordination they value most.

Researchers surveyed clinicians at 350 primary care practices and community clinics that had attained patient-centered medical home recognition and were participating in the MU program to find out:

how frequently they use electronic systems to address the proposed MU3 care coordination objectives,

how important they think IT is in supporting care coordination, and

what organizational and contextual factors facilitate using health IT for care coordination

The results showed that while 78% of respondents said that getting timely notification of patient hospital admissions or discharges or patient deaths was very important, fewer than half-48.7%-were actually using health IT systems to get the information. Conversely, 77% of practices use health IT to support providing clinical summaries to patients, but only 47.7% of respondents ranked that activity as very important.

The study also found that practices are less likely to use health IT to perform any of the 10 care coordination activities included in the original MU3 objectives than they are to use some other method. For example, while 90% said they routinely respond to requests for information from a clinician receiving a referral, only 54% routinely do so using health IT. Similarly, 69.4% say they provide comprehensive medical summaries for each site transition or referral, but only 45.4% routinely use health IT for that purpose.

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“Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent,” the authors note.

Another significant finding was a positive association between greater use of health IT, the assigning of care coordination responsibilities to a nonclinician, and the practice’s capacity for systematic change. “Dedicating staff to care coordination will require additional resources for many practices,” the authors note. Consequently, they say, reimbursement approaches that extend beyond face-to-face care, such as Medicare’s new chronic care management billing codes, are critical to improving care coordination.

The study, “Health IT-Enabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians,” appears in the May/June issue of the Annals of Family Medicine.