Healthcare is changing to a new model, and the information model must change with it. Traditional clinical decision support “point solutions” in an acute setting are inadequate to improve quality, reduce costs, and positively impact the patient experience: what the care system needs is care guidance across the entire patient journey. By Gregory Dorn, MD, MPH, EVP, Hearst Business Media
By Gregory Dorn, MD, MPH, EVP, Hearst Business Media
Healthcare is changing to a new model, and the information model must change with it. Traditional clinical decision support “point solutions” in an acute setting are inadequate to improve quality, reduce costs, and positively impact the patient experience: what the care system needs is care guidance across the entire patient journey.
Care guidance puts vital information into the hands of everyone who touches a patient's health journey – whether they are planning care, delivering care, paying for care, or receiving care. Along a person’s health journey, there are moments where decisions are made and actions are taken that dramatically affect the patient’s health outcome. For instance, for a 75-year-old with heart failure in the setting of fluid volume overload, there are a series of critical moments in her care that not only contribute to her recovery from the acute episode, but which can ultimately help her learn to manage her condition more effectively.
First, the hospital and health plan must have guidance that enables proper case communication to determine appropriate admission in a timely way. During her hospital stay, the physicians, nurses, and case managers should have a clear plan for what should happen each day of her stay, with clear benchmarks for knowing when she is sufficiently recovered to be safely discharged from the hospital.
Next, the nurse, pharmacist, and physician should have the necessary information in hand to ensure the patient has no duplicate therapies in her discharge medications. This transition out of the hospital into post-acute care is important both for the immediate safety of the patient, and for her understanding of her medication regimen going forward.
Finally, the home health nurse should have access to care guidance during the visit that helps reinforce to the patient how to take her medications, how to monitor her symptoms, and how to know when it is time to see her nurse practitioner or physician.
Throughout this journey, a number of people have a hand in ensuring the patient receives optimal care for the best possible outcome. It is vital for these individuals to have an understanding of the patient’s situation, know what to do, and be able to execute it. For this reason, information must be provided to them in a format that makes sense for their professional capacity and workflow, such that they are guided to the optimal course of care. And, the information fueling these actions should translate and interoperate across the tools they are using to accomplish the care. Vital, evidence-based information across the patient’s journey is what makes care guidance more powerful than traditional clinical decision support.
Care guidance is dynamic and takes into account the complexities of care, and uses intelligent technology to put knowledge into the workflow. Reaching across the patient journey, care guidance provides vital information for those critical moments in a patient's journey, from the decision to admit to the hospital, to the interventions given, to the medication ordered and reconciled, to the transitions to the post-acute setting, to the care given in the home. Care guidance has the power to manage a person's health journey longitudinally so that they attain an optimal outcome.
About the Author
Gregory Dorn, MD, MPH, is executive vice president of Hearst Business Media, where he oversees Hearst Health, which includes FDB (First Databank), Zynx Health, MCG (formerly Milliman Care Guidelines) and Homecare Homebase as well as Hearst Health Ventures and the Hearst Health Innovation Lab. Dr. Dorn’s expertise is in pioneering evidence-based health IT solutions that enable optimal patient outcomes and optimal efficiency. He is a co-inventor of two patented healthcare software technologies.
