Survey finds challenges to good care team communication, collaboration

Although the vast majority of clinical and administrative respondents to a population health management survey said improved communication with patients is required for effective population health management, clinicians said they struggle to communicate to coordinate care between themselves and their patients.

The survey of 955 healthcare professionals, including doctors, nurses, case managers and administrators in a variety of settings, was conducted online by Harris Poll and commissioned by PerfectServe.

More than two-thirds (69 percent) of clinicians feel patient care is often delayed while waiting for important information about the patient. Fifty-two percent of clinicians admit they don’t always know the correct care team member to contact in a given situation.

Nearly half (48 percent) of physicians report being frequently contacted erroneously when they’re not caring for the patient in question.

The most common current communication technologies used in optimizing population health management are phone calls (83 percent) and online patient portals (74 percent). Newer and more detailed remote and mobile technologies such as telemedicine (39 percent), remote coordination (36 percent), videoconferencing (36 percent), remote monitoring (32 percent), mobile care team communications (32 percent), and remote consults (31 percent) all lag behind.

Among clinicians, when there is a need to communicate with a physician within the organization around complex or in-depth information or to obtain answers to questions, the EHR is used as the mechanism only 12 percent of the time.

Nearly three in 10 medical professionals (29 percent) are not satisfied with the technology their organization uses for secure communications. Of those who are dissatisfied, that dissatisfaction largely arises from the fact that different members of the community use different technologies (68 percent) and/or that not all team members have access to secure communication technology (55 percent).

PerfectServe commissioned the survey because in working on population health management “many of the discussions we were having were around communications and collaboration between providers,” said the company's CEO Terry Edwards in an interview with Clinical Innovation + Technology. “We were trying to understand the role of clinical communications and collaboration within population health management, particularly the interoperability part of it because that has to do with creating situational awareness around information and getting information to the right provider in a timely manner."

There is a desire for inteoperable communications technology across the continuum. Almost most (88 percent) of the respondents said that mobile health is integral to the effort, Edwards said, only one-third were currently using mobile care team communication technology.

The survey also revealed concern about fragmentation of technology, especially related to secure technologies, he said. “That impedes the ability to make people aware of information that might exist in other systems.”

Fifty-nine percent reported they had experienced delayed patient care while waiting for important information and 76 percent reported delayed transitions to lower cost settings. “I see those things linking to each other because so much of communication between providers are really enabling a communication-driven workflow."

To achieve the strategic insight and direction for improvement that is the basis of population health management, “there are three high-level things we saw need to happen,” he said. First, technology providers, along with buyers and providers, need to really focus on collaborating and bring to market solutions that are required to improve care and ensure that they enhance the workflow of the providers.

Second, is a more aware and educated workforce. Edwards said he was surprised at the number of providers who are not aware of their organizations’ population health strategies. “Going forward over the course of the next year, organizations need to do a better job of increasing awareness.”

Third, providers need to be working together to gain better alignment as to best practice communications to ensure consistency and timeliness of communications. Nurses differed from physicians regarding their preferred communication method and the survey also revealed different preferences among primary care providers and specialists.

Although the communication and collaboration market in healthcare is fragmented, Edwards said there is an opportunity to bring the technology together whether through research and development or mergers and acquisitions or some of both. "It seems clear that there’s a need and an opportunity to unify care team members and the technologies they’re using. Doing that in a way that really enhances workflow will be critical to the transition to population health management and achieving the triple aim."