The future of coordination is smart coordination

Abstract

Healthcare delivery models are under intensifying pressure as health systems struggle with various challenges including employee burnout, workforce shortages, equipment scarcities, and outdated facilities. The COVID-19 pandemic has magnified the importance of coordination to secure access to and navigation between health services. By facilitating coordination within and between services, the goal is to guide people quickly to the level of care they need and prevent instances of those receiving too much or too little care or no care at all. Further, the COVID-19 pandemic has promoted the use of telehealth and digital services while continued implementation and utilization of modern technological advances are recommended for various target populations. Technology-enabled or digital innovation is accelerating the healthcare delivery models and ecosystems of tomorrow. The main feature of tomorrow’s healthcare delivery models and ecosystems is that these models and systems are about bringing care to the patient, rather than bringing the patient to care. As health care will become further decentralized, coordination is conditional for people to take advantage of the full range of (new) services. Historical review has shown that ill-coordinated or disjoined health initiatives lead to vertical or stand-alone information and communication technology applications that often result in information fragmentation and, consequently, poor delivery of services. To move into the future, healthcare models and ecosystems will need to become smart. They need to become highly technologically advanced and interconnected. Such transformation requires the participation of all stakeholders. Data sharing among all entities is crucial to ensure that patients receive high-quality healthcare efficiently and conveniently. Similar to change management and changes themselves, the best results are to be expected when as much attention is paid to coordination as to what needs to get coordinated. It is then when coordination becomes smart coordination to enable timely, convenient, and efficient patient and provider experiences. In this issue of the International Journal of Care Coordination, Shook et al. address the question of what tools improve care coordination for children with special health care needs. Their scoping review provides useful insights into the potential of telehealth, online health records, care plans, inpatient discharge protocols, family training, and reminders to address gaps impeding pediatric traumatic brain injury care coordination. The same authors also reviewed scientific literature on child and family outcomes when care coordinators are implemented as an intervention to facilitate long-term management of children with special health care needs. They found that utilization of care coordinators in different forms generally resulted in positive outcomes in terms of healthcare utilization, costs of care, disease status, parent and child quality of life, and healthcare satisfaction and perception of care. Future research is recommended to better understand which form of care coordination best matches specific care needs. By calculating a continuity of care index, Medves et al. studied the association between continuity of care and unplanned health service utilization in persons with a diagnosis of chronic obstructive pulmonary disease (COPD) in a rural health region in Ontario, Canada. A lower use of unplanned health services was observed in the cohort of patients experiencing higher continuity of care. It would, as the authors recommend, indeed be interesting to see whether the new option of virtual care improves continuity of care. The final paper in this issue reports on a qualitative study of the perceptions of Finnish health and social care professionals about client orientation as key principle of health and social care services. Kallio et al. point out that although client orientation occurs between a client and a professional, it can only happen in interprofessional collaboration and if the right regulations and contributory organizational structures run throughout all service provision. It is in this regard that authors report technology could enable and enhance information sharing between professionals so that they can serve their clients better. For this, the information systems used by different organizations need to be compatible to ensure smooth and smart data transfer.