During a July webinar hosted by Becker’s Hospital Review and sponsored by PointClickCare, leaders from Collective Medical, a PointClickCare company, discussed their organization’s partnerships with health plans and hospitals and explained how these organizations are driving success with care insights and relevant information at every step of the patient journey:
- Amanda Hane, Manager, Customer Success
- Jenna Moody, Director, Customer Success
- Nicole Sunder, Director, Health Plan Solution Design
Four key takeaways:
1. Care collaboration is the foundation of shared success. Collective Medical’s client success team uses a matrixed organization to support the free flow of real-time data across payers and providers. “Many members of our team have experience in the same roles as our customers. We can identify the workflows that we’ve seen work very well,” Amanda Hane said. Collective Medical creates care collaboration tools, as well as the infrastructure needed to share information bi-directionally across different entities. “Our goal is to place the right insights at the right time in front of every stakeholder along a patient’s journey to inform and encourage the right action,” Jenna Moody said. “We empower organizations across the entire care continuum to focus, engage and collaborate.”
2. Effective collaboration programs depend on visibility, optimization and coordination. When Collective Medical designs health plan programs, the team focuses first on visibility into member activity. Real-time admit, discharge, transfer messages expedite notifications about admissions and streamline utilization management processes. Effective programs focus on optimization of care, utilization, quality and coding. “We use network information to identify when someone falls into a HEDIS denominator, if there’s an opportunity to impact star ratings or whether coding gaps must be addressed to provide a more holistic view of the member or patient,” Nicole Sunder said.
3. When care insights are shared, health outcomes improve. Care insights provide details from healthcare providers and often contain actionable information, including how to avoid readmissions. Examples of care insights include information that can influence care in the emergency department, provider relationships for follow-up care, classes of medications that may be ineffective, patient contact preferences and more.
4. Clinical collaboration groups leverage processes and resources to engage providers, managed care organizations and members. CCGs identify populations of focus, share data on those populations and set goals in a regional context. Work groups break down silos, evaluate processes and measure progress. “CCGs drive toward win-win-win outcomes,” said Sunder. “Their goals might be ED diversion, reducing readmission risks or addressing social determinants of health. Collective Medical can adjust the collaboration dial for these groups and ensure that everyone gets the information they need to be effective.”
Stakeholders throughout the care continuum need tools, information and insights to support more productive conversations and greater alignment with patient care plans. Facilitating that information exchange, however, isn’t always easy. As Moody noted, “If there isn’t a shared EHR, information has to find a different path. Collective Medical’s platform captures information and care insights to support players throughout the patient journey.”
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