Health systems, providers, and patients all benefit from the improved care coordination that comes with clinical integration. Better communication between clinicians across specialties means they can make more informed decisions leading to better outcomes. At the same time, so many hospitals remain siloed, leading many clinicians to keep their heads down to protect their own interests. As healthcare leaders, what can we do to move past this problem?
In my experience, meaningful integration only happens when health systems and physicians work in collaboration. Leaving organizational silos standing is no longer a viable option. Whether or not we are ready to accept it, fee-for-service reimbursement is in its death throes. Hospitals that cling to this outdated model can expect their margins to decline.
Most healthcare administrators realize they must move toward new reimbursement models that reward care coordination despite the barriers to clinical integration. Perhaps the greatest is the challenge of physician engagement. After all, it’s difficult for physicians to thoughtfully innovate within a busy emergency department (ED) or ICU where lives are at stake.
I can relate. Several years ago, I was charged with integrating the emergency, inpatient, and outpatient services across a three-hospital system.
That experience taught me that the highest barriers to physician engagement were cultural. Physicians represent the system’s most direct link to patients but often have few opportunities to share ideas and influence the direction of an organization. This is unfortunate because they are best suited for creating the clinical strategies needed to succeed in value-based reimbursement.
What’s more, physicians are also in an excellent position to drive the cultural change that integration requires. An energized medical staff can fight the fee-for-service mindset by modeling collaboration across specialties, new uses of information technology, and proactive and holistic patient care.
So how can health system leaders align physicians to achieve greater patient and provider satisfaction and improved clinical results?
First, clinical leaders should work to create a culture that embraces and promotes provider-driven innovation. It can be tempting to lead from the top down. But remember that physicians are most influenced by other physicians. By collaborating with aligned physicians, an administrator will be able to achieve more than they ever could alone. And when it comes to disarming resistance to an unpopular initiative, an engaged physician champion can work miracles.
So how do you nurture physician champions?
First, get to know your physicians on a personal level. Make every effort to interact with your medical staff—both formally and informally. This can be as simple as being visible around the hospital, attending medical staff meetings and social events, and holding “listening sessions.”
As you get to know your physicians, pay attention to what motivates them. Often when physicians are disengaged, it’s tempting to throw money at the problem. However, when it comes to building loyalty, addressing the real pain points faced daily by physicians often goes further. This could mean providing administrative support, scribing, education, or leadership opportunities.
Once you’ve gained the trust of your physicians, it’s time to engage them in improving care coordination. Start by working with your physicians to create care pathways for high-risk populations (for example, frequent ED utilizers). Care pathways should be supported by shared metrics (e.g., joint scorecards) and shared incentives that encourage clinicians to work together across specialties.
Finally, recognize that care coordination doesn’t happen in a vacuum. It’s also important to provide your teams with the resources and education they need to succeed. For example, you may need to train your entire medical staff on new coordination tools, technologies, or protocols, like working with navigators and ancillary staff.
Anyone who has ever moved a health system toward clinical integration will tell you it doesn’t happen overnight. But it happens a lot faster when physicians are aligned and supportive of the goal.
In summary, treat integration as a journey rather than a destination. Celebrate forward movement, whether big or small. And never stop asking your medical staff, “How do you think we can take this further?”
Photo: Gerasimov174, Getty Images