Communication: The glue for a functional Accountable Care Organization (ACO)

Imagine your grandmother is hospitalized after suffering a heart attack. To everybody’s relief, she receives state-of-the-art medical care in a top-notch hospital a mere 10 miles from home. On discharge day, she is sent home with a long list of instructions, new medications, and a recommendation she follow up with her primary care doctor within the week.

A few days pass and she notices her feet begin to swell, even a little shortness of breath. She calls her doctor and books an appointment in three days – the soonest her doctor can see her. Not two days later, however, her breathing becomes more labored. Not knowing what to do, she calls 911 for an ambulance trip back to the ER, where she is diagnosed with congestive heart failure, a complicated illness to treat.

What’s the moral of the story? It’s that this situation, while fictitious, has happened and continues to happen to thousands of Americans. And the root cause is much less about a failure of one person’s heart as opposed to the failure of a very procedure-oriented and highly disconnected medical system.

Enter the Accountable Care Organization, or ACO, which is considered by some to be the medical system of choice in the (near) future. In an ACO, the same grandmother is given the same level of hospital care, but this time her primary care doctor is notified upon her release and given a brief synopsis of her hospital course and new medications. Courtesy of a secure communication platform used by physicians and support staff, the hospitalist even receives a “read” notification to ensure the message gets through to the primary care doctor.

The next day the primary care doctor’s office schedules a follow-up for 48 hours later. At the appointment, her doctor notices a slight swelling of the feet, something the untrained eye might miss. Her medication is immediately altered, and a home nursing visit is scheduled for the next day, and three times per week for the next two weeks.

Using the same mobile communication platform as the hospital and family care doctor, the home health nurse sends timely updates about your grandmother’s new vital signs, weight and other changes to her condition. Your grandmother is now able to start an in-home rehabilitation program. Even better, she has avoided a costly return to the hospital and prolonged illness.

With just one mobile message and a single face-to-face visit, the primary care doctor was kept at the center of her care. What’s more, previously unreimbursed costs like the hospitalist and primary care physician providing transitional care from the hospital to home are now billable thanks to new CPT codes, making non-face-to-face patient care financially sustainable for a family practice physician.

The bottom line is that an ACO network must be able to communicate timely to coordinate care across loosely affiliated healthcare organizations if it hopes to ensure optimal patient outcomes and lower healthcare costs for patients and providers alike.

This win-win-win scenario is actually already happening – the hospitals and payers save money by avoiding a readmission, the primary care doctor gets rewarded for good care, and most importantly, the patient is kept healthy. Ironically, the key to this success is deceptively simple: communication.

In my experience, doctors are always motivated to do the right thing for their patients – but without good communication, they are simply not armed with all of the information needed to help their patients.

Solving the problem of poor communication between health care professionals is a huge task, but with solutions like DocbookMD, intuitive, simple steps like bringing hospitalists and primary care doctors together through a trusted, secure communication community can be done today with a few taps on your mobile device.

If communication is the “glue” that can help ACOs operate successfully, then DocbookMD is helping connect disparate healthcare companies like the good old Elmer’s glue we all grew up with in grade school.

DocbookMD, a HIPAA-secure communication solution for physicians, care teams, hospitals and groups. Sign-up for a free 14 day trial.