Amanda Carbonneau's Profile
This is certainly the direction I believe more and more primary care practices will continue to move towards as the ability to identify high-risk co morbid medical and behavioral health issues will drive costs down so they can be addressed in this setting and not a more costly one downstream. Because PCPs have not been previously tasked with delivering this care, I can see how there are real financial burdens to increasing training, staff, practice space, and risk in caring for and treating these patients. There are also a number of digital and third party solutions that working to provide support both to primary care practices as well as ER discharges to support patients with co-morbidity using a number of different supports (diagnostic tools, telemedicine, case management, psychologist/psychiatrist referral networks). These solutions can take the risk/burden off of the provider while helping them save costs in the long term.
Since we are brought in to deliver non-clinical care to patients (oncology, gerontology, primary care, transplant, ob/gyn) we see patients turning to us for information on these things far too often, and generally in a state of confusion. There have been a number of cases when patients have been discharged without this information and have no place to turn. Although we are a safety net, what we really see a need for is helping make this a part of the conversation before it becomes too late or too obvious because it also then means the family is educated and able to make a decision vs. feeling trapped in an isolating/scary situation. In terms of integrating these services further into a practice, I think utilizing existing resources and supports outside of MD referrals, navigators, social workers, nurses who may see these concerns pop-up before a medical intervention is needed is also important in smoothing these transitions of care.
From my perspective, patient experience and staff satisfaction are inextricably linked – if a nurse/md/social worker feels their work environment and own satisfaction is a 2/5, how can we then expect them to turn around and deliver a 5/5 experience to their patient across a number of dimensions whether that is “softer skills” or the technical aspects of the patient plan. Often times staff understand their own environments and patients better than anyone else, and many are already implementing informal procedures to make their lives easier (satisfaction/experience) and deliver better care.
I think above all use, for technology to be successful in hospital settings and even adjacent settings of care delivery, the providers need to be engaged in the development/implementation of the solutions itself. Even though it does take time away from caring for/spending face time with patients in the short-term, in the long run it means that products are being developed with the stakeholder themselves. I think this can be done successfully both with internal innovation hubs, as well as with third party vendors who have appropriately engaged physicians champions and included them in R&D process to make sure a solution is created that is truly trying to address a problem at hand. However to date, most frustrations come from turnkey solutions being handed down from administration which can cause frustration and confusion as to who/what/how a technology is supposed to address.