Clinical integration at core of improving healthcare delivery

By George Thomas, Chief Operating OfficerGeorge-Thomas-2013

The American Medical Association describes clinical integration as:

"The means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused." Similarly, one of the principle mandates of the Affordable Care Act is to encourage or promote methodologies for reducing costs, increasing efficiency and enhancing the quality of care."

My interpretation of clinical integration and this mandate is that healthcare providers need to find innovative ways to provide a higher quality of care. Far too often, the news is blanketed with stories of malpractice, mismanagement, or – far worse – news of tragedy that could have been prevented.

While Methodist Healthcare Ministries of South Texas, Inc.'s clinics (Wesley Health & Wellness Center; Bishop Ernest T. Dixon, Jr. Clinic; and School Based Health Centers in Schertz and Marion) are not accredited by The Joint Commission – a leader in accrediting and certifying health care organizations in the United States – we do abide by a very strict and well-formulated set of standards in order to provide high quality care to low-income families in South Texas.

The American Medical Association understands the value of clinical integration, and the Affordable Care Act specifically addresses the need for improvements in the delivery of care. We at Methodist Healthcare Ministries, too, must look at ways to improve our operations.

It reminds me of the 'pot roast story' many of us have heard: One day after school a young girl noticed that her mom was cutting off the ends of a pot roast before putting it in the oven to cook for dinner. She had seen her mom do this many times before but had never asked her why. So this time she asked and her mom replied, "I don't know why I cut the ends off, but it's what my mom always did." So the young girl called her grandmother on the phone and asked, "Grandma why do you cut the ends off the pot roast before cooking it?" Her grandmother replied, "I don't know. That's just the way my mom always cooked it." Undeterred, the girl called her great grandmother and asked her the same question – why did you cut the ends off the pot roast before cooking it? She said, "When I was first married we had a very small oven, and the pot roast didn't fit in the oven unless I cut the ends off."

I hold this story very close to me. I want to always question our practices: Are we being good stewards of our resources? Are we looking for innovations to improve our operations? Do we have a safe environment for our patients? Are we providing quality care?

Far too often, health care providers practice in silos. They lack meaningful connections and their information exchanges with other health care entities or providers is limited. Without coordination, patients are more likely to receive duplicative diagnostic tests, have adverse prescription drug interactions and get conflicting care plans.

Clinical integration is a continuous process of alignment across the care continuum that supports the Triple Aim of health care: Improving quality of care; reducing or controlling the cost of care; and improving access to care and the overall patient experience.

Knowing that this is a continuous process, I am going to continuously ask questions, measure outcomes and look for improvements because I believe our patients' well-being is of the utmost importance.