Rethinking Coordinated Care: A Multidisciplinary Case Conference Approach to Enhancing Communication and Coordination Among Physicians Caring for Complex Patients

11.30.2010  PRESENTER: Sarah Kent, MD, PhD, Physician, General Medicine/Primary Care, BWH MODERATOR: Michael Gustafson, MD, MBA, Senior Vice President for Clinical Excellence, BWH / Faulkner Hospital

Forum Summary

The “Rethinking Coordinated Care” initiative is a project designed to improve the care of medically complicated patients by creating forums in which healthcare providers can discuss shared patients.  Today, healthcare is fragmented and expensive, and more people are living with chronic medical conditions than ever before.  Patients with chronic conditions account for over eighty percent of healthcare costs.  Many patients who see more than one doctor believe that their doctors do not communicate, and they are often correct.  In some settings, one out of every six patients reports receiving contradictory information from healthcare providers.  Payment schemes are changing as payers move away from a fee-for-service model, and this change creates an opportunity to change the way in which care is provided.

As part of the “Rethinking Coordinated Care” initiative, conferences for the care of complex patients are being held at the Fish Center for Women’s Health, an affiliate of Brigham and Women’s Hospital.  So far, theses multidisciplinary conferences have generated positive feedback.  Logistical challenges proved to be surmountable, and doctors felt that the conferences improved communication.  Doctors caring for a patient with complex rheumatologic disease, for example, were able to coordinate MRI scans.  The new system also allows doctors to incorporate multiple blood tests into one blood draw, and it allows patients to see multiple doctors on the same day to reduce transportation costs.  As the number of conferences increases, the leaders of the initiative will measure its impact on patient satisfaction, care quality, and financial cost.

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