Can't We Just Talk to Each Other? Advancing Clinical Information Systems to Support Integrated Care

­­­­­­­­­­­­­Historically, Clinical Information Systems (CIS) have been designed for use in single-provider settings.  This presentation shows how the functionality of CIS can be leveraged to support the complexity of integrating and coordinating services across multiple organizations. 

No single system-of-care fully meets the needs of individuals with complex and co-occurring health, mental health or substance-use disorders. Person centered care is enhanced when providers work together collaboratively. A critical tool to manage this coordinated, person-centered care is a CIS. CIS are products, such as registries and other population health management tools, which provide greater clinical functionality when compared to electronic health records (EHR). A well-designed CIS enables provider organizations to improve processes and ultimately, outcomes for individuals, cohorts and populations of patients. CIS support improved communication and real-time interactions with health-data between providers, payers, and patients. As such, they are quality-improvement tools and provide the infrastructure necessary to document and track improvements in population health and patient experience, while reducing the system fragmentation that leads to poor care quality and higher-costs. 

This presentation will engage leaders and users of provider and payer organizations in the practical benefits of incorporating CIS into their organizations; advance the use of CIS for care coordination and integration; and offer recommendations for critical CIS functionality and core data elements to be collected and tracked. Findings are based on the experience and outcomes of 10 multi-sector teams comprised of health and behavioral health providers and health plans that participated in Quality Improvement Collaboratives.