When specialty providers think about longitudinal care—efforts to meet patients’ whole-health needs at each point in their care journey—their first thought is typically the resources required to pull it off. Ideally, longitudinal care examines not just the impact of a diagnosis on the individual, but also the risk for family members (e.g., “Should a cancer patient’s children undergo gene testing?”). It also seeks to answer: “What matters most to the patient?” Digging into these questions takes time and manpower.

Data is available in many forms from many sources, but it needs to be collected and organized in a way that turns it into actionable information. That is the challenge and the opportunity for healthcare IT and providers: to collaboratively assemble the right, easy-to-use systems for data collection and analysis while maximizing benefits and minimizing the headaches of manual processes.

Accurately and consistently assessing patient acuity is important not only for workload balancing, but also for placing patients in the correct level of care. In many instances, low-acuity patients receive treatment in high-acuity hospitals, even though they would be better placed in another facility. Utilization review research has shown that many acute hospital bed days do not meet the criteria for an acute level of care, and a significant portion of medical emergency admissions remain in the hospital for non-acute care.

Oklahoma State University teamed up with Crucial Learning to address interpersonal communication among its medical students in three main categories: assumptions of incompetence, poor teamwork, and disrespect. The effort focused on the seven most crucial conversations in healthcare, with the goal of empowering staff to better communicate with each other.

Currently, many health plan members are not achieving their optimal health outcomes, and this can be manifested by missed preventive care opportunities, less activation in their care, or rating health plans poorly on quality measurement surveys. For health plans and their provider partners, now is the time to shift this dynamic by devoting greater resources toward improving health equity, in combination with other calls for change, including equity initiatives espoused by the Centers for Medicare and Medicaid Services and new accreditations offered by the NCQA.