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Filling the Gaps in Patient Care
pMD care coordination tool

The switch from traditional fee-for-service to the new, value-based care model has been slowly taking shape in health care, leaving practices to figure out how to stay ahead of the changes without taking significant hits to their practice. Specialized care involves referrals from different providers and transitions of care between facilities, which can create gaps in the patient’s care. The average patient over 65 years old sees more than 28 providers! So how will practices successfully coordinate care as patients move between multiple care settings and providers in this new world of reimbursement?

I’ll give you a hint: it doesn’t start with EHRs. EHRs were not designed for care teams to manage patients across multiple transitions of care and enhance the provider-patient relationship. And many EHRs are still resistant to work with external systems, not to mention that about one-fifth of practices are still using paper records. Practices that do have EHRs still revert to paper-based systems when they see patients outside the four walls of their clinic. Whether a physician is rounding at the hospital with a paper printout, or a nurse navigator is using a paper report to track patients, paper isn’t doing the caregiver or the patient any favors. Health information that can save a patient from duplicate procedures, improve the quality of care, or even save a patient’s life, is spread out across different pieces of paper.

Care coordination tools are emerging to fill these transitional gaps in the patient’s care and prevent avoidable readmissions. pMD’s care coordination tool allows caregivers to manage their patients in a more effective way to improve health outcomes, especially for patients with chronic conditions and who are part of a bundled payment or other risk sharing program. Caregivers can record progress notes, manage care plans, add personalized information about their patients, and run robust reports to get ahead of diseases before they require expensive treatments. pMD also connects the care team to the local medical community by allowing caregivers to invite others to the secure texting platform and create an easy-to-access, secure network.

The value-based care model is opening up new opportunities for creative solutions to improve quality of care and reduce health care costs, and pMD is happily taking on the challenge.

If you have any questions or would like to find out more about pMD's suite of products, which includes our MIPS registry, charge capture, secure messaging, and care coordination software and services, please contact pMD.