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more articles by Darlow, Lloyd A , MD  |  author's bio

What is clinical integration

Why is Clinical Integration Good for My Health?

By Lloyd Darlow, MD, FAAFP


Clinical integration is a health care philosophy centered on creating a network of doctors in each community who depend on each other and work cooperatively to improve the health of their patients.

How does clinical integration make health care better?

It forces doctors to look critically at how we practice, finding ways to more efficiently and effectively improve patient care. Participation is voluntary but each physician must agree to work collaboratively with the other professionals in the network on a comprehensive program for each person under their care.

Take, for example, the diabetic patient. Comprehensive care for diabetics requires multiple interactions within the health-care system to address the patient’s needs and slow progression of the disease. Such a plan includes routine visits to a primary-care physician, consulting with a nutritionist, and checking in regularly with eye and foot doctors. In an integrated system, instead of being isolated episodes of care, these are components of a complete program designed to improve the patient’s health. Each physician interacting with the patient is responsible for not only following the program but also sharing all findings with the patient’s other providers. Clinically integrated systems nationally have shown that their patients with chronic diseases like diabetes have lower incidences of blindness, kidney failure and the like, preserving quality of life while keeping health-care costs down.

Are all clinically integrated networks the same?

The clinically integrated network in each community is specifically structured to suit that community. As we strive to establish the first clinically integrated network in Tompkins County, one of our goals is to improve local access to health care. When people have to wait lengthy periods for medical care, they often decide to seek it elsewhere, but when they leave this community for care that is available locally, our physicians can no longer control the quality or cost of the care they receive. Patient care thus becomes fragmented, and timely communication – so crucial in ensuring safety – often breaks down with out-of-town providers; records are rarely shared efficiently, which can result in duplication of diagnostic testing or inadvisable medication prescribing. Cayuga Medical Center is electronically linked with its physician offices, making the flow of vital information easy and fast. This minimizes waste, provides a higher quality of care, and results in better value for our health-care dollars.

Each community is a unique entity, and Ithaca is certainly no exception. Through the Cayuga Area Physicians Alliance, we have a collection of doctors who are second to none in terms of education, quality, and commitment to the health care of Tompkins County. However, in some disciplines we need additional providers to truly improve access to care. We’re confident that our clinically integrated network will help the medical center recruit and retain the numbers of primary care and specialty physicians required to meet the needs of our population and make out-of-town travel for health care largely unnecessary.

How do you measure the best value for our health care dollars?

It starts with a stable, cohesive network of physicians, working together to share patient data, implementing evidence-based practice guidelines adapted for our community, and using the latest technology to measure clinical outcomes. By conducting ongoing peer-reviewed analyses of clinical outcomes, we identify areas where quality can be improved. When quality and safety intersect with efficiency, it equals value for our health care dollar. In the complex world of health care reform, clinical integration is our best chance to continually improve and streamline the care of our patients while addressing the ever-increasing cost of health care for everyone in Tompkins County.

 

Dr. Lloyd Darlow is vice president for clinical integration at Cayuga Medical Center and president of the Cayuga Area Physicians Alliance. He is board certified in family medicine and is in practice with Family Medicine Associates of Ithaca, where he can be reached at 607-277-4341.

 

 

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