Patient, Primary Care Provider, and Specialist Perspectives on Specialty Care Coordination in an Integrated Health Care System.

Vimalananda VG, Dvorin K, Fincke BG, Tardiff N, Bokhour BG. Patient, Primary Care Provider, and Specialist Perspectives on Specialty Care Coordination in an Integrated Health Care System. The Journal of ambulatory care management. 2018 Jan 1; 41(1):15-24.

Related HSR&D Project(s)

• CDA 15-070 – Measuring and improving specialty care coordination in VA
• IIR 12-346 – Patient-Experienced Integrated Care for Veterans with Multiple Chronic Conditions

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Abstract:

Successful coordination of specialty care requires understanding the perspectives of patients, primary care providers, and specialists-that is, the specialty care "triad." This study used qualitative methods to compare these perspectives in an integrated health care system, using diabetes specialty care as an exemplar. Primary care providers and endocrinologists relied on interclinician relationships to coordinate care. Clinicians rarely included patients or other staff in their conceptualization of specialty care coordination. Patients often assumed responsibility for specialty care coordination but struggled to succeed. We identified several opportunities to improve coordination across the triad. In an integrated medical system, the shared organizational structure can facilitate these efforts.