Knowledge gaps inhibit health IT development for coordinating complex patients' care.
OBJECTIVE
Complex patients incur a majority of healthcare costs in the United States, in part, because their care is poorly coordinated. We sought to determine the leading edge of health information technology (IT) tools for care coordination of complex patients.


METHODS
Qualitative discussions and technical expert panels.


METHODS
We conducted 35 discussions with clinical leaders, technology and startup executives, government officials, academic researchers, and 2 technical expert panels.


RESULTS
Although health IT has the potential to improve care coordination, the types of IT tools available to clinicians and patients are currently limited. We found substantial barriers to developing technical capabilities for improving care coordination, including lack of knowledge of users' needs; lack of standardized roles, responsibilities, and protocols; required changes in providers' work activities to achieve coordination; and an unclear value proposition.


CONCLUSIONS
We found several innovative tools, but existing efforts suffer from important limitations, including minimal engagement by physicians, lack of standardized definitions of what the tools do, and challenges integrating with clinical workflows. For health IT to facilitate coordination of care for complex patients, user needs and workflows must be better understood and used to guide the development of technology and policy.
RAND Corporation, 20 Park Plaza, Ste 920, Boston, MA 02116. E-mail: rrudin@rand.org.
Robert S
RS
Rudin
Eric C
EC
Schneider
Zachary
Z
Predmore
Courtney A
CA
Gidengil
D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D008490:Medical Informatics / Q000458:organization & administration*; D020380:Needs Assessment; D011785:Quality Assurance, Health Care; D014481:United States