Integrating Care Coordination

Regardless of your organization’s role in the Medical Neighborhood, coordinating care with and on behalf of your patients becomes increasingly important as we all strive to improve healthcare delivery. Coordination happens at many levels: among systems that share service utilization data, among physicians who sign care compacts, among care coordinators and the maze of community resources available to patients and their families, and among patients and their Medical Neighborhood. 

HealthTeamWorks can help organizations implement systems that promote coordinated care from the physician's office to to the hospital to the home and facilities in between. Our Health Informatics Team works closely with the practice transformation coaches to ensure the creation of appropriate quality reports to measure and monitor performance at many levels, including by individual physician and by aggregated networks.

HealthTeamWorks is well-positioned to enhance care coordination in your organization, whether you need help establishing a care coordinator role as you work toward becoming a PCMH or seek assistance in building ties to community collaborators. We are experienced in convening discussions on physician compacts, coaching and training practice teams in patient-centered care, and developing the care coordinator role in practices.