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Verbal communication is preferred to coordinate neurological services in a primary care setting (Preprint)


 BACKGROUND
 Poor communication between healthcare providers leads to medical errors, which cost an estimated $19.5 billion annually in the United States and lead to adverse patient outcomes. One model of healthcare delivery that aims to foster collaboration amongst providers is the medical home, whereby patients receive integrated care in a single setting with primary care and consultants working in close collaboration.even in integrated healthcare systems with uniform electronic medical record (EMR) systems, providers face challenges in coordinating primary care with specialty care including neurology.
 
 
 OBJECTIVE
 To investigate how primary care team members prefer to communicate with specialty offices to coordinate care of mutual patients. Primary care team members including physicians, advanced practice professionals (APPs), and office staff in the greater Grand Rapids, Michigan area.
 
 
 METHODS
 A four-item, multiple choice questionnaire was administered to primary care team members. Participants were asked what modality was preferred to coordinate both direct (e.g. treatment plan, diagnostic work-up) and indirect (e.g. scheduling, billing, insurance) patient care matters with specialty practices. We also queried whether primary care team members would be amenable to three different interventions aimed at improving management of patients with neurological conditions in a primary care setting.
 
 
 RESULTS
 174 primary care team members participated in the survey. Communication in person or by telephone are significantly preferred for coordination of both direct and indirect patient care matters (p<0.0001), but did not vary significantly by team member role. Additional preferred modalities include fax, electronic medical record chat (EMR chat), and Doc Halo pager. To improve management of outpatients with neurological conditions, primary care physicians and APPs expressed support for monthly neurologist visits (e.g., “lunch and learn” sessions), neurology telemedicine services, or a complaint-focused order set in the EMR.
 
 
 CONCLUSIONS
 These data suggest that person-to-person interaction is preferred by primary care providers and staff for coordination of specialty care. In sum, these findings support interventions utilizing person-to-person collaboration to improve management of patients across both primary and specialty care.
 
 
 CLINICALTRIAL
 NA
