Medical careers in the United States span more than 135 specialties and subspecialties, according to the Association of American Medical Colleges. While specialization enables medical professionals to become experts in particular aspects of health care, it also can lead to issues when patients receive treatment from multiple providers. The silos in health care that form when medical professionals work in isolation without good communication and coordination can have a detrimental effect on quality of care and result in increased costs and duplicative treatment.
Fortunately, a combination of solutions driven by information technology, organization and communication can help to eliminate silos in health care. Because students who pursue a Master of Healthcare Leadership degree will eventually be in positions to implement these solutions, it’s important for them to understand the concept of health care silos and learn how to address them.
What Are Silos in Health Care, and Why Are They Harmful?
Historically, the provision of health care in the U.S. has been designed around individual encounters between patients and a host of discrete parties (for example, primary care providers, specialists, different types of therapists and even insurers). However, that approach to providing care doesn’t always lend itself to adequate communication and coordination among all parties. The fragmented care that patients receive from providers operating in isolated health care silos is not always optimal.
The World Economic Forum has noted that health care silos can form when primary care providers and general practitioners lack sufficient time to oversee and coordinate patient care. These providers refer patients to specialists without active coordination and analysis of the entire scope of each patient’s care. This can create cost inefficiency, negatively affect quality of care and lead to wasted resources when care is duplicated.
Citing the example of a patient with diabetes, the World Economic Forum notes that this disease can lead to kidney damage, nerve damage, blindness and cardiovascular disease, each of which can necessitate treatment from a specialist. Without some form of integrated care, communication among specialists will be limited, and the patient’s care will likely be provided episodically, instead of from a holistic perspective.
According to a Managed Healthcare Executive report, roughly 80% of all serious medical errors in the U.S. involve miscommunication during transitions across health care settings, which can lead to medication errors, unnecessary hospital readmissions and other types of preventable harm.
The negative effects of health care silos are not difficult to find, and working to eliminate those silos has the potential to improve the efficiency and effectiveness of health care in significant ways.
Information Technology Solutions for Removing Health Care Silos
Information technology offers some of the most potentially effective solutions for removing health care silos. When all parties involved in a patient’s care can view the same information — and keep that information accurate and up to date — the possibility for enhanced communication and coordination improves.
The following are just a few of the ways in which information technology can help break down silos in health care:
Use Interoperable Electronic Health Records
Establishing secure, interoperable electronic health records (EHRs) that all medical professionals can review (and that patients themselves can see) is critical to promoting greater communication and coordination. The ability of EHR systems to facilitate everything from scheduling to treatment and follow-up care can help ensure that all parties are aware of the full scope of a patient’s treatment.
Standardize Health Care Information Technology Platforms
To work effectively, EHRs must be accessible to different parties from various platforms. As a Health IT Outcomes report notes, the health care industry lacks a universal, standardized way of accessing health records. Use of secure, nonproprietary platform technology, as well as developing consistent technology standards across providers, will be key in conquering the challenges to accessing patient information.
Digitize Referral Information and Specialist Notes
Managed Healthcare Executive reported in 2021 that providers send in excess of 75% of referral-based communication by fax; on top of that, 25-50% of referring providers don’t know whether their patients ever saw the specialists to which they were referred. The same report noted that, when patients do visit those specialists, many specialists still record their notes manually. Digitizing both referral information and specialist notes can enhance information sharing and the overall coordination of care.
Consistently Update EHR Information
EHRs can be effective only if providers consistently update them. Providers who maintain updated patient information and check on their patients’ statuses by regularly reviewing EHRs can help to reduce the harmful effects of health care silos.
Organizational and Communication-Driven Solutions for Removing Health Care Silos
A number of organizational and communication-driven approaches also can help address the problem of health care silos. One of the most direct approaches is to form interdisciplinary teams to reduce barriers to communication and coordination.
As the American Medical Association reported in 2020, the COVID-19 pandemic brought specialists and other physicians together at Northwell Health, which was treating 20% of COVID-19 patients in the state of New York at one point. Specialists such as nephrologists and cardiologists, who had temporarily closed their offices to promote physical distancing, joined hospital teams working with COVID-19 patients on the front lines. This collaboration enabled specialists to offer their expertise alongside doctors who were serving COVID-19 patients in the ICU, which reduced health care silo effects and resulted in greater teamwork.
Other solutions for removing health care silos include:
- Appointing care coordinators. Sometimes referred to as “nurse care coordinators,” “chronic care coordinators” or “transition guides,” these individuals facilitate continuity of care and help improve coordination and communication.
- Striving for more patient-centered care. Implementing a patient-centered model of care recognizes the patient as the one constant in their health care experience. Constructing care around that patient as a whole, rather than their individual health conditions, can establish a foundation for better coordination across providers.
- Conducting focused-event analysis. When medical professionals analyze events after a failure in care, they can identify improvements that can strengthen communication and coordination.
- Promoting more openness to collaboration and transparency. Health care leaders’ promotion of greater coordination and sharing of information can reinforce the importance of integrating health care and breaking down health care silos.
Finding a Role in Strengthening the Effectiveness and Efficiency of Health Care
Removing silos from health care will require leaders who seek out the best solutions and find innovative ways to implement them. Individuals who are interested in leading change in health care can explore Wake Forest School of Medicine’s online Master of Healthcare Leadership program to learn how a graduate degree can help them pursue their professional ambitions. Discover a rewarding career in health care leadership today.