Improving Collaboration and Breaking Down Silos Between Acute and Post-Acute Providers

Darren Swenson, MD, is an accomplished physician executive, healthcare entrepreneur and clinical educator who specializes in post-acute care delivery, value-based care programs and graduate medical education program development. As president of TeamHealth’s Post-Acute Care division, Dr. Swenson is responsible for developing, implementing, and advancing TeamHealth’s strategy to invest and expand the post-acute care service line while identifying and enhancing health outcomes through continuous innovation.

During this conversation with Modern Healthcare Custom Media, Dr. Swenson shares the ways in which optimizing alignment between acute and post-acute care providers can lead to improved outcomes for patients and clinicians.

What are the unique challenges facing both hospital and post-acute care providers right now?

There are many challenges across the healthcare ecosystem facing acute and post-acute providers. I’d categorize these into three areas: One being mental health, two being communication and transition of patient care, and three, managing the patient experience. When we think about mental health, we have an increasing number of patients with mental health comorbidities who are in need of post-acute care. But (post-acute care) has limitations regarding staffing ratios, regulatory challenges and the reimbursement framework which doesn’t support comprehensive patient care for behavioral health today. Regarding communication and transitions of care, while the acute care providers have moved to EHRs, in the post-acute environment, the providers are still in the early stages of EHR adoption. So, when we think about the transition of care and communication between acute and post-acute, we are not on a level playing field, and sometimes the patient is stuck in the middle. Lastly, when we think about managing the patient experience, which is a fundamental priority of the healthcare delivery system, the compression of the length of stay in the acute care environment leaves less time and opportunity to transition the plan of care to the post-acute team.

As one of the largest integrated physician practices in the nation, what solutions does TeamHealth offer to solve these challenges?

TeamHealth Post-Acute Care provides not only primary care but comprehensive onsite behavioral health. And in rural areas, we are providing telehealth behavioral healthcare. Additionally, our post-acute providers use a single EHR system, so we achieve an interdisciplinary approach that is comprehensive and consistent. TeamHealth is truly focused on providing a continuum of care solution. We provide a 360-degree, door-to-door connection of care to our patients. Regarding patient experience in post-acute care, it is about being available to the patient and family. This is our primary focus and central to what we provide. Our physicians and advanced practice clinicians are in the post-acute care facility five to six days a week, and our visibility and availability to patients are fundamental.

What do you see as key future trends facing post-acute facilities in the next year and beyond? And how can improved alignment with partners across the acute care spectrum help address those challenges?

In the next several years, we will see that the greatest challenge we face is staffing. Most clinicians don’t go to school to be a post-acute care provider. At TeamHealth, we are embracing new graduates who are trying to figure out where they fit into the healthcare ecosystem. We are educating them and providing resources to make them proficient in post-acute care. We have to attract clinicians who are going to be passionate about the post-acute care environment even with limited resources and staffing challenges. In terms of improved alignment with acute care, communication makes it a more comfortable environment. When we are aligned with our acute care colleagues around a common goal to provide outstanding patient care, we complement each other rather than compete with each other.

What are some of the successes you have seen in markets where TeamHealth has both a strong acute care and post-acute presence?

In markets where we are providing ER services, hospital medicine and post-acute care, there is a true seamless transition from one site of care to the next. We see a hand off between emergency medicine to the hospitalist, which means we are lowering ER wait times and we are ensuring the plan of care is evolving efficiently. When we take the hand off in post-acute, we are ensuring that there is open communication, and there is an understanding about what the patient needs. Ultimately the patient doesn’t want to be moved from location to location if it can be avoided. This is where TeamHealth really excels: in our ability to provide door-to-door care among teams that are aligned and working together.