Clinical collaboration

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Clinical collaboration is the collaboration of organizations, teams of professionals, or small groups of individual professionals, each having skills, equipment or information that will complement what their partner has, all seeking to be more effective. Choosing one's partner is important, and has been described as "similar to the accreditation process of Joint Commission on the Accreditation of Healthcare Organizations." [1] "CHOP Hub For Clinical Collaboration Arrives on the Skyline in University City, West Philadelphia" was a 2020 headline describing a coming 19-story medical building. [2]

Contents

While clinical collaboration, which has been described as a "culture" [3] rather than as something to be purchased, [4] is not a "full-asset merger," [5] a clinical collaboration does aid the financial goal of "to maximize the value of" a franchise. It also gives more eyes to aid in reducing risk. [6] [7]

Overview

Clinical collaboration is not "one size fits all", [8] and its areas of potential effectiveness include medical/pharmaceutical research, healthcare/doctors and nurses, emergency room care, and ambulatory and ambulance services. One potential obstacle they all face is anti-trust law, [9] [10] but proof of concept exists: partnership contract renewals. [11]

Other concepts affecting healthcare delivery are "clinical affiliation" [12] [13] and "non-clinical collaboration." [14] [15]

Medical research

Cancer research is an example where clinical collaboration can advance state of the art. [16]

Pharmaceutical research

Major pharmaceutical companies such as Pfizer [17] and Bristol-Myers Squibb have arranged clinical collaborations with companies such as NeoImmuneTech, [18] Checkmate Pharmaceuticals and Kitov [19] for testing and evaluating the effectiveness of combinations of existing medicines. If the tested combination attains regulatory approval, "it opens up new patient populations for each company’s drug." [20]

Healthcare

Clinical collaboration between facilities permits sharing the availability of specialists and high tech equipment, often involving specialized communication links to facilitate data sharing. [21]

Issues that must be prearranged include patient data privacy and security, including HIPAA compliance. [22] Some of this is software apps that go beyond standard data sharing using more "aware" software. [23]

Rural areas need it to provide service, [24] and small healthcare providers in large areas need it to survive. [5] In these seemingly asymmetrical arrangements, there is an avoidable potential for domination for which due diligence and preplanning and proper preparation is needed. [25]

Doctors and nurses

Clinical collaboration, properly implemented, must be seamless to be most effective. [26] This includes overlapping staffing and concurrent shifts of doctors with varying specialties and focus, along with nurses and paramedics. The goal is not new, and the situation has improved with use of technology that enables going beyond paper-based records. [27] [28]

Contrast to affiliation

Even though there may be financial benefits to the arrangement, [21] it contrasts with financial affiliation, where profit is the driving motive. An example is where a research project is incurring major expenditures with cost writeoffs: "cost-sharing clinical collaboration" enables "building value" that goes beyond making money to "encouraging activity" that is high risk but, if successful in the long run, will save lives. [16] The medical director of the Mayo Clinic Care Network referred to "due diligence" in an article about Clinical Collaboration as an alternative to health care mergers and acquisitions. [29] [1]

A well implemented medical facility clinical affiliation agreement "maintains each hospital’s independence in governance, budgeting, labor agreements and will not move or remove any local services." [30]

Related Research Articles

<span class="mw-page-title-main">Health care</span> Prevention of disease and promotion of wellbeing

Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.

<span class="mw-page-title-main">Pharmacy</span> Clinical health science

Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.

<span class="mw-page-title-main">Healthcare industry</span> Economic sector focused on health

The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It includes the generation and commercialization of goods and services lending themselves to maintaining and re-establishing health. The modern healthcare industry includes three essential branches which are services, products, and finance, and may be divided into many sectors and categories and depends on the interdisciplinary teams of trained professionals and paraprofessionals to meet the health needs of individuals and populations.

<span class="mw-page-title-main">Primary care</span> Day-to-day health care given by a health care provider

Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care that the patient may need. Patients commonly receive primary care from professionals such as a primary care physician, a physician assistant, a physical therapist, or a nurse practitioner. In some localities, such a professional may be a registered nurse, a pharmacist, a clinical officer, or an Ayurvedic or other traditional medicine professional. Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.

The School of Nursing is the graduate school of nursing at Columbia University in the Washington Heights neighborhood of Manhattan, New York City. Founded in 1892, it stands as one of the oldest nursing schools in the United States.

<span class="mw-page-title-main">Telenursing</span>

Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion, but does not provide the depth of expertise needed to recognize more complex conditions.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.

A Patient Safety Organization (PSO) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection and analysis, reporting, education, funding, and advocacy. A PSO differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery

Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disorders. The terms patient advocate and patient advocacy can refer both to individual advocates providing services that organizations also provide, and to organizations whose functions extend to individual patients. Some patient advocates are independent and some work for the organizations that are directly responsible for the patient's care.

Pharmaceutical policy is a branch of health policy that deals with the development, provision and use of medications within a health care system. It embraces drugs, biologics, vaccines and natural health products.

<span class="mw-page-title-main">Clinical pharmacy</span> Branch of pharmacy for direct provision

Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, physician assistants, nurse practitioners, and other healthcare professionals. Clinical pharmacists can enter into a formal collaborative practice agreement with another healthcare provider, generally one or more physicians, that allows pharmacists to prescribe medications and order laboratory tests.

<span class="mw-page-title-main">Greater Baltimore Medical Center</span> Hospital in Maryland, U.S.

Greater Baltimore Medical Center (GBMC) is a U.S. hospital located in the Baltimore suburb of Towson, Maryland. It was opened in 1965. GBMC serves more than 20,455 inpatient cases and approximately 52,000 emergency department visits annually. GBMC's main campus includes three medical office buildings—Physicians Pavilion East, Physicians Pavilion West and Physicians Pavilion North I. In addition to its main campus located in Towson, GBMC has several facilities located throughout the community including Hereford, Hunt Manor, Hunt Valley, Owings Mills, Perry Hall, Lutherville, Phoenix and Timonium.

<span class="mw-page-title-main">Health administration</span> Field relating to administration of hospitals

Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.

<span class="mw-page-title-main">Pediatric intensive care unit</span> Area within a hospital specializing in the care of critically ill infants, children, and teenagers

A pediatric intensive care unit, usually abbreviated to PICU, is an area within a hospital specializing in the care of critically ill infants, children, teenagers, and young adults aged 0-21. A PICU is typically directed by one or more pediatric intensivists or PICU consultants and staffed by doctors, nurses, and respiratory therapists who are specially trained and experienced in pediatric intensive care. The unit may also have nurse practitioners, physician assistants, physiotherapists, social workers, child life specialists, and clerks on staff, although this varies widely depending on geographic location. The ratio of professionals to patients is generally higher than in other areas of the hospital, reflecting the acuity of PICU patients and the risk of life-threatening complications. Complex technology and equipment is often in use, particularly mechanical ventilators and patient monitoring systems. Consequently, PICUs have a larger operating budget than many other departments within the hospital.

<span class="mw-page-title-main">Medical image sharing</span> Electronic exchange of medical images

Medical image sharing is the electronic exchange of medical images between hospitals, physicians and patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having patients carry it with them, technology now allows for the sharing of these images using the cloud. The primary format for images is DICOM. Typically, non-image data such as reports may be attached in standard formats like PDF during the sending process. Additionally, there are standards in the industry, such as IHE Cross Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between healthcare enterprises. A typical architecture involved in setup is a locally installed server, which sits behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society of North America launched the "Image Share" project, with the goal of giving patients control of their imaging histories by allowing them to manage these records as they would online banking or shopping.

HealthShare Exchange (HSX) is a membership-dues-supported nonprofit health information exchange formed in 2009 and incorporated in 2012 by Greater Philadelphia's hospitals, health systems, and healthcare insurers.[1][2] It links the electronic medical record (EMR) systems of different hospital health systems and other healthcare providers — and the claims data of healthcare insurers — to make this information accessible at inpatient and outpatient points of care (including medical practice offices) and for care management. HSX services provide recent clinical care information, and alert providers and health plans to care events.[2] Health information exchange makes patient care more informed and coordinated, and reduces unnecessary care and readmissions. HSX serves the greater Delaware Valley region, including southeastern Pennsylvania and southern New Jersey.[2]

Sophia Genetics is a data-driven medicine software company with headquarters in Lausanne, Switzerland and Boston, Massachusetts. It provides genomic and radiomic analysis for hospitals, laboratories, and biopharma institutions. The company was ranked among the 50 smartest companies by the MIT Technology Review in 2017. The company went public on the Nasdaq in 2021, floating at $1.1B.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on hospitals</span> Consequences of COVID-19 pandemic for hospitals

The COVID-19 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non-emergency care. This has medical consequences for the people served by the hospitals, and it has financial consequences for the hospitals. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Health facilities in many places are closing or limiting services. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity. The pandemic also resulted in the imposition of COVID-19 vaccine mandates in places such as California and New York for all public workers, including hospital staff.

References

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  13. "The View From: White Plains; A Partnership". The New York Times . November 28, 1993. This is our first clinical affiliation with
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  15. "Employee Profile Bridget Gunn". BayStateHealth.org. April 18, 2017. the Non-Clinical Collaboration Award
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  26. "North Texas Burn Rehabilitation Model System". who work together seamlessly
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