Med Students Cite Importance of—and Obstacles to—Care Coordination

The 9th annual Epocrates Future Physicians of America Survey from athenahealth polled more than 1,400 medical students about clinical teamwork, among other topics. A whopping 96% of respondents said that collaborating with “extended care teams”—members of which might include nurses, PAs, and medical staff—is important or very important to the delivery of high-quality care. Forty-three percent cited fragmented care as the number-one risk factor for compromised patient safety, with cost of care and medication non-compliance coming in a distant second and third, respectively. And, apparently aware of the shift toward financial incentives for better outcomes arising from team-based care, 67% rated care coordination as important or very important for a physician’s financial success.

However, 57% of respondents cited inadequate cross-team communication as the number-one barrier to coordinated care, with a lack of interoperability among current EHR systems cited by 42% as the primary hurdle. On a more positive note, the survey found that 86% of respondents felt that their medical training prepared them for patient-centered care, a model that stresses patient and family involvement in shared decision-making.

The survey also asked students about their awareness of accountable care organizations (ACOs). According to the American College of Physicians, “the core purpose of an Accountable Care Organization is to provide accessible, effective, team-based integrated care.” Yet, according to the survey, 65% of medical students feel they don’t know enough about ACOs. That’s down from 72% in last year’s survey, but it’s still a sizable proportion. Another 39% admitted that they are unsure about the purpose or structure of ACOs.

In two miscellaneous findings that reveal ambivalence among medical students regarding the personal versus technological in medical practice, 99% of respondents said they would prefer a face-to-face office visit over a virtual encounter for an initial patient interaction, while at the same time 97% said they would encourage patients to use remote monitoring devices such as those now available for tracking weight, physical-activity levels, blood sugar, and vital signs.

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