Very few events and paths in our lives occur in a truly linear fashion. Sometimes we intentionally choose a fragmented path, while other times it can be impacted by external factors beyond our control.

The healthcare journey is a prime example of a nonlinear journey that has been especially fragmented recently amidst the COVID-19 pandemic. This massive and unanticipated event significantly disrupted the care experience by challenging traditional communication touchpoints and continuity of care. 

Fragmentation in healthcare refers to the lack of coordination or misalignment of decisions among participants in the care journey, primarily a patient and their care team.

The chaos and disconnection sparked by the recent pandemic has contributed to higher costs of care, increased risk for bad outcomes, and stifled the patient's active role and voice in their own care journey. 

Evidence of Fragmentation in Healthcare

Fragmentation in healthcare has a particularly negative effect on patient self-efficacy. Low-income, at-risk populations, and those with chronic conditions experience higher levels of disjointed care.

The average Medicare beneficiary sees two physicians and five specialists each year. Patients with chronic illness see an average of 13 physicians.

Medicare does not pay these physicians to spend time coordinating care between different providers. This results in unmet social needs, conflicting treatment plans, incorrect dosing, and higher rates of hospitalization. 

A study of 506k+ chronically ill patients conducted over the course of four years set out to assess the correlation between fragmentation in healthcare and quality and costs of care. A Herfindahl-Hirschman concentration index (HHI) was utilized in this study to measure the degree to which a patient’s care is concentrated among a set of providers.

This study found that patients of primary care physicians (PCPs) in the highest quartile of fragmentation had a higher chance of having a departure from clinical best practices.

In that same vein, patients of PCPs with high rates of fragmentation had increased rates of preventable hospitalizations and experienced significantly higher costs in care (an average cost of $10,396 compared to $5,854). 

It's well-known that the exchange of information between providers can often be disjointed. Healthcare providers face challenges around data fragmentation that limits the exchange of health data, which increases the risk of treating patients without having the full patient profile. 

Fragmentation in Healthcare and Patient Self-efficacy

Self-efficacy in healthcare refers to a patient's confidence in their ability to undertake behaviors that lead to desired outcomes.

Patients should be active decision-makers and participants in their care journeys but are often limited by uncoordinated care experiences which can inhibit access to knowledge or resources. Informed patients have more motivation and confidence in adopting and carrying out their plan of care, which strengthens the continuity of care and improves overall outcomes.

Prioritizing patient care requires a shift towards patient-centric solutions. This emphasizes the patient as an integral member of the care team and delivers accessible resources to empower and support them.

A Solution

While this shift may seem fraught with challenges and barriers, a digital front door solution is purpose-built and equipped to support and empower patients.

Its capabilities go beyond consumer-friendly digital experiences and offer dynamic navigation throughout the care journey. Omnichannel and multilingual access broadens the solution's reach to support a variety of patients, while 24/7 access delivers a seamless journey across numerous patient-facing touchpoints.

Here is a glimpse at how Orbita's digital front door solution (OrbitaENGAGE) works to connect the dots across the patient care journey to support patient self-efficacy.

• Provider Profiles: In the search for care, patients can easily get lost online and feel overwhelmed with options. Ensure that patients have access to the right care at the right time with verified, high-quality provider profiles that support patients through the initial discovery and navigation of care.
• Online Scheduling: With 24/7 access, patients have a frictionless experience booking appointments and understanding care options, including costs and availability.
• Symptom Checking and Health Screening: Enable patients to self-check their symptoms and complete health screenings with vetted clinical content, such as for COVID-19 (and the COVID-19 vaccine), to aid in the decision-making process.

Healthcare organizations can reduce systemic fragmentation and provide high-quality, continuous care that empowers patients by implementing a patient-centric digital front door solution. There is so much that a digital front door solution can offer - read our latest white paper to learn more.