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By Anne Doessing
We recently published a scoping study addressing two issues: what are the conditions of care coordination for patients with multimorbidity; and which factors promote or inhibit care coordination in provider organizations and among healthcare professionals [1].
The central theme emerging was complexity: The specific medical conditions of patients with multimorbidity are highly complex as is the organization of care delivery.
What are the implications for care coordination then? One approach is to reduce complexity and the other is to embrace complexity. Either way, future research in care coordination interventions in multimorbidity must take a more explicit stand on complexity.
In the included studies there was a significant lack of clarity regarding the role of different professionals in care coordination. It is unclear what role the various health professions play in care coordination, what coordination tasks different professions perform and whether some professions are more suited for care coordination than others. Also, it is unclear how different organizations and sectors affect the coordination carried out by different professions.
The research on care coordination interventions for patients with multimorbidity seems to focus on organizing healthcare without paying much attention to the role of professions in frontline care coordination. However, this ought to be a prerequisite for the development of care coordination interventions.
Therefore there is a need for more research to uncover the role of different professions in care coordination. This must comprehend both their actions and the health professionals’ own understanding of their role in care coordination.
Perhaps some of the failures of existing care coordination interventions can be explained by the fact that the specific delegation of coordination is at odds with the health professionals’ own understanding of their professional domain?
The complete article can be accessed at: http://www.jcomorbidity.com/index.php/test/article/view/39
1: Doessing A, Burau V. Care coordination of multimorbidity: a scoping study. J Comorbidity 2015;5:15-28