Competing Health Care Systems and Complex Patients: An Inter-Professional Collaboration

Lauran Hardin
Adam Kilian
Kristin Spykerman
Peer-Reviewed Article
June 2017

This resource describes a collaboration between the Cherry Health Durham Clinic (CHDC) and Mercy Health Saint Mary’s (MHSM), which treated an overlapping population of patients with complex needs. This article provides a guide for facilitating inter-organizational collaborative practice.

  • The two competing health systems realized that many of the same patients with complex needs were utilizing their services, and that to stabilize their care they would need to collaborate.
  • The inter-organizational collaboration aimed to create a continuum of care across organizational boundaries to deliver integrated health care to patients.
  • Key elements included patient identification and root cause analysis; shared infrastructure (such as a Business Associate Agreement and integrated patient consent forms); and joint celebration of success.
  • The collaboration resulted in a decrease in average emergency department visits by 28 percent, inpatient admissions by 50 percent, length of stay by 49 percent, and CT scans by 67 percent.
  • Costs decreased by $721,654 in the 12 months after intervention, representing a 51 percent reduction.
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