Summary: The healthcare industry today is changing rapidly. There actually seem to be two differentand conflictingsets of pressure affecting healthcare that relate to communication. Intermountain Healthcare is a nonprofit healthcare system that provides hospital and other medical services in Utah and Idaho. Intermountain uses clinical data to improve patient outcomes. The importance of communication is highlighted in the way Intermountain works, especially in a field where information can be a matter of life and death.

Task: Read the "Intermountain Healthcare" case below and then consider the following questions.

>> Good communication will enable lower costs, better patient care and better patient outcomes and technology can facilitate that. Hi, I'm Mark Allen, I'm the Clinical Information Systems Manager for the Utah South Region and the Rural Region for Intermountain Healthcare. Intermountain is known internationally for its ability to be able to use clinical data to improve patient outcomes. So we have 22 hospitals across the state of Utah, one in Idaho, and we have over 300 clinics across the enterprise. And when you consider just the enormity of running a regional healthcare system there's a lot of data and information that needs to be stored and information that needs to be provided to the physicians and clinicians so that they can make good decisions.

>> So Intermountain is a very transparent organization. We know that people perform better when they feel informed. Hi, I'm Janet Frank and I'm the Communications Manager here at Utah Valley Regional Medical Center. We focus on physician communication even though a large percentage of them are partners versus employed physicians. So we see everybody on our team, employees, physicians, volunteers as well as part of our team and we want to keep them up to date with everything.

>> Communication is very important and one of the key things to keeping everybody on the same page is to develop a good communication plan and to repeat a consistent message often and frequently. Hi, I'm Fritz Kron. I'm the Regional Director for Quality at Intermountain Healthcare in the Urban south region here, and one of the most exciting things that I get to do every day is to work with our teams and accelerate bringing best practices to our patients. Every region supplies a local representative. We are very fortunate in our ability to engage physicians and nurse leaders who are willing to spend their time participating in the committee meetings and networking with their peers throughout the system and we always recognize that it is a challenge to get the word out and we do that through meetings, we do that through talking points, we'll

put flyers on bulletin boards. There's also some more formal documents called Care Process Guidelines and those are heavily researched documents that are available on the website. So we use a combination of methods to communicate what our goals are for that year. As a tertiary medical center at Utah Valley, many patients come up for higher levels of care. One of the advantages of the clinical programs is all of our providers understand our protocols and understand our practices, and so that when a patient needs to be referred to the tertiary medical center it really is a continuation of a care process model. One of the nice things is we do have an integrated longitudinal medical records system and that means that whatever is documented and whatever transpired at one medical center can be pulled up on the computer and can be seen at the other medical center. Part of our clinical program goals almost always involves patient education, because in addition to the providers, the physicians and the nurses and the laboratory support, as patients we're also very accountable for our health outcomes. We have standardized education and that allows us to deliver a consistent message. So when you're discharged from one facility we have a standardized brochure and teaching information that's given and again that information is available throughout the system, so that when the patient reports back to their primary care provider and appears to need a little reinforcement of the education or maybe has a knowledge deficit in a particular area and that happens, because when you're getting ready to be discharged you have so many things on your mind as a patient, you can't possibly comprehend everything. And so that provider in the hometown can also pull up the same information. And it's really very reassuring to patients because they actually see the same information and then it can help them ask us questions or ask the provider questions about a point that they didn't quite understand.

>> You know, Intermountain Healthcare really prides itself in being innovative and we've looked at what the discussion has been across the country. Tele Health Services is really a key that we've identified and invested in in Intermountain Healthcare. We have currently 26 projects across the enterprise where we're trying to find technical solutions to be able to provide better care to the patients. We have Tele Critical care, we have Tele Psych, we have a variety of other tele health initiatives that we're trying to initiate to provide care at the rural facilities that can't afford a neonatologist or a hospitalist and to be able to provide that expertise to the physicians in those areas so that they can understand how to address issues in a better way to have better outcomes for the patients. Another exciting project that we've got going on that I'm really excited about is the Parent at Home Project. What we're doing is that in a NICU you often have babies that stay an extended period of time in the facility, so what we're doing is we're going to provide them the ability to be able to see their infant from home, from work or any other type of device and they'll be able to stay in touch then with the physician more closely to know how their baby's progressing, and so that is just going to be a wonderful tool. In addition the information that we have within our system is also provided to our home health division. So as our home health nurses are visiting patients at home, they're going to have the full history and physical of the patient and the care that

they received in the hospital to be able to provide better patient care to the patients that they visit.

>> We know that healthcare is rapidly changing and healthcare today will be very different from healthcare in five years. We don't quite exactly know what that looks like but we do know that we will become more integrated across the continuum, really partnering with the patient and reaching out and being more involved. We have a lot of opportunity there. There are challenges with hand offs and I think that's one of the things that we'll be working on and I think we'll be able to do lot better.

(a) What is horizontal communication?

(b) How is the horizontal form of communication more prominent in Intermountain Healthcare?