Clinical integration is defined by the Advisory Board Company as “a strategy in which physicians – sometimes in partnership with a hospital or a health system – make significant collective commitment to performance improvement and investment in infrastructure to facilitate gains in quality and efficiencies.” The concept of Clinical Integration has been discussed extensively in the past few years. The healthcare landscape has begun to shift toward delivering a better quality of care at a lower cost. Clearly hospitals and physicians are at the core of the process.

Clinical integration is being discussed largely as a principal need for an Accountable Care Organization (ACO). An ACO will be required to be large, so it can provide a full array of health care services. However, ACOs may take years to come to fruition in South Florida and, given their complexity and cost, who knows if they will succeed. This does not mean, however, that medical practices – both independent and hospital owned – should not begin to absorb clinical integration concepts. In fact, forward-looking practices are starting to do just that! Below are some tips on how to make your practice more clinically integrated:
 
– Begin to Convert to Evidence Based Medicine by Adopting Clinical Protocols- Clinical integration requires a more standardized form of care, through clinical protocols.  
 
– Set Meaningful Performance Goals- Create clinical standards for your practice and then, through your IT, by which your practice should adhere.
 
– Get Moving on IT- Whether you like it or not, the push toward advanced technology for your practice is only going to increase. 2011 is the first year in which stimulus funds are available if “meaningful use” standards are met.
 
– Accountability and Physician Oversight- create accountability in following protocols and achieving standards. The protocols must be followed or consequences must occur. Revising partnership agreements to reflect the consequences of not meeting performance goals is a great start.
– Select Capable Physician Partners- Obviously many physicians of small practices that have been practicing with the same partners for years cannot start from ground zero. But when selecting new partners or hiring new physicians keep in mind that you will want physicians who are capable of achieving the performance goals you have created.
 
– Attempt to Negotiate Managed Care Contracts that have Incentives. Around the country, managed care plans are negotiating contracts that provide rewards for increasing quality and reducing costs. They are called “pay for performance” contracts. Look into this.
 
There are many more essential measures a medical group may begin to implement in order to move forward toward clinical integration. The push toward clinical integration is not a fad that will soon dissolve into thin air. Physicians need to begin focusing on their future.