Care Orchestration Explained

By Monica Demers, Director of Market Development, Lumeon

In a previous blog, we shared what to look for when rethinking your approach to patient engagement:  the need to think about the complete workflow to provide the best patient experience while freeing up staff. To do this, the focus must shift beyond simple communications to how technology uses inputs of information to determine the next appropriate action(s) intelligently, and orchestrate those actions efficiently throughout the care journey. In this article, we dive deeper into the technology concepts that are required to orchestrate care.   

What is an orchestration engine, and how does it work?

An orchestration engine works alongside existing systems, such as an EHR, providing functionality and tools that organize day-to-day complexity and drive care. There are four components to the engine:

  • Programmable workflows and decisioning

Digital transformation begins with re-imagining how to digitally optimize future workflows while leveraging the systems you already have in place – specifically by removing manual tasks, consolidating views, helping with prioritizations, and coordinating communication points between patients and staff. “Programmable” means that the engine can be tailored to keep what’s working well and change what you want to improve.   

Once digital workflows are defined, the orchestration engine does not assume each step is linear, handling the complexities and variations in each step such as cross-team collaboration, patient communication, or waiting for results. The engine takes inputs from all these elements to help decide the next best appropriate action.    

These workflows and decisioning flows are programmed into the system as the “orchestration plan” and run automatically in the background, ensuring consistency in care delivery while allowing for adjustments to individual care journeys.  

  • Digital tools to automate manual activities

The orchestration engine automates digital communication and care coordination to create a seamless digital experience. It includes a variety of secure communication (SMS, eForms, IVR, email) and coordination tools (worklists, patient-level views, tasking, ability to embed UI into applications).  

These tools are the workhorses that remove the repetitive manual activity such as sending out reminders and a variety of pre- and post-visit patient communications. They can be leveraged when you don’t have the functionality in place or when you need to optimize workflows among your existing tools.   

  • Interoperability

The orchestration engine needs context to work effectively. It includes an interface engine within, that helps gather (and return) the information from various sources, such as demographics, scheduling information, revenue cycle, orders and results, allergy and problem lists, and much more. It uses this information and other variables like event triggers and form responses to guide the decisioning process. 

Some health systems opt to start with flat files while they wait for interface resources. This approach works well for straightforward workflows and to get things up and running quickly.  

  • Timed, loop-closing functionality 

The reason this tool is an “engine” instead of a static solution is its auto-evaluation functionality. The engine knows the expected outcome for every step based on the “orchestration plan” described above. It works automatically to close the loop on each step of the process. 

The system constantly checks to see if each step is complete and “chases” it down if it isn’t. For example, when a patient is scheduled for an appointment, it will check if insurance information and privacy/consent signatures are present and up-to-date. If they are not, the engine will automatically text the patient requesting the outstanding items. It will do this on time ahead of a scheduled visit based on adjustable timers.  

If you’re looking to rethink your approach to patient engagement and replace your appointment reminder system, consider avoiding another narrow-function system and opt instead for a wider-angle solution. One that uses reminders as one component in supporting longitudinal, proactive, and guided individual patient experiences. One that lends a digital hand to the complexity of care delivery. Contact us today to learn more.