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Don't Be Fooled By A
Care Coordinator Imposter
Laurie Robinson, RN, CPUR | Director of Care Coordination Services, eQHealth Solutions
Marina Brown, BSN, RN, CCM | Product Development Manager, eQHealth Solutions
PUBLISHED: November/December 2011
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Four reasons why care coordinators
must be clinicians...
Care coordinators are not health coaches and they aren’t case managers with a new name. Care coordinators
do coach patients and perform case management functions. But they are not all the same. A lot
of similar job titles float around when we talk about care coordination. How do you know what qualifies
as a care coordinator? Care coordinators are clinical health care professionals. We have pointed out in
previous posts (on the eQHealth Solutions blog) that while health coaches must have health care experience,
they do not need to be clinicians. The same is not true for care coordinators for several reasons.
1. Care coordinators oversee
plans of care.
A care coordinator develops patient care plans and
coordinates them with physician treatment plans.
Regulations require that this is done by a licensed
health care professional, such as a registered nurse,
a certified case manager or a clinical social worker.
2. Care coordinators make
clinical decisions.
A care coordinator must be able to make independent,
clinically-based assessments about care plans
and respond to patients’ health needs. To do this
they must have in-depth knowledge of the pathophysiologies
of different disease processes.
3. Care coordinators activate
for patients.
Care coordinators manage patients who are not able
to do for themselves. This is beyond the scope of a
health coach.
For example, care coordinators have the clinical
skill set to address medical issues for patients. A
care coordinator would walk a heart failure patient
through the process of adjusting his water pill dosage.
A coach however, would guide the patient by
asking him to talk to his doctor about symptoms or
medications.
4. Care coordinators are members of the care team.
They have to be able to competently discuss medical
conditions and advocate for patients with the clinical
teams. This includes collaborating with physicians
and specialists to develop care plans. Care coordinators
then interpret this information for patients in a
way that relates to their specific situations. Coaches
on the other hand, work only with patients and do
not directly interact with the clinical teams.
Care coordinators are in for the long haul. Care coordinators manage patients over their lifetime. Health coaches
monitor patients for a period of time, such as the 30 days after discharge when patients transition from
the hospital to home. Care coordinators expand the traditional case management and disease management
roles. Care coordinators manage care for multiple chronic conditions. If a patient had diabetes, heart failure,
and COPD, the care coordinator would be responsible for all three. Care coordinators use a very high touch
approach. Depending on the level of acuity, they may visit patients in their home or even go with patients to
physician office visits. This approach may also require care coordinators to have smaller caseloads.
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