Coordinated delivery of clinical care: the "re-integration" of the medical group practice

This paper suggests that for medical knowledge to be effective, it must be reliably translated into a series of synchronized activities, both clinical and operational. The goal of medical information science must be not only to identify the best course of care, but also through the use of systems for the ordering, scheduling, and deployment of staff and resources to assure that the planned course of care is reliably and efficiently delivered in actual practice settings. We present a brief history of several innovations in patient care coordination and logistics at Mayo Clinic to provide background for the main concepts presented. The principle of patient care coordination underlying this history of innovation is shown to have evolved into a new need for information systems capable of proactively effecting the delivery of care through patient, staff and resource deployment and monitoring.