Five Things to Know About Health Care Silos and How They Harm Both Patients and Organizations

silo icons on a blue circle

A health care enterprise involves dozens of teams and specialties, from those providing care to those handling administration to those providing legal services. Unfortunately, too often, those teams and specialties cluster together without communication and input between one another.

They’re siloed. Apart. Disconnected. Working toward their own goals without fully understanding what others are doing.

Here are five things to know about silos that develop in the health care industry, along with the toll they exact and the benefits we all could achieve by breaking them down. (How do you actually break them down? That’s another conversation.)

Horizontal relationships matter just as much as vertical ones.

Laurence Sperling is chairman of the World Heart Federation group on the Roadmap for Cardiovascular Disease Prevention among People Living with Diabetes and a professor in preventive cardiology at Emory University School of Medicine. He outlined the difference between horizontal and vertical relationships for the World Economic Forum.

“People always tend to prioritize vertical relationships in their day-to-day job – that is, relationships with their boss, and direct reports,” he wrote. “Yet … companies with more horizontal collaboration achieve greater customer loyalty and higher margins. In healthcare, the same principles are true. It is in the horizontal communication space – expert to expert, department to department – that real gains in both patient outcomes and economic savings can be found.”

What are your workplace relationships like? Are they mainly vertical? Or does your employer emphasize efforts to communicate horizontally?

It doesn’t just hurt the organization. It hurts patients and workers.

While we usually look at the problem of health care silos from an organization-wide perspective, it creates real problems for the individuals inside it, writes Raquel Meneses and João Caseiro of Portugal’s University of Porto in a unique academic paper on the topic. Patients and providers bear the brunt, meaning the pressing health care problems don’t get solved and dedicated professionals encounter friction.

“Silo mentality compromises the efficiency of the organization and promotes conflicts, redundancy and waste. It distresses and demotivates the employees and frustrates clients who receive worse care and do not have their problems solved on time,” they write. “Silo mentality in healthcare can be defined as the set of individual or group mindsets that can cause divisions inside a health organization and that can result in the creation of barriers to communication and the development of disjointed work processes with negative consequences to the organization, employees and clients.”

In other words, you might easily underestimate how destructive this siloed mentality can be in health care. It takes a profound toll that can easily escalate.

The costs aren’t just about feelings. They also cost us financially.

Can this toll be estimated in dollars and cents? You bet it can.

Vikram Savkar, an executive at the Medicine Segment of the Health Learning, Research & Practice business at Wolters Kluwer, shared an alarming estimate: “One study from 2019 in the Journal of the American Medical Association estimated the waste in healthcare expenditure due to failure of care delivery, overtreatment, or low-value care ranges from $178B to $268B annually.”

That suggests the waste from siloed thinking could easily exceed a trillion dollars over five years, and two trillion dollars over a decade.

Break down the silos? You can save money and improve patient care.

On the other side, we don’t just see a reduction in waste. We see the promise of actual savings in providing health care to patients. In a Harvard Business Review article, Yvelynne P. Kelly, Diane Goodwin, Lisa Wichmann and Mallika L. Mendu describe efforts in dealing with end-stage renal disease. 

Their coordinated program includes “dialysis units, hospitals, primary care providers, and others” and has seen encouraging results. Emergency room visits are down, and transplants have been arranged.

Strikingly, “by reducing healthcare utilization and facilitating transplantation, we’ve thus far saved twice the amount that it costs to run the program,” the authors write. “In one slice of the data, we calculated $428,000 in savings from 74 avoided ED visits and 34 avoided admissions, and over $1 million in savings attributable to facilitated transplantations.”

What’s more, we can focus on treating the whole patient, not individual problems.

All of this brings us, finally, to the patient. Kam Reams and Alan Little point out in Becker’s Hospital Review that “episodic approaches to care delivery interfere with overall care by ignoring the totality of an individual’s health, leading to duplication of services and increased costs. Reimagining the healthcare system to focus on holistic approaches requires a more open exchange of information and shared accountability. Shifting to a holistic healthcare system will break down the operational silos that are inherent to episodic care and support higher quality collaborative care.”

If you want to learn more about the benefits of dissolving the silos between your health care and legal services team, as well as how your organization might tackle the challenges, get in touch with Med Law Advisory Partners. Med Law has the extensive experience needed to show how you can break free of bad habits and put staff and patients first — all while reducing waste and saving money.

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