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Several recent hospitalization events involving family and friends have identified weaknesses in the degree of coordination between providers and with the patient.  In one instance, the aftermath of open-heart mitral valve repair surgery demonstrated the lack of any "gatekeeper" in terms of coordination between physicians and the patient, resulting in a "left-hand, right-hand syndrome.  Despite efforts to provide interoperability between Electronic Health Records (EHR) systems, the ability of any one clinician to get a clear understanding of the full patient encounter was inhibited.  The patient continued to be frustrated by not knowing who to turn to in terms of coordinating their overall progress, such as when they would be discharged from a sub-acute care facility.

In another instance, an elderly friend fell and broke their femur, resulting in a hospital stay, followed by several weeks in a sub-acute facility.  The subacute facility had limited access to the hospital's EHR, complicating the ability to see what medications were ordered.  Again, there was distinct limitations in coordination between clinicians in managing the patient's progress.  Further complicating this case was the fact that the patient's regular cardiologist was not involved in nor communicated with in terms of managing an instance of arrhythmia.  

Despite great strides in the improvement of interoperability, it seems apparent from these experiences that more needs to be done in terms of improving the coordination of patient care.