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Improving Continuity of Care Standards

Continuity of care standards is a big subject in healthcare these days. Topics include a patient’s ability to see the same physician each time they visit a practice; smoother transitions between hospital and long-term care; and expanding the use of electronic health records.

While the Affordable Care Act tries to improve continuity of care issues, it is also accused of creating them by patients in some states who are receiving notices that their insurance Improving Communicationprovider will no longer provide coverage that includes their primary care physicians.

Patients who see the same physician each time they visit a medical practice benefit from developing a trusting relationship with their doctor. Doctors become more effective when they don’t have to spend most of the appointment ascertaining patient information that one of their coworkers learned during the patient’s prior visit.

“The purpose of continuity is to deepen our relationship with others, something that is utterly impossible if it never begins. It begins in every encounter where the patients feel known and – despite it – loved, or at least respected and cared for by another human being,” wrote David A. Loxterkamp, MD, MA in a Journal of American Medicine article.

The effects of discontinuity of care can often be seen when a patient transitions from hospital care to a nursing care facility. Changes to medications, follow-up appointments and other updates to treatment plans are often overlooked during transitions and lead to high numbers of hospital readmissions within 30 days of the original discharge.

These 30-day readmission rates are under close scrutiny thanks to the Affordable Care Act, which calls for penalties for having more than the national average. The purpose is to save Medicare millions of dollars as well as improve quality and continuity of care for patients.

Effective use of electronic health records is one way to smooth these transitions since they provide a snapshot of the patient’s current status, updated medication and treatment information, and referrals for needed specialists.

“Exchanging patient clinical summaries during all transitions of care not only leads to improved patient outcomes, but it is also a federally mandated objective,” reports Summit Healthcare, a company that specializes in electronic health records.

Electronic health records improve continuity of care for other patients as well. When a patient needs to see a practitioner other than his primary care physician, critical medical and family history and insurance information travels with him, ensuring the new physician won’t overlook pertinent information about the patient as she treats him. When he returns to his primary care physician, there will be no need to send for records or rely on the patient’s account of his visit with the other practitioner.

Efforts are underway to develop national standards for an electronic health records program that is accepted and usable by all participating systems to improve continuity of care and save Medicare money by providing useful analytical data in addition to a snapshot of the patient’s health information.

Although the Affordable Care Act includes mandates to improve continuity of care, there are some who are losing their long-time family physicians under the Act too. The American Academy of Family Physicians has taken notice and is taking action to try to prevent these severed doctor/patient relationships.

“The AAFP has evidence that thousands of patients, in multiple states, are being told that they must identify a new family physician in the next few months as a result of their family physicians being dropped from certain insurance products as a result of insurers optimizing their provider networks to better align resources. Many of these patients will have years’ long relationships with their family physicians terminated in the name of efficiency,” reports their website.

If you need help with continuity of care issues, contact General Medicine P.C. The Post-Hospitalist Company. They provide practitioners who specialize in the care of patients in long-term care facilities who can improve continuity of care and limit 30-day readmissions.

Tom Prose