A., a 55-year-old man, arrived at the ER with symptoms indicative of a stroke: slurred speech and weakness at the right side of his body. He was hospitalised, received urgent treatment, and by the next day was almost back to his usual self. During hospitalisation, A. was diagnosed with heart palpitations and was discharged under medical treatment and with instructions for follow-up examinations.
As he suffered a stroke, A. assumed the brain MRI test to which he was referred was more urgent than a heart echo test he was asked to undergo. Therefore, he focused on scheduling the MRI exam first. It was at this point that he chose to turn to Medix, seeking support in managing his medical condition and scheduling his appointments. However, as Medix’ medical team read through his medical history, they discovered a disturbing piece of information: while A. was concentrating on his stroke, he was neglecting to address the new heart palpitation diagnosis. A. did not realize that his stroke was caused by an arterial aneurysm that required urgent medical attention either by cardiac catheterization, or possibly even a heart bypass. Now, his life is hanging by a thread: without urgent treatment, he may die. Medix’ quick intervention saved his life.
A.’s judgment was not the problem in this story. The problem was the lack of “Continuity of Care”, a known systemic flaw that impacts millions of patients around the world. In some cases, this flaw ends in death.
Chronicle of a Foretold Flaw
Medical treatment is much like a relay race. Every runner is running on their own, trying to reach the maximal speed. But it’s the passing of the baton from one runner to another that requires the most practice: only if the baton is passed in perfect sync, without dropping, could the race end in victory. The medical treatment we receive aspires to resemble the act of passing a baton: continuous, efficient treatment with perfect coordination and synchronisation of all medical professionals involved. But unlike sports, where losing is not a matter of life and death: Continuity of Care can dramatically affect your health and quality of life.
Continuity of Care -- a standardised transfer of information between medical teams -- is especially difficult when moving between medical institutions, but can be just as difficult when the information is passed between caregivers at the same institution.
Unfortunately, healthcare systems fail again and again in synchronising different facilities and in delivering and communicating complete and clear information about the therapies and treatments patients receive. This doesn’t only apply to surgeries and critical conditions as in A.’s case; sometimes it could just as well apply to an ordinary drug that becomes a risk when prescribed along with other medications.
Important to Patients; Good for the System
Continuity of Care assists in maintaining patient’s health, the quality of the medical services they receive and is known to improve overall patient satisfaction. Patients who enjoyed good Continuity of Care were more likely to follow physician’ recommendations, had higher adherence to chronic medication and reported an overall higher improvement in medical condition, compared to patients who experienced lags in communication during in their medical journey.
Continuity of Care contributes not only to patients but also to the healthcare system. It was proven vital in prevention of unnecessary medical treatment, in decreasing 13% of the number of hospital admissions and 27% of the number of visits to the emergency room. Additionally, it aids in the early detection of new medical diagnosis. Continuity of Care improves medical outcomes, reduces costs and promotes more effective use of its resources.
Solutions Around the World: House Visits and Shared Databases
Different healthcare systems around the world offer varied solutions to face the problem of Continuity of Care, in an effort to improve the healthcare services they provide.
In the United States, for example, an Advanced Practice Registered Nurse (APRN) service provides support to patients when they are released from hospitals back into community care -- a sensitive phase that requires constant follow-up or even gradual medication discontinuation. APRNs offer regular house visits during this adjustment period and are available by phone to address any questions patients may have. On average, this service has proven to reduce the cost of medical care by 19% for such patients, as well as increase the intervals between hospital admissions. Among patients who suffered heart failure, the service reduced all-cause rehospitalisations by up to 35%.
In Singapore, the Agency for Integrated Care (AIC) oversees the synchronising of hospital medical teams and community caregivers. Among other roles, the agency gives caregivers access to patients’ medical history thus reducing risks and possible errors and complications. This methodology also spares the patient from needing to carry thick medical files from one doctor to another and helps in protecting medical rights and privacy.
Patients Still Hold Most of the Responsibility
Until more healthcare systems apply similar solutions, patients must take responsibility and due their utmost to uphold the Continuity of Care themselves. Here are a few suggestions anyone can do to ensure better communications flows throughout their medical journey:
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Document all prescriptions and treatments you receive in an organised manner, chronologically.
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Every time you meet a new doctor or start a new treatment, make sure the physician is aware of your medical history. Let your doctor know about every treatment or medication you are currently taking, any changes in your medical condition, or even if you were recently requested to change your diet. If you have any relevant documents - bring them with you and present them to the doctor.
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If you are receiving ongoing treatments from multiple doctors, make sure to document their details as well, so you can suggest them to communicate with each other. This way, they’ll be able to fully assess your medical condition.
Remember: Continuity of Care doesn't only improve your quality of care and effectiveness. In cases such as Mr. A.’s, it can also save your life.