What is Continuity of Care?
“Continuity of Care” is concerned with quality of care over time. It is the process by which the patient and his/her physician-led care team are cooperatively involved in ongoing health care management toward the shared goal of high quality and cost-effective medical care.
Continuity of care is the primary objective of family medicine and is consistent with quality patient care provided through a patient-centered medical service. The continuity of care approach helps family physicians gain their patients’ confidence. It also facilitates the family physician’s role as a cost-effective coordinator of the patient’s health services by making early recognition of problems possible. This is rooted in a long-term patient-physician partnership in which the physician knows the patient’s history from experience and can integrate new information and decisions from a whole-person perspective efficiently without extensive investigation.
[The above is a lightly edited version of the definition of Continuity of Care from the American Academy of Family Physicians (“AAFP”) website.]
Continuity of care has several dimensions:
Management continuity is relevant whenever a patient is receiving care from more than one clinician or healthcare provider. It concerns the processes involved in co-ordinating, integrating and personalising care to deliver a high-quality service. The General Physician’s (GPs) clinical responsibility as coordinator of care for patients includes helping patients to understand and plan their treatment, navigate unfamiliar services successfully and remain engaged with their care. Good relationship continuity can contribute substantially to achieving this. Having one principal care provider with a holistic view of the patient is central to patients’ experiences of good management continuity and provides a sense of security and confidence about the future.
Benefits of Continuity of Care
Continuity of care approach has significant benefits and will result in better care at a lower cost over a period of time. Some of the specific benefits include:
Use of Technology in Continuity of Care
Technology is a major enabler towards ensuring continuity of care. Some of the key technology elements that are widely used for this purpose are:
Challenges in Continuity of Care
While there are significant benefits of the continuity of care approach, there are a few challenges that we need to recognize.
1. Patients with acute problems (like a chest infection), don’t really care which doctor they see. They are looking for someone who can see them in a timely fashion and will treat them.
2. Need specialised care from another member of the team
3. Wish to discuss a problem they find embarrassing to discuss with their regular doctor
4. Chose to consult a GP of the same gender
“Continuity of Care” does not necessarily mean that the patient will consult with the same doctor each time. This might not be possible. In such cases, we will need to ensure continuity using technology and services of other clinicians in the network. When it comes to continuity, the patients are really looking for the following:
We need to ensure that the patient does not experience the above.
However, we should endeavour to provide “Continuity of Care” through the same doctor during an “episode of care” (healthcare services for a specific medical problem, condition or illness) for each patient.
At iKure, “Continuity of Care” is a key focus area and our primary healthcare delivery model is built around this theme. For us, continuity of care involves integrating patient care in his home with our Clinic services through the following:
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