Post Acute Care and Health Information Technology
In the British Medical Journal post ‘The Stress of Sending Patients Home’, physician David Oliver recalls how he was publicly threatened by the relative of a patient in the supermarket. Seemingly, the patient had suffered from complications after he had been sent home, and the relative was unhappy with the doctor’s decision to discharge the patient. Oliver goes on to state post-discharge problems are a growing concern.
Although Oliver admits that there is no single solution to solving such problems, he suggests that post-acute care could be a panacea for improving patient care outcomes. In this context, this blog highlights the problems in post-acute care and suggests how post-acute care strategies can be developed effectively using health information technology.
Post-acute care is defined as the ‘rehabilitation or palliative services that beneficiaries receive after, or in some cases instead of, a stay in an acute care hospital’. After the hospital stay, a trouble-free transition is essential for ensuring that readmissions are low. However, at present, a disproportionate focus is placed on the quality of care received by the patients during the hospital stay, and post-acute care tends to be overlooked.
[Transition in Care. Adapted from http://ahhqi.org/images/uploads/Revolutionizing_Healthcare_Pam_Duncan_Article_05-08-13.pdf]
For ensuring the smooth transition between care settings, providers undertake the process of discharge planning. This includes outlining activities ranging from follow-up tests and appointments to the usage of exercise equipment for the patients. However, fragmentation in data systems prevents providers from getting a comprehensive picture of the patients’ requirements. In order to overcome this problem, providers could use an integrated Electronic Health Record functioning across different care teams. At the same time, a real-time communication channel between different care teams could help in the meaningful interpretation of data present in the EHR. This would allow providers to get the necessary information to plan the discharge process.
Follow-ups are essential for monitoring the disease parameters, and failing to do this could result in future complications. Evidently, the problem of irregular follow-ups has worsened due to the perception of hospitals being high-risk zones during the ongoing pandemic. To ensure the successful follow-up of patients, providers could consider the usage of telemedicine. Telemedicine can allow remote monitoring, and ensure that the patient is able to successfully manage the disease post-discharge with the assistance of his provider.
Essentially, post-acute care involves equipping the patients with the ‘skills required for caring for themselves.’ However, in a short amount of time, transferring these skills to the patients could be difficult. For making sure that this information stays with the patients, providers can make use of health information technology tools. This could include a digital record of the necessary information, along with baseline assessments to ensure that the patient understands what has been told to him at his own time.
In conclusion, it is evident that technology could help us improve post-acute care. However, to ensure widespread adoption, it would be essential that these technologies are both provider-friendly, and patient-centric.