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Quality/Integration
Healthcare providers usually do not have the time or expertise to do comprehensive evaluation and treatment assessment. The result is frequently a cascade of problems. The present number using electronic based records with web integration is less than 30%. The result is poor timely communication and much waste. As there is increased use of cell phone technology this can be utilized to expedite the integration process.
A couple of many examples of areas of poor quality and integration are:
72 year old lady who doesn't follow up recommendation to evaluate and treat increased blood sugar. Six months later she is taken by ambulance, hospitalized and then discharged to rehabilitation center. Proactive assistance to her, Dr. family to intervene would improve quality and decrease costs.
Similar problem with 30 yr old lady who had 5 hospital admissions for broken bones from falls over 15 years. Had diagnosis of seizures but the focus of treatment was fractures and no support to help her follow up with seizure treatment
Many such examples with congestive heart failure, faints , dizziness where patient and local Dr. and RN were not assisted to proactively get patient into needed program before emergency room and hospital treatments.
An easily used quick screening tool to identify pychosocial and
other relevant issues is described below. Tool called
Physical, pyschological, social trend chart.
It is helpful to identify other issues which bear on getting best results.
Quality and Integration Must Start at First Point of Service
PHYSICAL, PSYCHOLOGICAL, SOCIAL TREND CHART
We have ways of very quickly screening patients at first point of service with a five-minute tool that can be used by patient and unskilled medical personnel. This simple tool has five scales: physical, psychological, social, work/school and random (accidental or acts of God). Each of these scales has a maximum score of two, with best health equating to a score of 10. Placing these scores on a time-oriented trend chart - score by both patient and physician - gives an overview of issues in addition to the presenting medical problem (example: broken leg). Comparing scores at the next contact and over time gives one a better view of issues and interventions that are needed and helpful.
Please refer to Archives/Trend Charts-
Other screening tools are the SF-12 and SF-36.
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