For many patients, especially those with multiple chronic conditions, recognizing simple factors such as a missed medication or expired bandage could be the difference between a positive outcome and a costly hospital readmission.
This issue was recently illuminated in a study that examined patients’ understanding of post-acute care plans. In the study, researchers examined 500 recently discharged trauma patients, finding that only ¼ had the reading skills necessary to understand their dismissal notes and instructions.
In particular, researchers identified that this gap occurred because the notes were written for two very different audiences:
In other words, doctors often write instructions for other medical professionals, but fail to adopt them to the needs of their patients.
While the researchers recommend that all patient notes be written at a sixth grade level, this only fixes part of the problem. Regardless of reading comprehension, a number of other factors can cause care lapses and mix-ups with the patient.
The study’s authors summed up this sentiment best, saying:
“Even if patients believe they understand what occurred during their hospitalization and the instructions they are to follow upon dismissal, they can become confused after they leave the hospital environment as their memory can be clouded by medications they were administered, the stress of hospitalization, and, particularly within our patient population, traumatic brain injuries such as concussions.”
Expecting patients to take full charge of their own treatment programs, and essentially leaving them in the “wild” is not providing optimal levels of care. In the change to outcomes-based reimbursements, we must move away from handing out instructions and hoping for the best- as today’s healthcare environment calls for the effective management of the patient in all settings.
Instead, programs such as Medicare’s Chronic Care Management (CCM), which reimburses providers for telehealth “check-ins”, should be championed as the standard of care moving forward. By providing a medical professional as an available resource, CCM allows patients to ask questions and better understand their care routines.
With the success that physicians are having with CCM, it’s easy to imagine a future where telehealth fully mitigates these post-discharge concerns, allowing for the effective management of eachpatient, and ultimately, an improved care continuum for all involved.