Literature DB >> 24996874

A patient-centered longitudinal care plan: vision versus reality.

Patricia C Dykes1, Lipika Samal1, Moreen Donahue2, Jeffrey O Greenberg1, Ann C Hurley3, Omar Hasan4, Terrance A O'Malley5, Arjun K Venkatesh6, Lynn A Volk7, David W Bates8.   

Abstract

OBJECTIVE: As healthcare systems and providers move toward meaningful use of electronic health records, longitudinal care plans (LCPs) may provide a means to improve communication and coordination as patients transition across settings. The objective of this study was to determine the current state of communication of LCPs across settings and levels of care.
MATERIALS AND METHODS: We conducted surveys and interviews with professionals from emergency departments, acute care hospitals, skilled nursing facilities, and home health agency settings in six regions in the USA. We coded the transcripts according to the Agency for Healthcare Research and Quality (AHRQ) 'Broad Approaches' to care coordination to understand the degree to which current practice meets the definition of an LCP.
RESULTS: Participants (n=22) from all settings reported that LCPs do not exist in their current state. We found LCPs in practice, and none of these were shared or reconciled across settings. Moreover, we found wide variation in the types and formats of care plan information that was communicated as patients transitioned. The most common formats, even when care plan information was communicated within the same healthcare system, were paper and fax. DISCUSSION: These findings have implications for data reuse, interoperability, and achieving widespread adoption of LCPs.
CONCLUSIONS: The use of LCPs to support care transitions is suboptimal. Strategies are needed to transform the LCP from vision to reality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Entities:  

Keywords:  Care Coordination; Electronic Health Record; Longitudinal Care Plan; Meaningful Use

Mesh:

Year:  2014        PMID: 24996874      PMCID: PMC4215040          DOI: 10.1136/amiajnl-2013-002454

Source DB:  PubMed          Journal:  J Am Med Inform Assoc        ISSN: 1067-5027            Impact factor:   4.497


  30 in total

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5.  The completeness and accuracy of patient record transfer between practices.

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9.  Implementation of a Web-based system to improve the transitional care of older adults.

Authors:  Zeke Zamora; Brenda McCall; Laura Patel; Kevin Biese; Michael Lamantia; Tim Platts-Mills; Nelson Naus; Hans P Jerkewitz; Charles B Cairns; Jan Busby-Whitehead; John S Kizer
Journal:  J Nurs Care Qual       Date:  2012 Apr-Jun       Impact factor: 1.597

10.  Perceptions of the effect of information and communication technology on the quality of care delivered in emergency departments: a cross-site qualitative study.

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Journal:  Ann Emerg Med       Date:  2012-10-18       Impact factor: 5.721

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  22 in total

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Authors:  Jan Horsky; Stephen J Morgan; Harley Z Ramelson
Journal:  AMIA Annu Symp Proc       Date:  2014-11-14

3.  Health Information Technology Coordination to Support Patient-centered Care Coordination.

Authors:  O Steichen; W Gregg
Journal:  Yearb Med Inform       Date:  2015-08-13

4.  Unstructured clinical documentation reflecting cognitive and behavioral dysfunction: toward an EHR-based phenotype for cognitive impairment.

Authors:  Andrea L Gilmore-Bykovskyi; Laura M Block; Lily Walljasper; Nikki Hill; Carey Gleason; Manish N Shah
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5.  Assessing Commercially Available Personal Health Records for Home Health: Recommendations for Design.

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6.  User-centered design of a longitudinal care plan for children with medical complexity.

Authors:  Arti D Desai; Grace Wang; Julia Wignall; Dylan Kinard; Vidhi Singh; Sherri Adams; Wanda Pratt
Journal:  J Am Med Inform Assoc       Date:  2020-12-09       Impact factor: 4.497

7.  Transitions From Hospitals to Skilled Nursing Facilities for Persons With Dementia: A Challenging Convergence of Patient and System-Level Needs.

Authors:  Andrea L Gilmore-Bykovskyi; Tonya J Roberts; Barbara J King; Korey A Kennelty; Amy J H Kind
Journal:  Gerontologist       Date:  2017-10-01

8.  Regional Multiteam Systems in Cancer Care Delivery.

Authors:  Katia Noyes; John R T Monson; Irfan Rizvi; Ann Savastano; James S A Green; Nick Sevdalis
Journal:  J Oncol Pract       Date:  2016-09-30       Impact factor: 3.840

9.  An implementation model for managing cloud-based longitudinal care plans for children with medical complexity.

Authors:  Grace Wang; Julia Wignall; Dylan Kinard; Vidhi Singh; Carolyn Foster; Sherri Adams; Wanda Pratt; Arti D Desai
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10.  Technology-facilitated care coordination in rural areas: What is needed?

Authors:  Emily Gill; Patricia C Dykes; Robert S Rudin; Marianne Storm; Kelly McGrath; David W Bates
Journal:  Int J Med Inform       Date:  2020-02-19       Impact factor: 4.046

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