More Pondering: The ACA Continuum of Care Concept

The concept of continuum of care is not a new one. Depending on where you look for the definition, there are variations. In general, though, a continuum of care refers to an integrated system that includes all types and levels of care a patient may require during a lifetime. Hospital, specialty, well baby, women’s health, chronic disease management, pharmacy management and many others. Folks talk about the continuity of care related to the ACA like it is a new idea! Nurses and physicians have been hearing about the continuum of care for almost 50 years.

Examples of the continuum not working well are numerous. One I heard about recently was a home care RN trying to find out from a local pharmacy about a patient’s meds that had been called in. The pharmacy tech who answered the phone said the prescription had never been called in, and therefore the patient would experience a delay in getting the meds. Two hours later, the home health agency received a call from the same pharmacy asking why this same patient’s meds that had been called in the previous day were never picked up.

The good news is that RNs have always been the choreographers of the care experiences for patients, no matter where the patients fit on the continuum. Companies that recognize the value of RN choreography are already offering turn-key programs and plans to manage populations. The bad news is that the healthcare continuum is not consistent, efficient or unbroken, as noted by the example above. RNs and other healthcare workers will spend much of the next decade refining the inconsistencies, inefficiencies and broken portions of the continuum for patients. Once patients, executives, nurses and physicians recognize that the continuum components will drive the focus to wellness, they will be less able to work in an “illness” model and will either change industries, retire or conform.