Enhancing continuity of care using an emergency medical card and a continuity of care report.

摘要

Discontinuity of care due to poor communication of patient health information among healthcare providers (HCPs) is a major efficiency and patient safety concern. Patients often see multiple HCPs and during each visit, the patient's core health information is required for appropriate decision making. Patients with access to their electronic medical records (EMR) may wish to share information, but not all HCPs may have access to EMR systems. Errors of commission and omission may also exist within the EMR. The patient is potentially an excellent source of quality control for the record, but the patient's direct access to the record is rarely available. HCPs may, therefore, provide care without knowing the patient's full health status or what procedures have been performed previously.;The findings showed that the reviewers and patients found the EMC and CoC report to be useful in transporting patients' healthcare information across the healthcare continuum and to identify missing information in the EMR. HCPs can now access more accurate, complete and readily available patient information for use in medical decision making, and, therefore, enhance CoC. The results also showed that patients are an important source of quality control for their records in the EMR by identifying data errors and sending new data to their HCPs for EMR updates.;To address these problems, we implemented an automated system compliant with a continuity of care record (CCR) standard (E2369-05) in Intermountain Healthcare. The new tool ("CCR application") enabled patients to view, add and modify their information in a personal database and create an emergency medical card (EMC) and a continuity of care (CoC) report. We undertook the following tasks: (a) Described the development of the CCR application, EMC and CoC report. (b) Simulated the use and assessed the usefulness of the EMC and CoC report in enhancing CoC. (c) Compared the patient-entered data using the CCR application and HP-entered data in the EMR and evaluated the effect of the patient-entered data on the quality (i.e., accuracy and completeness) of HCP-entered data. (d) Assessed the patient satisfaction with the usefulness of the EMC and CoC report in enhancing CoC.