Chronic Condition Management Workflow: How Assessment & Consultation Services Improve Care
At Central Health Solutions, we recognize that it is continuous, coordinated care rather than occasional visits to a doctor that builds good chronic care management. Accounts for individualized health needs. In contrast, by focusing purely on acute episodic care, the acute care system falls short in supporting a patient with chronic health concerns. The chronic care assessment service evaluates every patient’s medical history, present health situation, and the lifestyle factors of that patient to complete the picture of chronic care needs. This exhaustive assessment then serves as the base of our Chronic Condition Management Workflow that implements treatment protocols based on evidence and modern health technology to ensure smooth and timely care. Our integrated chronic disease management model of care links primary care providers to specialists, pharmacists, and behavioral health providers, making sure the entire team is working in harmony. Our Chronic Care Consultation Services provide expert clinical advice to healthcare practitioners and patients, to optimize treatment decisions and improve long-term management outcomes.
The true power of our chronic care assessment services lies in their ability to spot not only medical but also behavioral, social, and environmental factors that may influence a patient’s health. The assessments include medication checks, symptom reports, lifestyle habits, and social determinants of health to provide a 360-degree perspective of the patient’s scenario. This information sustains our advanced Chronic Condition Management Workflow, with automated reminders for medicines and appointments, remote monitoring of vital signs, and periodic check-ins by care coordinators. Therefore, our chronic disease management model of care aligns perfectly all providers involved in managing a patient, even eliminating the fragmented care that exists all too often for chronic disease patients who are seeing multiple specialists. The care coordination component of our Chronic Care Consultation Services is a true boon for patients with complex, multiple chronic conditions, as it takes care of any competing treatment suggestions and duplicate tests. For healthcare organizations, our system generates solid analytic reports on key quality metrics, identifies population health trends, and measures intervention efficacy – data crucial to an increasing degree when it comes to value-based care arrangements and quality reporting requirements.
What truly makes the difference in our approach is the synergistic combination of chronic care assessment services, the Chronic Condition Management Workflow, and Chronic Care Consultation Services within our integrated chronic disease management model of care to bring about superior outcomes. Having a care team dedicated to a patient, well-versed in their full health history, can identify even the most nuanced signs of a potential problem. Providers, in turn, obtain the critical means to extend their reach beyond the walls of their offices yet closely oversee their patients’ conditions. This feature is critical for elderly and rural populations faced with steep barriers to consistent, high-quality care. Central Health Solutions offers these novel chronic care assessment services alongside our proven-out Chronic Condition Management Workflow and expert Chronic Care Consultation Services part of an integrated chronic disease management model of care. By marrying clinical excellence with technology in care coordination, Central Health Solutions is shifting chronic care from the ever-reactive, episodic model to the proactive and continuous system that simply keeps patients well and out of the hospital.
