In my previous post, I discussed the second link in the Patient-Centered Life-Cycle (PCLC) Value Chain, which is sick-care. In this post, I discuss the third link, which involves well-care, as well as the integration of emergency-care, sick-care and well-care.
Well-Care (Prevention & Self-Management)
The third link in the PCLC Value Chain involves well-care, which includes prevention & self-management. Three well-care delivery models are the:
- Preventative Maintenance model, which focuses on (a) delivery of primary prevention -- such as physical activity, nutrition, stress relief, vaccinations, etc. -- that help people avoid health problems, as well as promoting peek performance, and (b) secondary prevention for at-risk persons to prevent recurrences of health problems, such as avoiding recurrent coronary artery disease events in a person with a history the illness.
- Recovery/Rehabilitation model, which focuses on adherence (compliance) to doctors’ orders to foster recovery, rehabilitation, and complication avoidance for patients having chronic or catastrophic health problems.
- Compassionate Home Care model, which focuses on making people near end of life as comfortable as possible in a supportive environment where they have dignity and family support.
- Recovery/Rehabilitation and Preventative Maintenance well-care may be delivered face-to-face, over the internet, and via phone sessions. They include processes for: (a) ongoing risk and health status assessments; (b) ongoing generation of personal health plans identifying any risk factors people may have, as well as primary and secondary prevention plans of action (i.e., health directives); (c) health education presenting concrete, understandable action steps and psychological counseling for dealing with physical problems and psychological stressors; (d) compliance motivation involving motivating and reminding people to do the things that will help them improve their own health; (e) accessing health coaches for health information and advice; (f) outcome studies used in continuous quality improvement feedback loops; (g) care coordination for patients with catastrophic health problems, so multidisciplinary teams can work together effectively; (h) promotion of environmental and workplace safety; and (i) encouraging lifestyle and attitudinal changes for peek performance.
- Delivering Compassionate Home Care well-care includes processes for helping individual obtain home care nursing and homemaking assistance; arranging for transportation to and from doctor appointments; and addressing the psychological, social and spiritual well-being of patients and families.
Integrating Emergency-Care, Sick-Care & Well-Care in the PCLC Value Chain
Instead of viewing emergency-care, sick-care and well-care as separate and distinct, the PCLC Value Chain solution integrating all three. This process involves a new kind of coordination and collaboration between:
- First responders focused on safe passage to and from disaster sites, victim rescue and triage, and trauma center response
- Medical and related sick-care practitioners focused on the diagnosis and treatment of health problems
- Well-care practitioners focused on prevention, recovery, and self-maintenance.
In subsequent posts [starting here], I discuss what’s needed to implement this integrated care strategy successfully, including:
- Specific clinical and financial processes of our current healthcare system that must be transformed
- Specific infrastructural needs, in terms of health information technology use.