...I just returned from
speaking at the California Association of Long Term Care Medicine conference
in Long Beach
where the topic was transitions in care. It is very evident that the health care system for our seniors is
often times as confused as the seniors we serve. Despite our best efforts and
intentions, there are breakdowns in the communication systems that are as
frustrating to the physicians as they are to the seniors.
...I found that the physicians
attending the conference share these concerns and often times have reasonable
solutions. However, due to HIPAA, the hands of most parties are tied and
information does not transfer due to the efforts to “protect” health privacy
information. The greatest concern expressed by these physicians was the
inconsistency in medication listing for the patients.
...Take for example the
individual who becomes ill at home, and is transported to the hospital. Often
the listing of medications he/she is taking, is not available. If the
individual is unable to express him/her self properly, or the family member
is not in the know, the hospital personnel are at an disadvantage as they try
their best to gather the necessary information to treat the individual. The same is true for those transported from
a care facility. Medical conditions and medication lists are often sent with
him/her, but can become misplaced. If admitted, medications may change or not
be available as they were at the facility or home. Upon discharge, there may
or may not be a reconciliation of the old medications with the new.
...What lessons are learned
from this? It is critical to have a
listing of all prescription medication’s, over the counter medications and
supplements that one is taking. The list should include the drug name, dose
(i.e. amount in milligrams), and the frequency of the medication (how many
taken and at what times). It is also beneficial to list the doctor’s name who
prescribed the medication. This
information should be kept on the person (in a purse or wallet) of the
individual and updated each time there is a change. When one is being transferred from a
facility to the hospital, the facility should assure the medication
information is identifiable and easy to locate. I suggest printing it in a
bright color, pink or yellow, so that it is easy to locate in the admission
record among the mass of documentation now required in our health care
system.
...As a person transitions
from home to hospital to skilled nursing to home, so many inconsistencies can
occur. Be aware that the physicians are equally concerned about the safest
treatment of the patient, but since numerous doctors may be involved in the
care, medication history may be overlooked. It is the responsibility of the
family or patient representative to assure the physicians have the best
information possible to provide for the best outcome. Be an advocate for
those who need it most. Navigating the transitions in care is not easy.
