Whole Patient Care: Reaching beyond Traditional Healthcare

By McGaw, Jeryl L. | Frontiers of Health Services Management, Winter 2008 | Go to article overview
Save to active project

Whole Patient Care: Reaching beyond Traditional Healthcare


McGaw, Jeryl L., Frontiers of Health Services Management


AS THE AVERAGE LIFE SPAN increases and more people develop chronic illnesses, it is becoming apparent that our healthcare system is not providing the necessary combination of coordinated systems to an aging and increasingly complex population. The fact that healthcare costs keep rising without comparable increases in national health outcomes proves this.

Thirty years ago, when life expectancy was shorter and demands on the healthcare system were not as profound, the system delivered care from personal family physicians (physicians working with less complex patients, with more time, and with better relationships with patients and their families). Population growth, better research, better medications, and more intensive interventions created a new period in healthcare history, a period of endless information and incredible patient needs. Fortunately forward-thinking healthcare analysts and researchers have identified gaps in care and developed proposals and theories to bridge the gap. Beginning with the Institute of Medicine's Crossing the Quality Chasm, new ideologies emerged which impugned current practices while identifying primary areas of need (Institute of Medicine 2000).

INTERSECTING MODELS REVOLUTIONIZE HEALTHCARE

In 1992, the American Academy of Pediatrics (AAP) repudiated the current system of care for children with special healthcare needs and published a policy statement defining the medical home (American Academy of Pediatrics 2002). The AAP believes care should be accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective. In 2002, the AAP disseminated an updated policy that refers to a care-delivery system that provides timely access to medical care, improved communication between patients and their healthcare team, coordination and continuity of care, and focus on quality and safety.

The medical home concept aims to improve the entire healthcare delivery system. The medical home idea is a "family-centered" approach, and it stipulates that patients need coordinated and continuous care. In a system that has grown beyond the primary care provider to care from a complex array of providers, coordinated and continuous care has become an absolute necessity.

In 2007, the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA) released "Joint Principles of the PatientCentered Medical Home" (ICIC 2008.) With the support of these organizations the medical home model went beyond an approach to manage children with special needs to become an ideology for improving care for patients across the life span.

In 1998, chronic care innovator Dr. Ed Wagner published the first in a series of precedent-setting articles that evolved into the Chronic Care Model (Wagner 1998). Based on the knowledge that 133 million people live with a chronic condition, a number that is projected to increase by more than 1 percent per year, and that nearly half of those individuals have multiple chronic illnesses, Wagner conceptualized a new, transformative delivery system. This system includes not only an informed patient but an active community, plus health systems that use decision support and clinical information systems such as electronic medical records. Similar to the medical home model, the chronic care model has moved the patient from a place of isolation into a larger family and community support structure, acknowledging that people do not function or live in dissociated states. Further, the chronic care model fosters communication between an involved and educated patient and a proactive, interactive care team. No longer is communication of facts and figures acceptable -communication must involve an exchange of knowledge in a collaborative relationship, what Wagner refers to as "productive interactions." This cooperative model abolishes the hierarchical, archaic structure of physician-patient care and introduces the concept of equal partners using information and decision support to establish unified and achievable goals.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Whole Patient Care: Reaching beyond Traditional Healthcare
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?