Rising costs, doctor shortages with increasing demand, and falling standards of care have impacted just about every health care sector in the world. Today, we’re facing one of the most significant humanitarian challenges of the century. How do we sustainably provide high-quality, affordable, and accessible health care to a growing population? The industry’s forward-thinking innovators are working towards a care model—aided by technology—that solves many of these problems. But this requires shifting the focus of medicine away from “sick care” to a system that supports well-being, prevention, and early intervention. That means reimagining the cycle of care and how it serves both doctors and patients.
The “sick care” model of medicine
Think about the last time you saw a doctor. Maybe your congestion had turned into painful throbbing behind your eyes. Or that lingering cough just wouldn’t go away, even with rest, cough drops, and hot tea. “Sick” care is the care you expect to receive when you are under the weather or experiencing an emergency. And it’s how the majority of us navigate the current healthcare system.
Here’s how it works: you experience your first symptoms, but they’re not that serious. An appointment means losing hours at work for long commutes and time spent waiting. So you ignore the early signs. Then your symptoms get worse. There’s no denying it now. You’re definitely sick. Suddenly, seeing your doctor isn’t an option. It’s a necessity. When you’re experiencing illness, it’s your doctor’s role to diagnose your symptoms and return you to a state of health as quickly as possible. That can mean expensive diagnostics, treatments, and even more time away from work or juggling appointments.
But what if you never got sick in the first place?
You can avoid a sinus infection by treating seasonal allergies. Education around hand-washing practices can limit germ and bacteria exposure, which can prevent certain strains of bronchitis. Preventative medicine and routine screening can detect conditions before they become life-threatening. While sickness, disease, and accidents are not always preventable, focusing on a preventative model of medicine transforms “sick” care into actual health care.
Reimagining the cycle of care
Lumeca believes we need to shift from a physician-centered way of looking at medicine, to a patient-focused one. In other words, the cycle of care shouldn’t be about what physicians do, but what patients need. The cycle of care helps your physician understand your concerns, prioritize your needs, and address those needs promptly. It also provides opportunities for education to prevent future complications and illnesses.
Understanding the cycle of care
The cycle of care—also known as the patient pathway, or the care map—refers to the series of interactions between you and your health care facility when you seek medical attention. By focusing on each part of the patient pathway, medical professionals are trying to improve the quality of care. According to a report by clinical scientist X.A.A.M. Verbeek and researcher W.P. Lord, quality of care is based on accessibility, affordability, and an achievable health outcome. By understanding each step in the cycle of care, physicians can boost positive treatment outcomes.
Promotions and preventions
Medical care doesn’t always start with an appointment. It also refers to the systems in place to help you prevent sickness in the first place. Often, this means a two-prong emphasis on education and awareness.
Examples of promotions and prevention include anti-smoking campaigns or support programs to help smokers quit. They can also be population-specific, targeting groups that are at high risk for certain diseases. For example, ads raising awareness about prostate cancer would be a promotion aimed at middle-aged men.
Secondary prevention includes routine screenings, such as annual blood work, screening for breast cancer, and keeping vaccinations up-to-date.
Despite the best preventative efforts, everyone is destined to get sick at some point in their lifetime. And when you do, an accurate, timely diagnosis is an essential part of getting on with your treatment and recovery. During the diagnostic phase of the care cycle, nurses, physicians, and patients should work together to understand how genetics, lifestyle, medical history, and symptoms all impact each other in the context of the potential illness.
The role of context
Each consultation between you and your doctor has context. In this case, context refers to the sequence of events leading up to your appointment. During an effective consultation, your doctor will carefully consider each of these events, as well as any high-risk genetic or lifestyle factors. For instance, a longtime smoker with a persistent cough will get different treatment than a child with a persistent cough thanks to context.
Another context consideration is the likelihood of different symptom/illness combinations—for example, tension is a more likely cause of headaches than aneurysm.
Your physician should also consider your pre- and post-test odds of having a particular condition. Have you experienced these symptoms before, or is it a new problem? Do you have any related conditions? Does your family have any history of similar symptoms? All of these considerations help your physician during this stage of the care cycle, as they work with you to determine the best treatment plan.
We already know that a healthy doctor-patient relationship improves treatment outcomes. But it can also increase the odds of getting a timely, accurate diagnosis. When patients are comfortable communicating with their doctor, they’re more likely to explain their symptoms clearly. This helps the physician fully comprehend the extent of the issue and create a more strategic diagnostic plan.
Of course, the cycle of care has two primary goals: to prevent illness, and get you healthy when you do get sick. That requires a treatment plan, or a road map, that the patient can follow to return to normal health. Context is also crucial in developing a treatment plan. Even the gold standard in healthcare won’t work if you, the patient, are unable to follow the recommendations. This is especially true in treating chronic conditions, which often require time-consuming follow-up visits, expensive medications, and open communication between doctors and patients.
During the cycle of care, physicians and patients must work together to develop a comprehensive, realistic treatment plan.
There’s no such thing as one-size-fits-all in healthcare. It’s outdated, and potentially dangerous, to believe there is. Instead, each case requires tailored treatment and management that accounts for the patient’s genetic risks, lifestyle, family history, and medical history. The management phase in the care cycle might include follow-up appointments, diagnostics to determine how effective treatment has been, or adjusting medications. It requires open lines of communication between patients and medical teams, as well as the resources to adjust treatment as needed.
The ultimate goal of any cycle of care is getting you back to your pre-illness lifestyle. That may be something as simple as taking a course of antibiotics to clear up an infection, or something as intensive as recovering from surgery. Another critical part of the rehabilitation process is working to prevent the illness or injury from reoccurring.
While the care cycle covers an individual’s path from wellness to illness and back, not every patient will experience every phase. Patients who recover during the treatment phase will not need management or rehabilitation.
Continuity through the cycle of care
One obstacle to high-quality care in Canada’s healthcare system is a lack of continuity. At its core, continuity of care refers to how you experience care over time. For example, how did your perception of the care you received change from your cancer diagnosis to your final radiation treatment? For continuity to exist, according to George Freeman of London’s Imperial College School of Medicine, care must feel smooth and coordinated. That means that every member of your medical team—nurses, general practitioners, and specialists—are up-to-speed on your treatment, management, and rehabilitation. By providing a digital space for your medical records, telehealth companies like Lumeca are creating solutions to fragmented care. This allows for more continuity through the entire cycle of care.
Focusing on the entire cycle of care improves health outcomes
Whether it has to do with disease, injury, or disability, the cycle of care should follow the same general phases. Each step gives your doctor a better understanding of the specific health concerns and conditions while allowing them to facilitate appropriate and timely treatment, post-visit management, and follow-ups. All of this is to help you get back to your normal, healthy life. At Lumeca, we’re with our patients at every point in the cycle of care. Our team of Canadian-licensed nurses, doctors, and mental health professionals are here to support and collaborate with you through your care pathway.