There are two types of care, episodic and longitudinal care. Episodic care means that a person sees a provider or health care organization that they do not have a pre-established relationship with, such as care received during visits to an emergency room or a walk-in clinic. Episodic care providers can struggle to gain access to patient data since it is often not available within their electronic health record system. Health Information Exchanges, like the one operated by VITL, provide access to patient records from different care settings. However, the utility of the Health Information Exchange is dependent on how many electronic health record systems are connected and regularly feeding in quality data. Gaining access to patient data via a Health Information Exchange allows providers to make more informed decisions about a patient they may not be familiar with.
Longitudinal Care refers to when a person has a condition that requires ongoing management and intervention by health care providers. Longitudinal Care incorporates the holistic needs of a patient and relies on information from various providers and care visits. Chronic conditions such as diabetes, heart disease, and cancer often require Longitudinal Care.
Use Case | Peter’s Story
Episodic Care
Maria is a nurse working in a hospital emergency room. One night, she meets Anna as she arrives in the emergency room with her son Peter. Peter is experiencing signs of a severe asthma attack. With help from her colleagues, Maria moves Peter into a room and begins treatment. Maria asks Anna about Peter’s allergies and medical history, but she is too upset to share full details. Maria’s nursing assistant quickly logs into the electronic health record system, which is connected to the Health Information Exchange, to see if she can find Peter’s health records. She learns that Peter has experienced this type of attack before, which allows the treating providers to administer the best course of care. Peter quickly stabilizes.
Transitioning from Episodic to Longitudinal Care
When Peter’s record was updated with information about his hospital visit, a “ping” was sent to his pediatrician’s office notifying them of the event. This occurs through Event Notification software that is linked to providers’ records nationwide. The pediatrician’s office follows-up by scheduling a time for Peter to come in and see his regular doctor.
Longitudinal Care
At Peter’s next appointment, his pediatrician, Dr. Adams, logs into the office’s electronic health record system to see the details of when Peter was admitted to and discharged by the hospital (via an “ADT” message) and reads the treating providers’ notes about Peter’s experience (in a “CCD” message). This information was electronically transmitted from the emergency room to Dr. Adams through the Health Information Exchange. Dr. Adams uses that information to better understand what led to the asthma attack and adjust his regular treatment accordingly.
Tom, a care coordinator that works with Dr. Adams office, spends time speaking to Anna about environmental factors that may be impacting Peter’s asthma and how to manage her son’s condition. Tom uses Peter’s electronic health record and an electronic care coordination tool to help her best support Anna and Peter to continually manage Peter’s asthma condition