continiuty-of-care

Have you ever seen a specialist for your chronic health condition, only to find out they haven’t communicated your treatment plan to your family doctor? Unfortunately, this lack of communication occurs all too often, and you end up stuck in the middle, trying to get all your healthcare providers on the same page. It’s frustrating and can make managing your chronic condition all the more difficult.

Continuity of care is a type of care that aims to provide healthcare in a coordinated manner so that even if a person has multiple healthcare providers, everyone is on the same page regarding the treatment plan. It empowers you, the patient,  to work collaboratively with your healthcare providers to ensure you receive the best care possible.

That’s where CopilotIQ comes in. CopilotIQ is paving the way for data-driven care that fosters continuity of care for people living with type 2 diabetes and chronic high blood pressure. Read on to learn about continuity of care, the barriers to achieving it, how ongoing care can benefit people with type 2 diabetes and high blood pressure, and how CopilotIQ is a leader in delivering continuity of care.

What is Continuity of Care?

Continuity of care describes how a patient and their doctor or nurse practitioner-led healthcare team work together for long-term health management. Continuity of care aims to ensure high-quality, cost-effective medical care.1

When a person experiences continuity of care, they should know:

  • What the plan of care is.
  • What happens next in the care plan.
  • Who is involved in providing care.
  • That their healthcare team understands them. 

Continuity of Care Benefits

Studies show that continuity of care leads to better healthcare outcomes, increased patient satisfaction, and more cost-effective healthcare. In particular, older adults and people with multiple chronic illnesses have been shown to benefit from continuity of care.2

A systematic review including 22 studies from nine countries found that continuity of care (in this case, seeing the same doctor repeatedly) was associated with a reduction in death rates in almost 82 percent of the studies reviewed.3

Overall, studies show that the more involved patients are in the decision-making related to their health, the more satisfied they are with the process and the better the results. Plus, for healthcare providers, continuity of care means they can provide more effective care and make treatment more cost-effective.

Advantages of Managing High Blood Pressure with Continuity of Care

Several studies show the advantages of managing high blood pressure with continuity of care. One study involving 1,200 people found that people who experienced continuity of care had significant improvements in physical functioning, general health, and mental health. The study concluded that a long-term relationship between physicians and their patients was important for improving health-related quality of life for people with high blood pressure.4

Another study involving 421,640 people found that team-based continuity of care with a coordinated doctor team was associated with a lower risk of developing heart disease and lower death rates from all causes among people with high blood pressure. The study also found that starting continuity of care earlier was associated with even more health benefits.5 

Finally, a study including 50,785 people found that people who received continuity of care had lower rates of hospital admissions than those with less continuity of care.6

Overall, the advantages of managing high blood pressure with continuity of care include:

  • Better physical health.
  • Better mental health.
  • Lower risk of developing heart disease.
  • Lower risk of death from all causes.
  • Lower risk of hospital admission.

CopilotIQ’s remote blood pressure monitoring enables better continuity of care for adults managing high blood pressure through Medicare.

Managing Type 2 Diabetes with Continuity of Care

There is also a large amount of evidence that people with type 2 diabetes benefit from continuity of care.

A study involving 23,294 people found that adults with type 2 diabetes who received continuity of care had lower rates of death and were more likely to achieve desired clinical targets for health markers such as A1C (the average of your blood sugars over a period of three months) and blood pressure.7

Another study involving 285,231 people with diabetes found that people who received continuity of care had a lower risk of death and hospitalization and better clinical outcomes, even if they had more than one chronic disease.8

Continuity of care also helps people stick to their medication routines. A study of people with newly diagnosed type 2 diabetes found that those who experienced continuity of care were more likely to follow their prescribed medication routines than those who had low continuity of care scores. This led to better healthcare outcomes.9 

A study involving 47,433 people newly diagnosed with high blood pressure, diabetes, or high cholesterol found that lower levels of continuity of care were associated with more deaths, more heart-related events (such as heart attacks), and higher healthcare costs. They concluded that healthcare systems should be designed to foster long-term, trusting relationships between primary health providers and patients to improve patient outcomes.10

Finally, a study examining the effect of continuity of care on A1C levels in people with type 2 diabetes found that higher levels of continuity of care were associated with reductions in A1C.11 

Overall, the advantages of managing type 2 diabetes with continuity of care include:

  • Lower rates of death.
  • Higher likelihood of achieving desired clinical targets for health markers like A1C and blood pressure.
  • Lower risk of hospital admission.
  • Better adherence to medication routines.
  • Lower healthcare costs.
  • Better healthcare outcomes.
Woman with monitoring device

What are the Barriers to Continuity of Care?

Given the many benefits of continuity of care for managing chronic diseases like high blood pressure and type 2 diabetes, you may wonder why continuity of care isn’t always used.

There are several barriers to implementing continuity of care. They include having many healthcare providers, moving from one care setting to another (also known as “transition of care”), rules within the healthcare system, and lack of access to care.12

Barrier 1: Many Healthcare Providers

The more healthcare providers a person has, the more likely it is that continuity of care will be disrupted. This can occur for several reasons. First, one healthcare provider may not have up-to-date information about the care given by another provider. Plus, they may not think to contact other providers to get that information.

In addition, information can be miscommunicated or misunderstood. Providers may also have different opinions about a person’s healthcare, which can be confusing and overwhelming for patients and their families.

Barrier 2: Many Settings

When a person moves between care settings (for example, from a hospital to a nursing facility), there is an increased chance of errors. This is particularly true for medications. While United States regulations require healthcare organizations to check medications when a person goes to a different care facility, this may not happen if they are transitioned back home.

If you’ve recently been discharged from a hospital or another care facility, it’s important to make an appointment with your doctor. During that appointment, review your medications to ensure that you aren’t taking any duplicates and that none of your medications interact negatively with other medications you’re taking. 

Barrier 3: Many Rules

Many rules can hinder continuity of care, including rules made by insurance companies, the government, or professional organizations for healthcare providers. For example, if a healthcare provider is not on staff at a hospital, they may be unable to provide care there. That means a person will have all new healthcare providers who likely don’t know the person’s full medical history. 

If you’re moving between care settings, it’s a good idea to keep your own personal record of important details to share with healthcare providers so they have up-to-date information about your health conditions.

Barrier 4: Lack of Access to Care

One of the biggest disruptions to continuity of care is a lack of access. For example, an older person may miss a follow-up appointment because they lack transportation. Some people may not see a healthcare provider because they don’t have insurance and can’t afford to pay.

Luckily, solutions are geared toward improving access to quality care for patients. While CopilotIQ does not replace primary care providers or healthcare providers, it can be considered an extension of care or a helping hand to make patients healthier.

CopilotIQ’s Approach to Ongoing Care for Older Adults

CopilotIQ aims to bring world-class care to seniors with chronic health conditions like diabetes and high blood pressure. For many people living with these conditions, there’s a gap in the data provided to healthcare providers. This can lead to inadequate treatment plans and a worsening of chronic health conditions. Plus, it is hard to promote continuity of care when there isn’t enough data to treat the health condition effectively. 

CopilotIQ is a system that automatically collects data daily. By continuously monitoring your blood sugar and blood pressure readings, you can detect possible risks and take action before they become an emergency.

CopilotIQ ensures continuity of care by assigning you a U.S.-based nurse to monitor your progress, discuss your challenges, and help you stay on track with weekly calls. Your personal nurse will use RemoteIQ, our artificial intelligence-driven software, to identify potential issues, correlate your health readings with your daily choices, and provide personalized support.

Continuity of Care Solutions for Managing High Blood Pressure and Diabetes

Both high blood pressure and diabetes can be managed using continuity of care. For people with high blood pressure, daily data collection can provide insights into potential trends so your doctor can make adjustments to your care plan based on when your blood pressure is out of target, making more natural solutions available also.

For people with diabetes, automatic data collection and analysis means you can better tailor your medication and diet plan to correspond with trends in your blood sugar readings. In both cases, sending data to a CopilotIQ nurse enables you to manage your chronic disease with expert support and personalized treatment plans. 

Dr Greene

Continuity of Care Provides Connected Care Older Adults Need

Continuity of care is vital to a mutually beneficial relationship between a patient and their healthcare providers. When continuity of care is achieved, patients feel supported. Plus, numerous studies show that continuity of care also leads to better clinical outcomes, including lower rates of death, lower rates of hospitalization, lower A1C, lower risk of heart disease, better physical and mental health, better adherence to medication regimens, and lower healthcare costs.

CopilotIQ aims to foster continuity of care through a data-driven approach to care. Whether you have high blood pressure or type 2 diabetes, CopilotIQ will match you with a personal nurse who will review your readings and meet with you weekly to discuss the next steps in your healthcare plan. It’s this type of ongoing care that will help you take control of your health and live your best life.

Learn more about how CopilotIQ works and get started today!

Join the 1000’s of CopilotIQ members reversing their diabetes and blood pressure.

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References

  1. Continuity of Care, Definition of. American Academy of Family Physicians. Retrieved November 6, 2023, from https://www.aafp.org/about/policies/all/continuity-of-care-definition.html#:~:text=Continuity%20of%20care%20is%20concerned,%2C%20cost%2Deffective%20medical%20care.
  2. Jeffers H, Baker M. Continuity of care: still important in modern-day general practice. Br J Gen Pract. 2016 Aug;66(649):396-7. 
  3. Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors-a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018 Jun 28;8(6):e021161. 
  4. Ye T, Sun X, Tang W, Miao Y, Zhang Y, Zhang L. Effect of continuity of care on health-related quality of life in adult patients with hypertension: a cohort study in China. BMC Health Serv Res. 2016 Nov 28;16(1):674. 
  5. Xu W, Yu EYT, Chin WY, Mak IL, Chan CIY, Lam CLK, Wan EYF. Team-based continuity of care for patients with hypertension: a retrospective primary care cohort study in Hong Kong. Br J Gen Pract. 2023 Oct 26;73(736):e807-e815. 
  6. Nam YS, Cho KH, Kang HC, Lee KS, Park EC. Greater continuity of care reduces hospital admissions in patients with hypertension: An analysis of nationwide health insurance data in Korea, 2011-2013. Health Policy. 2016 Jun;120(6):604-11.
  7. Lustman A, Comaneshter D, Vinker S. Interpersonal continuity of care and type two diabetes. Prim Care Diabetes. 2016 Jun;10(3):165-70. doi: 10.1016/j.pcd.2015.10.001. Epub 2015 Nov 1. PMID: 26530317.
  8. Weir DL, McAlister FA, Majumdar SR, Eurich DT. The Interplay Between Continuity of Care, Multimorbidity, and Adverse Events in Patients With Diabetes. Med Care. 2016 Apr;54(4):386-93. 
  9. Chen CC, Tseng CH, Cheng SH. Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a longitudinal analysis. Med Care. 2013 Mar;51(3):231-7. 
  10. Shin DW, Cho J, Yang HK, Park JH, Lee H, Kim H, Oh J, Hwang S, Cho B, Guallar E. Impact of continuity of care on mortality and health care costs: a nationwide cohort study in Korea. Ann Fam Med. 2014 Nov-Dec;12(6):534-41. 
  11. Franklin B.  The impact of continuity of care on A1c levels in adult type 2 diabetic patients: a review of the literature. Journal for Nurse Practitioners 2014; 10 (7): 486-92.
  12. Continuity of Care. Merck Manual, Consumer Version. Retrieved November 6, 2023, from https://www.merckmanuals.com/en-ca/home/older-people%E2%80%99s-health-issues/providing-care-to-older-people/continuity-of-care#v835906 

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