The lack of care coordination from their providers is a universal complaint of older patients, according to a survey of 1,000 adults aged 65 and up.
The survey, from the John A. Hartford Foundation, a New York-based nonprofit organization focused on the geriatric patient population, found that just 27 percent of older adults surveyed are receiving the kind of coordinated care services seen in a patient-centered medical home. The desire for these types of services is strong as 61 percent say they believe team care would improve their health, and 73 percent say they would want this type of care.
More specifically, 84 percent of survey respondents say they would want their provider to call them to follow up after a hospital stay or emergency room visit, and 67 percent say that such coordination would improve their health. Less than half (46 percent) say their current non-team care practice would do this for them.
Access to the electronic health record (EHR) is also a problem for many of these older patients, as only 38 percent say they can see their medical records or test results online or through email. Of those that do have that access, only one-in-three (36 percent) say it has improved their health.
"Interestingly, patients want and benefit from a number of services made possible or easier by electronic health records -- reminders, extensive care coordination, tailored care management -- but only 36 percent note that the EHR helps improve their care. The focus should be on what the EHR and related systems do and how they are used, not just the fact that one exists," states David Dorr, M.D., Associate Professor and Vice Chair of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University. Dr. Dorr is a co-creator of a medical home model for older patients.
One of the other struggles of coordinated care, the report found, was access to services. According to findings of the survey, only half of those surveyed say they can get a same-day appointment when they need it. Of those who do receive it, 78 percent say such expanded access to primary care say it has made a difference in improving their health.
There was similar low numbers for patients having received a formal plan of care (14 percent), a written list of their medications after a visit (48 percent), and reminders from their practice on when they need preventive care services (42 percent).