To be Continued

Express News Service

For a critically ill patient, a second could mean the difference between life and death. Continuum care fills this vulnerable gap. It provides transitionary recuperative, rehabilitative, and palliative support to patients. Widely prevalent in advanced countries, it is a practice that is slowly catching on in India. Given the rising number of patients and a severe shortage of manpower in hospitals, this small-format treatment protocol can bring down your medical bill by 10 to 20 percent, while providing a customised healthcare plan.    

The glaring gap

Even though the health sector has been tested to its limits many times in the past, and more recently during the pandemic, people undervalue the relief continuum care can extend. “This is a serious shortcoming because hospitals are short-staffed, there are extreme shortages in skilled professionals, medical equipment, technology, and beds. Continuum care acts as a bridge that gives you hospital-like care at home or a special care facility,” says Bengaluru-based Rajinish Menon, Founder and CEO, Sukino Healthcare Solutions Pvt Ltd. 

Continuum care looks at improving the effectiveness of clinical interventions undertaken at the hospital by prolonging the same/similar care post-discharge. It follows treatment protocols suggested by 
the primary physician.

Who needs it most?

Over the years India has become the chronic disease capital of the world. Of the overall mortality rate, more than 60 percent is from these diseases. “If this is not managed, India will lose $6 trillion, according to a study by BAIN Consultancy. Needless to say, this makes ‘chronic continuum care’ crucial. If advanced diseases are not managed continuously, it could lead to acute incidents. Investing time and resources to make care pathways that are comprehensive and consistent and provide high-quality outcomes is the need of the hour,” says Noida-based Vivek Srivastava, Co-founder and CEO, HCAH, a continuum care provider.

Those who have suffered traumatic brain injuries need careful monitoring that can only be extended by professionals. Rehabilitative care in ortho-related conditions like hip and/or knee replacement is covered comprehensively under continuum care and so are neurological conditions.

Cardiology-related services are most sought after. Menon explains, “After cardiac surgery, a patient is discharged with a set of dos/don’ts. He needs to be doubly careful about everything but he is not prepared for such an undertaking physically or mentally. If there is a service through which the patient can be hand-held during the first few weeks/months of recovery, it could help tremendously. This includes educating them about their condition, updating them regarding progress, administering injections/medicines, providing motivation, physical assistance and specific exercise and nutritional needs.”

There is more to it

Continuum care is commonly thought of as post-hospitalisation care but it also covers predictive and preventive care. For instance, if somebody needs joint replacement surgery, a lot can be done before getting admitted. “The patient can be educated about their condition, put through muscle strengthening, be coached psychologically, their home can be set up with medical apparatus, and risk factors such as diabetes, BP etc. can be brought under control,” says Dr Mahesh Joshi, CEO, Apollo Home Healthcare Services, Hyderabad.

Setbacks

The fragmented nature of healthcare is the biggest obstacle. Also, the healthcare system is hospital-focused and not health-focused. “Insurance companies, the government and employers need to recognise that adopting the continuum care model will only help them as it will lower costs when health outcomes improve,” says Srivastava. 

Way forward

Firstly, health spending needs a hoick up. Secondly, regulations need to be put in place so that quality of care is maintained. Insurance companies should cover continuum care. “There also needs to be seamless coordination among hospitals, physicians, nurses, paramedics, institutions, and commercial groups. Efforts are needed to educate caregivers,” says Srivastava. Alternative medicines can also be incorporated for best outcomes. Because taking care is priority. 

Role of technology

● It makes available secure electronic health records that are stored in a single place and accessible to patients, industry players and decision-makers
● It aids in providing data through wearable and remote monitoring devices. This helps predict adverse events/outcomes, improve compliances in therapy and medications, and assists patients and their families get timely information.
● Leveraging the Internet of Things and Artificial Intelligence, prediction models can be created to use resources in focused areas. 

Dr Mahesh Joshi

“Hospitals are short-staffed, there are extreme shortages in skilled professionals, medical equipment, technology, and beds. Continuum care acts as a bridge that gives you hospital-like care at home or a special care facility.” 

Rajinish Menon Founder and CEO, Sukino Healthcare Solutions Pvt Ltd, Bengaluru

“Continuum care is commonly thought of as post-hospitalisation care but it also covers predictive and preventive care. A lot can be done before a person gets admitted like educating them, physical and psychological coaching, controlling risk factors etc.” 

Dr Mahesh Joshi CEO, Apollo Home Healthcare Services, Hyderabad

“To offer timely and optimal continuum support, there should be seamless coordination among hospitals, physicians, nurses, paramedics, institutions, and commercial groups. More efforts are needed to educate and train physicians, nurses, and caregivers.”

Vivek Srivastava  Co-founder and CEO, HCAH, Noida