Video · CAIR Platform
Where care breaks down between visits
One care plan, four handoffs after the visit: a referral, a prescription, a follow-up, and a prior authorization. See where each can stall and lead to the ED.
Transcript
- Care depends on what happens between visits. John’s care plan has four parts. Each one happens after he leaves.
- A referral isn’t closed when it’s sent. John has to reach the cardiology practice, get a visit booked, and show up. Any handoff can stall. The pathway only closes when the visit notes reach his primary care doctor.
- Prescribed isn’t the same as understood, or taken. Does John know when to take each one, and which reactions to watch for? If he misses a dose, will anyone know?
- John’s follow-up is due in six weeks. He misses it. The next opening is twelve weeks out. In that gap, John may end up in the ED.
- His treatment needs prior authorization. The payer reviews the documentation. If it’s denied, John’s treatment waits on an appeal. A denial can become another care gap.
- The care plan exists. So where does care break down? Open handoffs lead to the ED. After discharge comes a new care plan, and a higher readmission risk. Each time around, costs rise and John’s health declines.
- See where care gaps happen, and how to close the loop. Visit ensurecare.ai to learn more.
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