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services
Intake
services
Intake services might
include:
-
introduction to and interview with the PHCA (for local clients,
in-person interviews are preferable; on-line or telephone interviews can
be used for long-distance clients)
-
complete medical history by the PHCA
-
critique of client’s health insurance plan
-
develop a list of the client’s overt and potential health
problems, and a set of overall health care goals
-
PHCA
begins coaching client on how to become a more effective patient
-
with specific health care goals in mind, PHCA develops specific
recommendations on how the client can optimize the care he/she is
receiving
-
initiate formal discussions on living wills and organ donor options
-
instructions on accessing ongoing services
-
assistance in obtaining
client’s medical records, to build an ongoing centralized medical record
that can be controlled and accessed (i.e., owned) by the client
Ongoing
services
Ongoing
services might include:
-
develop ongoing relationship between
client and PHCA
-
“coaching” service before key doctor’s appointments (strategy
session prior to doctors visit: decide what medical issues need to be
resolved, what information will be needed in order to make decisions, what
questions to ask the doctor to gain that information)
-
“debriefing” service after key doctor’s appointments
(critique of what transpired during visit to doctor, assessment of
adequacy of the plan developed by the doctor and client, assessment of
whether there is a need for follow-up contact with doctor prior to next
scheduled visit)
-
timely revision of client’s medical problem list and goals
-
continual updating of client’s computerized medical records
-
secure access to computerized medical records by client 24
hours/day
-
with client’s permission, providing doctors with data from
client’s computerized medical records
-
replying by phone or e-mail to any non-emergency health care
questions within 24 hours
Ad
hoc services
Ad
hoc services will be more active and more direct than intake or ongoing
services. Whereas intake and ongoing services take place outside of the
traditional health care setting (i.e., in an office or on-line), and at a
time other than when the client is actively undergoing a health care
episode, ad hoc generally will take place during the health care episode
itself, and may occur on-site if necessary (and if possible).
-
assessment during health care episode (such as hospitalization) of
client’s health care status, needs and appropriateness of care
-
ongoing monitoring of client’s condition/status during health
care episode
-
directly communicating or negotiating on client’s behalf with
physicians, hospitals or insurers, to clarify issues of care (such as
definition of the medical problem(s), defining the diagnostic and
therapeutic options, defining the risks and benefits of various options,
clarifying the physicians recommendations, assessment as to the adequacy
of care).
Next: Where
will PHCAs come from?
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advocacy role
traditionally provided by an individual’s physician.
This goal implies an ongoing relationship between the client and
the PHCA. (Such an ongoing relationship, of course, is also implied by the
“doctor in the family” model on which these services are based.)