Envision

Optimal Care at the End of Life

Goals for Health Care

Coping with illness at the end of life

The healthcare concerns of the group

Comfort, dignity, life closure, caregiver support, planning ahead

 

Major Components of Health Care

At-home services, hospice, and personal care services

Vision for Individuals at the End of Life 

Cost:

Basic cost for health care services, treatments and support services are covered fully. In addition where appropriate lifestyle related interventions, screening and prevention activity are also covered.

 

Coverage:

The coverage is universal and not dependent on the condition, stage of life or ability to pay. Current arrangements through Medicare, the VA or other insurers will continue to provide services. Easy to use tools to most effectively choose health coverage plan. Prevention and early diagnosis is fully covered under his health plan. Additionally lifestyle improvements are also covered. Supplemental insurance may be purchased. Plans may compete of riders for additional services. Employers may also provide additional services

 

Access:

The healthy person selects his provider for prevention utilizing a Primary Care physician, local pharmacy, or certified health club. The person has a primary care doctor who will coordinate their care and provide resources for health lifestyle, screening and preventive activity. There are community resources available for various healthy activities. Public web sites and other media services as well as social organizations promote Optimal Care. Certified health clubs provide more specialized services. Equal access to health care services; equal access to healthy lifestyle choices, health education, and maintenance; opportunities tailored to situation. Administrative needs are minimal.

 

Quality Healthcare:

Patient Centered (No Helplessness or Unjustified Routines): Care is patient centric and is provided with dignity, cultural sensitivity and respect for the person. Information is provided in age and education level appropriate manner. Informed and shared decisions reflecting parents’ values (constrained by legal limits).

 

Safe (No Harm): Care that is provided will be safe from errors. This will be of particular importance regarding immunizations and programs for physical activity. Minimal and known risk from false positive or false negative screenings.

Effective (No Needless Failures): Specific outcomes will be measures and adjustment in the services made. Recommendations from national agencies and groups will be followed.

 

Efficient (No Waste): For brief acute episodes, diagnosis is made and care provided in timely efficient manner. For immunizations particularly for children, a plan is formulated according to an informed dialogue with the person or their legal representatives. Government and professional association guidelines are readily available and are transparent. Regulatory agencies oversee quality of services, and advertising to consumers.

 

Timely (No Needless Delays): Evaluation and treatment for brief acute episode is available promptly. Convenient and responsive scheduling, no waiting for health care services; immediate access to results of tests; immediate access to clinical guidance and other information; timely education and support;

 

Equitable (No Unjustified Variation): Preventive services are provided universally with no bias due to personal characteristics. Regulatory agencies oversee quality of services, and advertising to consumers.

 

Coordination of Care (Social Determinants): 

Care is patient centric and revolves around the patient (person who is frail) and their doctor (clinician). Public health services that have provisions for early identification of community trends. Education regarding risk factors and practical ways to avoid them. For identified problem and secondary prevention, care is coordinated regionally, through medical records, supported by privacy provisions.

 

Innovation (Public Reporting and Transparency:

The goal of innovation is to improve quality of the person thorough achieving and maintaining optimal function. Personalized medicine, identified early susceptibility based on genetics, technological tools to assure compliance with treatments and ability to monitor response to interventions. Utilization of personal medical records that can automatically provide reminders of needed screening, immunizations and monitoring response. A personal record of treatments for acute episodes including medications and side effects that is paper or electronic based. Advance care plans available for those interested. Access to information about treatment options is available in language and level of education of the person. Secure message capability.

 

 

 

 

 

 

 By the Numbers 

End of Life 

 

Population (in United States)

1 million

Cost/Person/Year

$45,000

Total Cost/Year

$50 billion

 

Priority Concerns for this Population

Autonomy, maintaining function, rehabilitation, limiting progression, accommodating environment, caregiver support

Typical Example

 

Mrs. Black, a 68-year-old realtor, found she had metastatic ovarian carcinoma a few months ago and is now fatigued and losing weight. After several unsuccessful treatment regimens, she has accepted hospice services, and friends and hospice staff ensure that she can stay home to the end of her life. The hospice clinicians manage pain and other symptoms aggressively, and she is able to direct the completion of her life to her own satisfaction.

My Optimal Well-being

 Healthy Adults and Health Children