- Developing and maintaining referral agreements and care plans with primary practices;
- Providing superior access to care (including electronically) when patients need it;
- Tracking patients over time and across clinical encounters to ensure patient care needs are met; and
- Providing patient-centered care that includes the patient, and when appropriate, the family or caregivers, in planning and setting goals.
The motivation behind the PCSP program began when reporting discrepancies were identified between referring physicians and the specialists they refer to. For example, referring doctors claimed that between 25 and 50% of time they were unaware if the patients they refer are actually seen by the specialists. Another discrepancy was the specialist claiming they sent consult reports 80% of the time, but the primary care physicians state they receive this information only 60% of the time.
With the PCSPs intent on improving care coordination and communication between specialists and their primary care physician, managing chronic and acute conditions across continuum of care will be better accomplished. The PCSP program also evaluates medication management, test tracking and follow-up and information flow over care transitions. This recognition program is expected to result in a better patient experience and improved outcomes.
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