Meeting COPD Challenges with The Care Pathway (Part 3)

  This is the final part of our tripart series on meeting COPD challenges with Virtual Care. To recap, the 1st part covered using education to drive patient adherence in managing COPD. The 2nd part focused on the period right after a patient is discharged, where virtually monitoring the patient is crucial. Part 3 deals with the long-term connectivity and care of the patient.  As COPD is an irreversible chronic disease, the patient is never quite let off the hook. There is a reason why most COPD guidelines have stages to them. If we take the GOLD Guideline for example, a patient advancing to a severe or end of life stage is dangerous. That’s why even when everything seems to be going well, it is good to remain connected with patients. 

Reaching Isolated Patients: Need for Connection and Health Maintenance 

Patient isolation starves COPD patients of human connections, which is needed for achieving greater patient engagement, which in turn leads to better health outcomes. There is another hidden ill associated with patient isolation. It leads to indifference over time and accepting limitations. Such signs are misinterpreted to be positive just because symptoms are controlled. But it ignores the drop in quality of life for the patients as they are rendered increasingly immobile.  

Supporting Patients on the Long Run by Maintaining a Communication Channel 

Healthcare professionals thus have to proactively ask patients how they are doing, and if they are satisfied with their COPD management. Surveys can be sent out that ask them to indicate their level of comfort or agreement. When this is done, patients are able to express themselves and a lot of information comes out that paints a more accurate picture of their current condition. We look at some ways in which care providers and patients can remain in touch via virtual care. 

Empowering Respiratory Therapists 

  There are limited Respiratory Therapists outside the hospital setting. Despite them playing an essential role in the care for COPD patients, three fourths of them are employed by acute care hospitals. To cover for their shortage, one respiratory therapist can be connected to multiple patients at once via a virtual care platform. So despite being stationed in a hospital, the RTs can be involved in greater community outreach by managing multiple patients enrolled in various COPD programs. For RTs working in clinics, they can do the same in community based chronic care programs administered by primary care clinics. By onboarding multiple patients to their group, they can manage multiple cases at once and be more efficient. 

Distant Therapeutic Interventions 

  COPD is a chronic disease that weakens patients over time. In order to reduce their suffering, sometimes out of the box thinking is required. Incorporating mindfulness into their daily practice is one such idea. Physicians testify on the emotional and attitudinal components of COPD care.  Dr. Benzo, Director of the Mayo Clinic Mindful Breathing Laboratory, says that COPD treatment can be subjective to how the patient receives it. This is where mindfulness makes a big difference as patients become more accepting of their condition and are more likely to have a positive outlook and change their behavior. If this leads to smoking cessation, then it’s a big win for them, as continued smoking throughout COPD is a leading cause of COPD progression. Mindfulness group sessions can be delivered as a distance intervention which is a great use of virtual care platforms. Such sessions can be part of care pathways to build a rapport with patients over time. 

Considering All Possible Scenarios when Maintaining Dialogue with a Patient 

  Although there are guidelines in place to treat COPD, Dr. Keller of University of Washington says that patients can deviate from the course. So it’s fine to use one’s discretion to suggest treatment that works best for individual patients. It’s okay to consider different therapies if the patient is not able to use a certain device. Vaccinations and smoking cessation therapies should be considered if it prevents further harm to the patient. The workflows created in the care pathways can be very elaborate. They can include such options if it comes down to other paths not working. In later, more severe stages of COPD, oxygen tank therapy may need to be incorporated as a part of the pathway. 

  Considering people’s co-morbidities is essential for COPD treatment, as it is a better predictor of mortality than just considering frequency of COPD exacerbations. It’s possible to stratify COPD patients by risk in a virtual care platform. A nurse can have a glimpse of all patients in the system and identify which patients are in higher risk of danger.  

If you are interested in learning more about how the Aetonix aTouchAway platform can help with patient management, click here.

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